The Use of a Cemented Dual Mobility Socket to Treat Recurrent Dislocation
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The treatment of recurrent dislocation after total hip arthroplasty remains challenging. Dual mobility sockets have been associated with a low rate of dislocation but it is not known whether they are useful for treating recurrent dislocation.
We therefore asked whether a cemented dual mobility socket would (1) restore hip stability following recurrent dislocation; (2) provide a pain-free and mobile hip; and (3) show durable radiographic fixation.
We retrospectively reviewed 51 patients treated with a cemented dual mobility socket for recurrent dislocation after total hip arthroplasty between August 2002 and June 2005. The mean age at the time of the index procedure of was 71.3 years. Of the 51 patients, 47 have had complete clinical and radiographic evaluation data at a mean followup of 51.4 months (range, 25–76.3 months).
The cemented dual mobility socket restored complete stability of the hip in 45 of the 47 patients (96%). The mean Merle d’Aubigné hip score was 16 ± 2 at the latest followup. Radiographic analysis revealed no or radiolucent lines less than 1 mm thick located in a single acetabular zone in 43 of 47 hips (91.5%). The cumulative survival rate of the acetabular component at 72 months using revision for dislocation and/or mechanical failure as the end point was 96% ± 4% (95% confidence interval, 90%–100%).
A cemented dual mobility socket was able to restore hip stability in 96% of recurrent dislocating hips. However, longer-term followup is needed to ensure that dislocation and loosening rates will not increase.
Level of Evidence
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
KeywordsFemoral Head Acetabular Component Radiolucent Line Cumulative Survival Rate Recurrent Dislocation
We dedicate this paper to the memory of Frantz Langlais, MD. We thank O. Chaix, MD, and Jean Pierre Courpied, MD, for contributing patients and Nicolas Barba, MD, for help in gathering data.
- 7.Bousquet G, Gazielly DF, Giradin P, Debiesse JL, Relave M, Israeli A. The ceramic coated cementless total hip arthroplasty. Basic concepts and surgical technique. J Orthop Surg Tech. 1985;1:15–28.Google Scholar
- 12.De Lee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res. 1976;121:20–32.Google Scholar
- 22.Guyen O, Pibarot V, Vaz G, Chevillotte C, Carret JP, Bejui-Hugues J. Unconstrained tripolar implants for primary total hip arthroplasty in patients at risk for dislocation. J Arthroplast. 2007;22:849–58.Google Scholar
- 31.Lecuire F, Benareau I, Rubini J, Basso M. [Intra-prosthetic dislocation of the Bousquet dual mobility socket] [in French].Rev Chir Orthop Reparatrice Appar Mot. 2004;90:249–255.Google Scholar
- 35.Merle d’aubigné R. Numerical classification of the function of the hip [in French]. Rev Chir Orthop Reparatrice Appar Mot. 1970;56:481–486.Google Scholar
- 38.Philippot R, Adam P, Reckhaus M, Delangle F, Verdot FX, Curvale G, Farizon F. Prevention of dislocation in total hip revision surgery using a dual mobility design [in French]. Rev Chir Orthop Reparatrice Appar Mot. 2009;95:407–413.Google Scholar
- 41.Ritter MA. The cemented acetabular component of a total hip replacement. All polyethylene versus metal backing. Clin Orthop Relat Res. 1995;311:69–75.Google Scholar
- 42.Sanchez-Sotelo J, Berry DJ. Epidemiology of instability after total hip replacement. Orthop Clin North Am. 2001;32:543–552, vii.Google Scholar