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Dual-mobility implants prevent hip dislocation following hip revision in obese patients

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Abstract

Purpose

Revision total hip arthroplasty (THA) is associated with increased rates of dislocation in obese patients. It is not known whether dual-mobility implants decrease dislocation in these patients with obesity.

Methods

We retrospectively reviewed two groups of revision THAs to compare the dislocation rate between 32 obese patients (BMI >30 kg/m2) with standard cups, and 35 obese patients (BMI >30 kg/m2) with dual-mobility cups. All patients received the same implants except for diameter head (32-mm head with standard cups and 28-mm head with dual mobility) and had the same cemented stem that was not changed at revision. The patients were followed at routine intervals and were specifically queried about dislocation. The two groups were similar in terms of age, gender, causes of revision and follow-up since the primary arthroplasty.

Results

With standard liners, more hips in obese patients dislocated than did hips in obese patients who received dual-mobility implants. The number of dislocations in standard hips was at one year follow-up 15.6 % (5 of 32) compared with 0 % in dual-mobility hips and was at five year follow-up 21.8 % (7 of 32) compared with 2.8 % (1 of 35). After a mean follow-up of seven years no cases of loosening were found. Five patients in the obese group with a standard liner underwent re-revision surgery, the additional re-operations being necessary to treat recurrent postoperative dislocation.

Conclusions

Obese patients should be counselled about the important risk of dislocation that occurs with standard liners after revision THA. Dual-mobility liners in these patients with hip revision is an efficient technique to prevent post-operative hip dislocation.

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References

  1. Caton JH, Prudhon JL, Ferreira A, Aslanian T, Verdier R (2014) A comparative and retrospective study of three hundred and twenty primary Charnley type hip replacements with a minimum follow up of ten years to assess whether a dual mobility cup has a decreased dislocation risk. Int Orthop 38(6):1125–1129

    Article  PubMed  PubMed Central  Google Scholar 

  2. Chee YH, Teoh KH, Sabnis BM, Ballantyne JA, Brenkel IJ (2010) Total hip replacement in morbidly obese patients with osteoarthritis: results of a prospectively matched study. J Bone Joint Surg (Br) 92:1066–1071

    Article  CAS  Google Scholar 

  3. Combes A, Migaud H, Girard J, Duhamel A, Fessy MH (2013) Low rate of dislocation of dual-mobility cups in primary total hip arthroplasty. Clin Orthop Relat Res 471:3891–3900

    Article  PubMed  PubMed Central  Google Scholar 

  4. Donovan J, Dingwall I, McChesney S (2006) Weight change 1 year following total knee or hip arthroplasty. ANZ J Surg 76:222–225

    Article  PubMed  Google Scholar 

  5. Elkins J, Daniel M, Pedersen D, Singh B, Yack H, Callaghan J, Brown T (2013) Morbid obesity may increase dislocation in total hip patients: a biomechanical analysis. Clin Orthop Relat Res 471:971–980

    Article  PubMed  Google Scholar 

  6. Elkins JM, Stroud NJ, Rudert MJ, Tochigi Y, Pedersen DR, Ellis BJ, Callaghan JJ, Weiss JA, Brown TD (2011) The capsule’s contribution to total hip construct stability: a finite element analysis. J Orthop Res 29:1642–1648

    Article  PubMed  PubMed Central  Google Scholar 

  7. Hamadouche M, Arnould H, Bouxin B (2012) Is a cementless dual mobility socket in primary THA a reasonable option? Clin Orthop Relat Res 470:3048–3053

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hayashi S, Nishiyama T, Fujishiro T, Hashimoto S, Kanzaki N, Nishida K, Kurosaka M (2012) Obese patients may have more soft tissue impingement following primary total hip arthroplasty. Int Orthop 36:2419–2423

    Article  PubMed  PubMed Central  Google Scholar 

  9. Hernigou P, Filippini P, Flouzat-Lachaniette CH, Batista SU, Poignard A (2010) Constrained liner in neurologic or cognitively impaired patients undergoing primary THA. Clin Orthop Relat Res 468(12):3255–3262

    Article  PubMed  PubMed Central  Google Scholar 

  10. Hernigou P, Roussignol X, Delambre J, Poignard A, Flouzat-Lachaniette CH (2015) Ceramic-on-ceramic THA associated with fewer dislocations and less muscle degeneration by preserving muscle progenitors. Clin Orthop Relat Res 473(12):3762–3769

    Article  PubMed  PubMed Central  Google Scholar 

  11. Hernigou P, Trousselier M, Roubineau F, Bouthors C, Flouzat Lachaniette CH (2016) Dual-mobility or constrained liners are more effective than preoperative bariatric surgery in prevention of THA dislocation. Clin Orthop Relat Res 474(10):2202–2210

    Article  PubMed  Google Scholar 

  12. Kim Y, Morshed S, Joseph T, Bozic K, Ries MD (2006) Clinical impact of obesity on stability following revision total hip arthroplasty. Clin Orthop Relat Res 453:142–146

    Article  PubMed  Google Scholar 

  13. Lissner L, Bjorkelund C, Heitmann BL, Seidell JC, Bentsson C (2001) Larger hip circumference independently predicts health and longevity in a Swedish female cohort. Obes Res 9:644–646

