Top

Journal of Orthopaedics and Traumatology

Published in:

Open Access 01-06-2016 | Original Article

The use of a dual mobility cup in the management of recurrent dislocations of hip hemiarthroplasty

Authors: Christian Carulli, Armando Macera, Fabrizio Matassi, Roberto Civinini, Massimo Innocenti

Published in: Journal of Orthopaedics and Traumatology | Issue 2/2016

Abstract

Background

Dislocation is one of the most frequent causes of failure of hemiarthroplasties of the hip, which is the most common treatment for femoral neck fractures in elderly patients. A revision with conversion to total hip arthroplasty is the gold standard in case of failure of closed reduction: however, the use of standard or modular components shows variable outcomes. The use of a dual mobility cup has been evaluated in patients with unstable implants, given the good outcomes obtained in primary and revision surgery. The aim of this study was to assess the results of revisions by dual mobility cups in unstable hemiarthroplasties.

Materials and methods

Thirty-one patients (mean age 75.4 years) were retrospectively evaluated between 2006 and 2010 after conversion to total hip arthroplasty with dual mobility cups for recurrent dislocations. The mean number of dislocations was 2.6 (range 2–5). The evaluation was performed by the American Society of Anesthesiologists physical function score (ASA) and the Harris hip score, and several radiologic criteria.

Results

The mean follow-up was 3.8 years. No recurrence of dislocation was recorded. The ASA score remained unchanged, and the mean Harris hip score improved from 62.2 before dislocation to 76.0 points postoperatively.

Conclusions

Dual mobility cups may be a useful option in the treatment of a hemiarthroplasty dislocation. No risk of a new revision due to instability after insertion of dual mobility cups resulted in our experience, and this option may be strongly considered in cases of revisions of unstable hemiarthroplasties.

Level of evidence IV.

Iorio R, Healy WL, Lemos DW, Appleby D, Lucchesi CA, Saleh KJ (2001) Displaced femoral neck fractures in the elderly: outcomes and cost effectiveness. Clin Orthop Relat Res 383:229–242CrossRefPubMed

Sah AP, Estok DM II (2008) Dislocation rate after conversion from hip hemiarthroplasty to total hip arthroplasty. J Bone Joint Surg Am 90:506–516CrossRefPubMed

Blewitt N, Mortimore S (1992) Outcome of dislocation after hemiarthroplasty for fractured neck of the femur. Injury 23:320–322CrossRefPubMed

Meek RMD, Allan DB, McPhillips G, Kerr L, Howie CR, From the Scottish Arthroplasty Project (2008) Late dislocation after total hip arthroplasty. Clin Med Res 6:17–23CrossRefPubMedPubMedCentral

Holmes JD, House AO (2000) Psychiatric illness predicts poor outcome after surgery for hip fracture: a prospective cohort study. Psycol Med 30:921–929CrossRef

Daly PJ, Morrey BF (2002) Operative correction of an unstable total hip arthroplasty. J Bone Joint Surg Am 74:1334–1343

Berry DJ (2001) Unstable total hip arthroplasty: detailed overview. Instr Course Lect 50:265–274PubMed

Earll MD, Fehring TK, Griffin WL, Mason JB, McCoy T, Odum S (2002) Success rate of modular component exchange for the treatment of an unstable total hip arthroplasty. J Arthroplasty 17:864–869CrossRefPubMed

McGann WA, Welch RB (2001) Treatment of the unstable total hip arthroplasty using modularity, soft tissue, and allograft reconstruction. J Arthroplast 16(Suppl. 1):19–23CrossRef

10.

Toomey SD, Hopper RH Jr, McAuley JP, Engh CA (2001) Modular component exchange for treatment of recurrent dislocation of a total hip replacement in selected patients. J Bone Joint Surg Am 83:1529–1533PubMed

11.

Shapiro GS, Weiland DE, Markel DC, Padgett DE, Sculco TP, Pellicci PM (2003) The use of a constrained acetabular component for recurrent dislocation. J Arthroplast 18:250–258CrossRef

12.

Yun AG, Padgett D, Pellicci P, Dorr LD (2005) Constrained acetabular liners: mechanisms of failure. J Arthroplasty 20:536–541CrossRefPubMed

13.

Ekelund A (2003) Trochanteric osteotomy for recurrent dislocation of total hip arthroplasty. J Arthroplasty 8:629–632CrossRef

14.

Hughes AW, Clark D, Carlino W, Gosling O, Spencer RF (2015) Capsule repair may reduce dislocation following hip hemiarthroplasty through a direct lateral approach: a cadaver study. Bone Joint J 97-B:141–144CrossRefPubMed

15.

