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A comparative study about the incidence of dislocation and peri-prosthetic fracture between dual mobility versus standard cups after primary total hip arthroplasty

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Abstract

Purpose

Dislocation and peri-prosthetic fracture (PPF) are major reasons for revision THA (total hip arthroplasty). The main advantage of dual mobility (DM) cups is to minimize the incidence of dislocation compared to single mobility (SM) cups. We hypothesized that the use of DM would lead to an increased risk of PPF because of its greater stability. In contrast, standard cups would be at higher risk of dislocation.

Methods

A retrospective comparative study was performed in our institution including 126 revision THAs between January 2013 and December 2017. Collected data included gender, age, BMI, Parker score, ASA score, the etiology for primary THA, type of cup (SM or DM), cortical index, Noble index, and the stem fixation.

Results

Overall, 53 standard and 73 DM cups were included for study. In the dislocation group, 29 had standard cups (83%) and 6 had DM cups (17%). Dislocation was 12-fold higher in SM cups (p < 0.001). In the PPF group, 24 had standard cups (26%) and 67 had DM cups (74%). PFF was 12-fold higher for DM cups (p < 0.001). A higher Parker score and a higher cortical index had a protective effect on the risk of PPF (OR = 0.76 (p = 0.03), OR = 0.57 (p = 0.048)).

Conclusion

The use of DM increased hip stability but led to a higher rate of PPF by load transfer on the femur. Further studies with larger cohort and follow-up are needed to confirm these findings and measure the incidence of these complications.

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Authors and Affiliations

  1. Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Service de Chirurgie Orthopédique et Traumatologique, 165 Chemin du Grand Revoyet, 69495, Pierre Benite Cedex, France

    Elliot Sappey-Marinier, Anthony Viste, Romain Desmarchelier & Michel-Henri Fessy

  2. Equipe biostatistique Santé – LBBE, Université Lyon 1, 162, av. Lacassagne, 69003, Lyon, France

    Anthony Viste, Yoann Blangero & Michel-Henri Fessy

  3. IFSTTAR, UMRT_ 9406, Laboratoire de Biomécanique et Mécanique des Chocs, 25 avenue Mitterrand, 69500, Bron, France

    Anthony Viste & Michel-Henri Fessy

  4. Université Claude Bernard Lyon 1, 69100, Villeurbanne, France

    Anthony Viste & Michel-Henri Fessy

Authors
  1. Elliot Sappey-Marinier
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  2. Anthony Viste
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  3. Yoann Blangero
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  4. Romain Desmarchelier
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  5. Michel-Henri Fessy
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Correspondence to Anthony Viste.

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M-H. Fessy received royalties from Serf and Depuy. The other authors declare that they have no conflict of interest.

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Level of evidence: Retrospective case study, Level IV.

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Sappey-Marinier, E., Viste, A., Blangero, Y. et al. A comparative study about the incidence of dislocation and peri-prosthetic fracture between dual mobility versus standard cups after primary total hip arthroplasty. International Orthopaedics (SICOT) 43, 2691–2695 (2019). https://doi.org/10.1007/s00264-018-4279-y

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