Cementless dual-mobility cup in total hip arthroplasty revision.

Abstract

PURPOSE:

Dislocation is a frequent complication in total hip arthroplasty (THA) revision. Cup fixation is the second concern. In order to know outcomes at two years, we prospectively followed a continuous series of 78 patients to demonstrate that cementless dual-mobility cup (DMC) used in revision THA is safe as regards dislocation risk and bone fixation.

METHOD:

We enrolled 78 consecutive patients (79 cases) in a prospective study. Mean interval between index surgery and revision was 12.9 years. Mean age at revision was 75.5 years. Two types of cementless DMC were used: a standard DMC in 68 cases with low-grade bone defect (Paprosky grade 1 and 2), and a specific design reconstruction DMC in 11 cases with severe bone loss (Paprosky grade 3).

RESULTS:

At two years of follow-up, 68 patients were reviewed; four were lost to follow-up., and six patients were deceased. We identified three types of situations at risk:standard risk (33 cases), Paprosky grade 1 or 2; medium risk (37 cases), revision for recurrent instability (21), periprosthetic fractures (14) or severe loosening Paprosky grade 3 without femorotomy (2); high risk (nine cases), revision for severe loosening with a femorotomy. One (1.3%) patient dislocated her hip at one month without recurrence. Revision rate for dislocation was 0%; two (2.7%) early mechanical failures occurred.

CONCLUSION:

Considering outcomes of this series, cementless DMC can be suggested in THA revision surgery.

• Authors: Jean Louis Prudhon, François Steffann, André Ferreira, Régis Verdier, Thierry Aslanian, Jacques Caton
• Journal: International orthopaedics (Int Orthop) Vol. 38 Issue 12 Pg. 2463-8 (Dec 2014) ISSN: 1432-5195 [Electronic] Germany
• PMID: 25078366 (Publication Type: Journal Article)

Chemical References

• Bone Cements

Topics

• Adult
• Aged
• Aged, 80 and over
• Arthroplasty, Replacement, Hip (adverse effects, methods)
• Bone Cements
• Cementation (methods)
• Female
• Follow-Up Studies
• Hip Dislocation (surgery)
• Hip Prosthesis
• Humans
• Male
• Middle Aged
• Periprosthetic Fractures
• Prospective Studies
• Prosthesis Design
• Prosthesis Failure
• Reoperation (methods)
• Retrospective Studies