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Obesity is no longer a risk factor for dislocation after total hip arthroplasty with a double-mobility cup

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Abstract

Purpose

Dislocation is one of the most feared complications after total hip arthroplasty (THA). This risk is greater in obese patients compared with the general population.

Methods

We performed a retrospective cohort study in which the main objective was to compare the dislocation rate between obese patients (BMI > 30 kg/m²) (exposed group) and non-obese patients (BMI ≤ 30 kg/m²) (unexposed group) after primary THA with a double-mobility acetabular cup. The patients had a minimum follow-up of 24 months.

Results

The ‘obese’ group consisted of 77 THA cases and the ‘non-obese’ group of 425 cases; the two groups were similar in terms of age, gender and ASA score. After a mean follow-up of 58.3 ± 27 months (range 27–159), 43 patients had been lost to follow-up and 56 had died; the two groups had similar mean values. One patient in the ‘obese’ group had suffered a dislocation due to a fall 16 months after the THA. One patient in the ‘non-obese’ group had suffered a dislocation after a periprosthetic femur fracture with stem subsidence two months after the THA procedure. Both patients underwent surgical revision where the double-mobility cup was preserved; there were no further dislocation events as of the last follow-up. The dislocation rate in the two groups was similar (1.3 % versus 0.23 %, p > 0.05). No cases of loosening were found. Revisions were secondary to deep or superficial infection (n = 22), periprosthetic femur fracture (n = 10) or haematoma (n = 3).

Conclusion

These findings imply that double-mobility cups are a reliable way of reducing the risk of dislocation in obese patients after primary THA.

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Acknowledgments

The authors are grateful to Joanne Archambault, PhD for her editorial support during preparation of this manuscript.

Conflict of interest

P. Chiron is a consultant for Zimmer, Smith & Nephew and Sanofi, and has received royalties from Zimmer and Integra. Jean Michel Laffosse is a consultant for Tornier and Stryker.

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Correspondence to Jean-Michel Laffosse.

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Maisongrosse, P., Lepage, B., Cavaignac, E. et al. Obesity is no longer a risk factor for dislocation after total hip arthroplasty with a double-mobility cup. International Orthopaedics (SICOT) 39, 1251–1258 (2015). https://doi.org/10.1007/s00264-014-2612-7

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