Weber M, Berry DJ (1997) Abductor avulsion after primary total hip arthroplasty: results of repair. J Arthroplast 12:202–206CrossRef

16.

Ali Khan MA, Brakenbury PH, Reynolds I (1981) Dislocation following total hip replacement. J Bone Joint Surg Br 63:214–218PubMed

17.

Lind M, Krarup N, Petersen LG, Mikkelsen S, Horlyck E (2002) Acetabular revision for recurrent dislocations: results in 14 cases after 3 years of follow-up. Acta Orthop Scand 73:291–294CrossRefPubMed

18.

Morrey BF (2004) Results of reoperation for hip dislocation: the big picture. Clin Orthop Relat Res 429:94–101CrossRefPubMed

19.

Robbins GM, Masri BA, Garbuz DS, Greidanus N, Duncan CP (2001) Treatment of hip instability. Orthop Clin North Am 32:593–610CrossRefPubMed

20.

Figved W, Dybvik E, Frihagen F, Furnes O, Madsen JE, Havelin LI, Nordsletten L (2007) Conversion from failed hemiarthroplasty to total hip arthroplasty: a Norwegian Arthroplasty Register analysis of 595 hips with previous femoral neck fractures. Acta Orthopaedica 78:711–718CrossRefPubMed

21.

Llinas A, Sarmiento A, Ebramzadeh E, Gogan WJ, McKellop HA (1991) Total hip replacement after failed hemiarthroplasty or mould arthroplasty. Comparison of results with those of primary replacements. J Bone Joint Surg Br 73:902–907PubMed

22.

Diwanji SR, Kim SK, Seon JK, Park SJ, Yoon TR (2008) Clinical results of conversion total hip arthroplasty after failed bipolar hemiarthroplasty. J Arthroplast 23:1009–1015CrossRef

23.

Guyen O, Chen QS, Bejui-Hugues J, Berry DJ, An KN (2007) Unconstrained tripolar hip implants: effect on hip stability. Clin Orthop Relat Res 455:202–208CrossRefPubMed

24.

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 33:927–932CrossRefPubMedPubMedCentral

25.

Bouchet R, Mercier N, Saragaglia D (2011) Posterior approach and dislocation rate: a 213 total hip replacements case-control study comparing the dual mobility cup with a conventional 28-mm metal head/polyethylene prosthesis. Orthop Traumatol Surg Res 97:2–7CrossRefPubMed

26.

Vielpeau C, Lebel B, Ardouin L, Burdin G, Lautridou C (2011) The dual mobility socket concept: experience with 668 cases. Int Orthop 35:225–230CrossRefPubMedPubMedCentral

27.

Mohammed R, Hayward K, Mulay S, Bindi F, Wallace M (2015) Outcomes of dual-mobility acetabular cup for instability in primary and revision total hip arthroplasty. J Orthop Traumatol 16:9–13CrossRefPubMedPubMedCentral

28.

Langlais FL, Ropars M, Gaucher F, Musset T, Chaix O (2008) Dual mobility cemented cups have low dislocation rates in THA revisions. Clin Orthop Relat Res 466:389–395CrossRefPubMedPubMedCentral

29.

Grazioli A, Ek ET, Rudiger HA (2012) Biomechanical concept and clinical outcome of dual mobility cups. Int Orthop 36:2411–2418CrossRefPubMedPubMedCentral

30.

Hailer NP, Weiss RJ, Stark A, Karrholm J (2012) Dual-mobility cups for revision due to instability are associated with a low rate of re-revisions due to dislocation. Acta Orthop 83:566–571CrossRefPubMedPubMedCentral

31.

Civinini R, Carulli C, Matassi F, Nistri L, Innocenti M (2012) A dual mobility cup is effective for reducing dislocations in isolated acetabular revisions. Clin Orthop Relat Res 470:3542–3548CrossRefPubMedPubMedCentral

32.

Tarasevicius S, Robertsson O, Dobozinskas P, Wingstrand H (2013) A comparison of outcomes and dislocation rates using dual articulation cups and THA for intracapsular femoral neck fractures. Hip Int 23:22–26CrossRefPubMed

33.

Dripps RD, Lamont A, Eckenhoff JE (1961) The role of anesthesia in surgical mortality. JAMA 178:261–266CrossRefPubMed

34.

Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51:737–755PubMed

35.

Loudon JR, Charnley J (1980) Subsidence of the femoral prosthesis in total hip replacement in relation to the design of the stem. J Bone Joint Surg Br 62:450–453PubMed

36.

