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22-04-2023 | Hip-TEP | Original Paper

Dislocation and survival rate of dual mobility cups in revision total hip arthroplasty in patients with high risk of instability

Authors: Juan Ameztoy Gallego, Ana Cruz Pardos, Javier Gomez Luque, Luis Eduardo Cuadrado Rubio, Ricardo Fernández Fernández

Published in: International Orthopaedics | Issue 7/2023

Abstract

Purpose

Instability remains as an unsolved complication after revision total hip arthroplasty (rTHA). Dual mobility (DM) cups have decreased dislocation rate in rTHA; however, there are few clinical studies that evaluate the risk of dislocation after rTHA in patients with high risk of instability.

Methods

Between 2007 and 2019, 95 consecutive rTHA using a DM cup, in 93 patients with instability risk factors were retrospectively reviewed. Instability risk factors were defined as follows: deficient abductor mechanism (22.1%), previous dislocation (68.4%), Paprosky 3 acetabular bone defect (21.1%), neuromuscular disease (4.2%), lumbar spine arthrodesis (6.3%), and more than one previous surgery (33.6%). Mean follow-up was 4.3 ± 2.4 years. Clinical and radiographic parameters were reported. DM cup survival was determined using a Kaplan–Meier analysis with re-revision for any cause as the end-point. Surgical complications and re-dislocation rate was recorded.

Results

Seven DM cups were re-revised; three due to aseptic loosening, three due to peri-prosthetic joint infection (PJI), and one due to instability. At seven years follow-up, the survival rate of the DM cup using re-revision for any reason as the end-point was 82.4% (95% confidence interval, 66.4–98.4%). There were 12 (12.6%) complications: two (2.1%) dislocations, six (6.3%) PJI, four (4.2%) peri-prosthetic fractures.

Conclusion

Our findings suggest DM cups are effective reducing dislocation rate in rTHA in patients with a high risk of instability, without increasing early aseptic loosening and with a low rate of dislocation. Nevertheless, longer follow-up is needed to confirm implant stability and dislocation rates in the long term.

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Title: Dislocation and survival rate of dual mobility cups in revision total hip arthroplasty in patients with high risk of instability
Authors: Juan Ameztoy Gallego
Ana Cruz Pardos
Javier Gomez Luque
Luis Eduardo Cuadrado Rubio
Ricardo Fernández Fernández
Publication date: 22-04-2023
Publisher: Springer Berlin Heidelberg
Keywords: Hip-TEP
Hip-TEP
Published in: International Orthopaedics / Issue 7/2023
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-023-05816-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Dislocation and survival rate of dual mobility cups in revision total hip arthroplasty in patients with high risk of instability

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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