    Article  CAS  PubMed  Google Scholar 

  14. Lubbeke A, Moons KG, Garavaglia G, Hoffmeyer P (2008) Outcomes of obese and nonobese patients undergoing revision total hip arthroplasty. Arthritis Rheum 59:738–745

    Article  PubMed  Google Scholar 

  15. Lubbeke A, Stern R, Garavaglia G, Zurcher L, Hoffmeyer P (2007) Differences in outcomes of obese women and men undergoing primary total hip arthroplasty. Arthritis Rheum 57:327–334

    Article  PubMed  Google Scholar 

  16. Maisongrosse P, Lepage B, Cavaignac E, Pailhe R, Reina N, Chiron P, Laffosse JM (2015) Obesity is no longer a risk factor for dislocation after total hip arthroplasty with a double-mobility cup. Int Orthop 39(7):1251–1258

    Article  PubMed  Google Scholar 

  17. McClung CD, Zahiri CA, Higa JK, Amstutz HC, Schmalzried TP (2000) Relationship between body mass index and activity in hip or knee arthroplasty patients. J Orthop Res 18:35–39

    Article  CAS  PubMed  Google Scholar 

  18. Merle dAubigné R, Postel M (1954) Functional results of hip arthroplasty with acrylic prothesis. J Bone Joint Surg Am 36:451–475

    Article  Google Scholar 

  19. Middleton F, Boardman D (2007) Total hip arthroplasty does not aid weight loss. Ann R Coll Surg Engl 89:288–291

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Nadzadi ME, Pedersen DR, Yack HJ, Callaghan JJ, Brown TD (2003) Kinematics, kinetics, and finite element analysis of common place maneuvers at risk for total hip dislocation. J Biomech 36:577–591

    Article  PubMed  Google Scholar 

  21. Paans N, Stevens M, Wagenmakers R, van Beveren J, van der Meer K, Bulstra S, van den Akker-Scheek I (2012) Changes in bodyweight after total hip arthroplasty: short-term and long-term effects. Phys Ther 92:680–687

    Article  PubMed  Google Scholar 

  22. Parvizi J, Trousdale RT, Sarr MG (2000) Total joint arthroplasty in patients surgically treated for morbid obesity. J Arthroplasty 15(8):1003–1008

    Article  CAS  PubMed  Google Scholar 

  23. Philippot R, Camilleri JP, Boyer B, Adam P, Farizon F (2009) The use of a dual-articulation acetabular cup system to prevent dislocation after primary total hip arthroplasty: analysis of 384 cases at a mean follow-up of 15 years. Int Orthop 33:927–932

    Article  PubMed  Google Scholar 

  24. Prudhon JL, Desmarchelier R, Hamadouche M, Delaunay C, Verdier R, SOFCOT (2015) Causes for revision of dual-mobility and standard primary total hip arthroplasty: matched case–control study based on a prospective multicenter study of two thousand and forty four implants. Int Orthop. doi:10.1007/s00264-015-3064-4

    PubMed  Google Scholar 

  25. Prudhon JL, Steffann F, Ferreira A, Verdier R, Aslanian T, Caton J (2014) Cementless dual-mobility cup in total hip arthroplasty revision. Int Orthop 38(12):2463–2468. doi:10.1007/s00264-014-2448-1

    Article  PubMed  Google Scholar 

  26. Sadr Azodi O, Adami J, Lindstrom D, Eriksson K, Wladis A, Bellocco R (2008) High body mass index is associated with increased risk of implant dislocation following primary total hip replacement: 2,106 patients followed for up to 8 years. Acta Orthop 79:141–147

    Article  PubMed  Google Scholar 

  27. Widmer KH (2004) A simplified method to determine acetabular cup anteversion from plain radiographs. J Arthroplasty 19:387–390

    Article  PubMed  Google Scholar 

  28. Zhu S, Heo M, Plankey M, Faith MS, Allison DB (2003) Associations of body mass index and anthropometric indicators of fat mass and fat free mass with all-cause mortality among women in the first and second national health and nutrition examination surveys follow-up studies. Ann Epidemiol 13:286–293

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University Paris East (UPEC), Hôpital Henri Mondor, 94010, Creteil, France

    Philippe Hernigou, Damien Potage, François Roubineau, Charles Henri Flouzat Lachaniette & Arnaud Dubory

  2. Department of Orthopedic Surgery, University Paris West, Hôpital Antoine-Béclère, 92140, Clamart, France

    Jean Charles Auregan

Authors
  1. Philippe Hernigou
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  2. Jean Charles Auregan
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  3. Damien Potage
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  4. François Roubineau
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  5. Charles Henri Flouzat Lachaniette
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  6. Arnaud Dubory
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Correspondence to Philippe Hernigou.

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The authors declare that they have no conflict of interest.

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There is no funding source.

Ethical approval

All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Hernigou, P., Auregan, J.C., Potage, D. et al. Dual-mobility implants prevent hip dislocation following hip revision in obese patients. International Orthopaedics (SICOT) 41, 469–473 (2017). https://doi.org/10.1007/s00264-016-3316-y

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  • DOI: https://doi.org/10.1007/s00264-016-3316-y

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