Current Topics Concerning Joint Preservation and Minimally Invasive Surgery of the Hip

HSS Journal ®

, Volume 8, Issue 3, pp 251-256

Open Access This content is freely available online to anyone, anywhere at any time.

Recurrence of Dislocation Following Total Hip Arthroplasty Revision Using Dual Mobility Cups Was Rare in 180 Hips Followed Over 7 Years

  • Patrice MertlAffiliated withOrthopaedics Department, University of Amiens
  • , Antoine CombesAffiliated withRoger Salengro Hospital, Centre Hospitalier Régional Universitaire de LilleOrthopaedics Department, University of Lille
  • , Frédérique Leiber-WackenheimAffiliated withOrthopaedics Department, University of Amiens
  • , Michel Henri FessyAffiliated withDepartment of Orthopaedics, Traumatology and Sports Medicine, Centre Hospitalier Lyon Sud, chemin du Grand-Revoyet
  • , Julien GirardAffiliated withRoger Salengro Hospital, Centre Hospitalier Régional Universitaire de LilleOrthopaedics Department, University of Lille
  • , Henri MigaudAffiliated withRoger Salengro Hospital, Centre Hospitalier Régional Universitaire de LilleOrthopaedics Department, University of Lille Email author 

Abstract

Background

Dual mobility (DM) cups of mobile polyethylene were introduced to prevent total hip arthroplasty (THA) dislocation, but no large series with this design to treat recurrent instability have been reported.

Purpose

Our retrospective investigation ascertained the efficiency of DM cups in correction of recurrent dislocation and assessed any adverse effects.

Methods

One hundred eighty THAs with recurrent instability were revised to DM cups in 180 patients (mean age, 67.4 ± 11.7 years; range, 19 to 92 years). Thirty-one patients (17.2%) underwent at least one earlier THA revision, and 15 (10.3%) incurred non-union of the greater trochanter. Of the initial group in 2009, 145 patients had completed evaluations which included assessment of the Harris Hip Score and a radiographic assessment at a mean follow-up of 7.7 ± 2.2 years (range, 4 to 14 years). The rate of survival was calculated considering any reason for revision as failure.

Results

At follow-up, Harris hip score was 83.9 ± 16.1 (range, 21 to 100). Dislocation of the large articulation occurred in seven hips (4.8%), and only two recurred (1.4%) (one requiring additional revision). In addition, two intra-prosthetic dislocations of the small articulation (1.4%) were observed and needed revision surgery. The large number of earlier surgeries and non-union of the greater trochanter were related to recurrent instability. Two cups (1.4%) showed signs of definite loosening; six (4.1%) presented signs of possible loosening. Twenty-nine hips manifested femoral or acetabular osteolysis (20%), but only three were severe. Eight-year survival rate considering revision for any reason was 92.6% (95% CI, 85.5–96.4%).

Conclusions

This series indicates that DM cups are a viable option to treat recurrent THA instability. Their design provides a low risk of recurrent instability without increasing mechanical complications.

Keywords

hip arthroplasty instability dual mobility revision bearing wear polyethylene