Engh CA, Massin P, Suthers KE (1990) Roentgenographic assessment of the biologic fixation of porous-surfaced femoral components. Clin Orthop Relat Res 257:107–128PubMed

37.

DeLee JG, Charnley J (1976) Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop Relat Res 121:20–32PubMed

38.

Gruen TA, McNeice GM, Amstutz HC (1979) Modes of failure of cemented stem-type femoral components: a radiographic analysis of loosening. Clin Orthop Relat Res 141:17–27PubMed

39.

Brooker AF, Bowerman JW, Robinson RA, Riley LH Jr (1973) Ectopic ossification following total hip replacement: incidence and a method of classification. J Bone Joint Surg Am 55:1629–1632PubMed

40.

Liu X, Zhang X, Chen Y, Wang Q, Jiang Y, Zeng B (2011) Hidden blood loss in hip arthroplasty. J Arthroplast 26:1100–1105CrossRef

41.

Lachiewicz PF, Heckman DS, Soileau ES, Mangla J, Martell JM (2009) Femoral head size and wear of highly cross-linked polyethylene at 5 to 8 years. Clin Orthop Relat Res 467:3290–3296CrossRefPubMedPubMedCentral

42.

Tarasevicius S, Kesteris U, Robertsson O, Wingstrand H (2006) Femoral head diameter affects the revision rate in total hip arthroplasty: an analysis of 1720 hip replacements with 9–21 years of follow-up. Acta Orthop 77:706–709CrossRefPubMed

43.

Chatrath V, Beaulé PE (2013) The changing paradigm of revision of total hip replacement in the presence of osteolysis. Instr Course Lect 62:215–227PubMed

44.

Paprosky WG, Perona PG, Lawrence JM (1994) Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplast 9:33–44CrossRef

45.

Cross MB (2015) Dual mobility acetabular components for revision THA. J Orthop Traumatol 16:21–22CrossRefPubMedPubMedCentral

46.

Adam P, Philippe R, Ehlinger M, Roche O, Bonnomet F, Molé D, Fessy MH (2012) Dual mobility cups hip arthroplasty as a treatment for displaced fracture of the femoral neck in the elderly. A prospective, systematic, multicenter study with specific focus on postoperative dislocation. Orthop Traumatol Surg Res 98:296–300CrossRefPubMed

47.

Masonis JL, Bourne RB (2002) Surgical approach, abductor function, and total hip arthroplasty dislocation. Clin Orthop Relat Res 405:46–53CrossRefPubMed

48.

Demos HA, Rorabeck CH, Bourne RB, MacDonald SJ, McCalden RW (2001) Instability in primary total hip arthroplasty with the direct lateral approach. Clin Orthop Relat Res 393:168–180CrossRefPubMed

49.

Lecuire F, Bernareau I, Rubini J, Basso M (2004) Intra-prosthetic dislocation of Bousquet dual mobility socket. Rev Chir Orthop Reparatrice App Mot 90:249–255CrossRef

50.

Banzhof JA, Robbins CE, van der Ven A, Talmo CT, Bono JV (2012) Femoral head dislodgement complicating use of a dual mobility prosthesis for recurrent instability. J Arthroplast 28:543.e1–543.e3CrossRef

51.

Philippot R, Boyer B, Farizon F (2013) Intraprosthetic dislocation: a specific complication of the dual-mobility system. Clin Orthop Relat Res 471:965–970CrossRefPubMedPubMedCentral

Title: The use of a dual mobility cup in the management of recurrent dislocations of hip hemiarthroplasty
Authors: Christian Carulli
Armando Macera
Fabrizio Matassi
Roberto Civinini
Massimo Innocenti
Publication date: 01-06-2016
Publisher: Springer International Publishing
Published in: Journal of Orthopaedics and Traumatology / Issue 2/2016
Print ISSN: 1590-9921
Electronic ISSN: 1590-9999
DOI: https://doi.org/10.1007/s10195-015-0365-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The use of a dual mobility cup in the management of recurrent dislocations of hip hemiarthroplasty

Abstract

Background

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 2/2016

Isolated reconstruction of the medial patellofemoral ligament with autologous quadriceps tendon

Blood metal ions after hybrid metal-on-polyethylene Exeter−Trident total hip replacement

Are work return and leaves of absence predictable after an unstable pelvic ring injury?

Deep peroneal nerve palsy with isolated lateral compartment syndrome secondary to peroneus longus tear: a report of two cases and a review of the literature

Cross-cultural adaptation and validation of the International Knee Documentation Committee Subjective Knee Form in Greek

Outcomes of intramedullary nailing for acute proximal humerus fractures: a systematic review