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Cementless dual-mobility cup in total hip arthroplasty revision

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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.

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Authors and Affiliations

  1. Clinique des Cèdres, 21 rue Albert Londres, 38432, Echirolles, France

    Jean Louis Prudhon & François Steffann

  2. Clinique du Parc-Lyon, 155 Ter Boulevard de Stalingrad, 69006, Lyon, France

    André Ferreira

  3. Groupe lépine, Genay, 175 rue Jacquard, 50307-69727, Genay, Cedex, France

    Régis Verdier & Thierry Aslanian

  4. Clinique Emilie de Vialar, 116 rue Antoine Charial, 69003, Lyon, France

    Jacques Caton

Authors
  1. Jean Louis Prudhon
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  2. François Steffann
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  3. André Ferreira
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  4. Régis Verdier
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  5. Thierry Aslanian
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  6. Jacques Caton
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Correspondence to Jean Louis Prudhon.

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Prudhon, J.L., Steffann, F., Ferreira, A. et al. Cementless dual-mobility cup in total hip arthroplasty revision. International Orthopaedics (SICOT) 38, 2463–2468 (2014). https://doi.org/10.1007/s00264-014-2448-1

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  • DOI: https://doi.org/10.1007/s00264-014-2448-1

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