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International Orthopaedics
Published in: International Orthopaedics 3/2017

01-03-2017 | Original Paper

Low friction arthroplasty and dual mobility cup: a new gold standard

Authors: Jean Louis Prudhon, Régis Verdier, Jacques H. Caton

Published in: International Orthopaedics | Issue 3/2017

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Abstract

Introduction

Low friction arthroplasty (LFA) introduced by Sir John Charnley was the gold standard for many years. Dislocation and infection are the first causes for early revision. Late failures are polyethylene (PE) wear and loosening. Due to dislocation risk we slowly switched to the use of LFA with dual mobility cups (DMC). The purposes of this study are (1) to assess whether our changes have improved outcomes and (2) what is the new gold standard?

Material and methods

We selected from an observational registry of 1,091 cases of hybrid Charnley total hip arthroplasty (THA). The acetabular component was either DMC in 455 cases or fixed cup (FC) in 636 cases.

Results

Three dislocations (0.6%) occurred in the DMC group (none revised). In the FC group 54 dislocated (8.49%) and 20 were recurrent and underwent revision (revision rate 3.14%). In the DMC group, five acetabular and three femoral revisions were performed (revision rate for loosening 1.7%). In the FC group 19 cases underwent acetabular revision, and five cases had femoral component revised (revision rate for loosening 3.7%).

Discussion

Charnley’s LFA has proven over 50 years of excellent survivorship. To decrease dislocation risk, one suggested increasing femoral head diameter. Gilles Bousquet proposed another way, namely, the DMC concept. Dislocation is no longer a critical issue with DMC as demonstrated in our series and main series. DMC in primary THA is still a subject of debate. Mid-term results do not demonstrate a higher rate of wear than LFA. What is the current gold standard? LFA was and is our current gold standard in association with a DMC.
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Metadata
Title
Low friction arthroplasty and dual mobility cup: a new gold standard
Authors
Jean Louis Prudhon
Régis Verdier
Jacques H. Caton
Publication date
01-03-2017
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 3/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-016-3375-0

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