Skip to main content
Top
Published in: Archives of Orthopaedic and Trauma Surgery 7/2013

01-07-2013 | Hip Arthroplasty

The use of a dual-mobility concept in total hip arthroplasty patients with spastic disorders

No dislocations in a series of ten cases at midterm follow-up

Authors: Rick J. M. Sanders, Bart A. Swierstra, Jon H. M. Goosen

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 7/2013

Login to get access

Abstract

Introduction

Total hip arthroplasty (THA) is one of the treatment options in patients with cerebral palsy (CP) with painful osteoarthritis of the hip. However, the risk of dislocation of the prosthesis is higher in patients with CP when compared with physically normal patients. In this retrospective study of ten consecutive cases, we hypothesized that the use of a dual-mobility cup could reduce this risk of dislocation combined with good functional results.

Materials and methods

From January 2008 until October 2010, eight patients (ten hips) with CP who consecutively received a THA using a dual-mobility cup were identified. At the time of surgery, the average age of the patient group was 54 years (range 43–61). Latest follow-up took place after on average 39 months (range 22–56 months). All patients or their caregivers were interviewed by telephone. They were asked if dislocation of the prosthesis had occurred. To evaluate quality of life and health in general, patients completed the SF-36 questionnaire.

Results

None of the prostheses had dislocated at the latest follow-up. Reoperation was needed in one patient after a periprosthetic fracture. Radiologic evaluation showed a mean cup inclination of 46 (range 27–58). On average, the quality of life of patients in this study was found to be limited in particular on the domains of physical health and functioning, while a fair to good score was measured at the six other different domains.

Conclusion

The use of a dual-mobility cup in THA in patients with CP can lead to favourable results with respect to dislocation and clinical outcome.
Literature
1.
go back to reference Aaronson NK, Muller M, Cohen PD et al (1998) Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol 51(11):1055–1068PubMedCrossRef Aaronson NK, Muller M, Cohen PD et al (1998) Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol 51(11):1055–1068PubMedCrossRef
2.
go back to reference Alberton GM, High WA, Morrey BF (2002) Dislocation after revision total hip arthroplasty: an analysis of risk factors and treatment options. J Bone Joint Surg Am 84-A(10):1788–1792 Alberton GM, High WA, Morrey BF (2002) Dislocation after revision total hip arthroplasty: an analysis of risk factors and treatment options. J Bone Joint Surg Am 84-A(10):1788–1792
3.
go back to reference Blake SM, Kitson J, Howell JR, Gie GA, Cox PJ (2006) Constrained total hip arthroplasty in a paediatric patient with cerebral palsy and painful dislocation of the hip. A case report. J Bone Joint Surg Br 88(5):655–657 Blake SM, Kitson J, Howell JR, Gie GA, Cox PJ (2006) Constrained total hip arthroplasty in a paediatric patient with cerebral palsy and painful dislocation of the hip. A case report. J Bone Joint Surg Br 88(5):655–657
4.
go back to reference Boldingh EJ, Jacobs-van der Bruggen MA, Bos CF, Lankhorst GJ, Bouter LM (2005) Determinants of hip pain in adult patients with severe cerebral palsy. J Pediatr Orthop B 14(2):120–125PubMedCrossRef Boldingh EJ, Jacobs-van der Bruggen MA, Bos CF, Lankhorst GJ, Bouter LM (2005) Determinants of hip pain in adult patients with severe cerebral palsy. J Pediatr Orthop B 14(2):120–125PubMedCrossRef
5.
go back to reference Buly RL, Huo M, Root L, Binzer T, Wilson PD, Jr. (1993) Total hip arthroplasty in cerebral palsy. Long-term follow-up results. Clin Orthop Res (296):148–153 Buly RL, Huo M, Root L, Binzer T, Wilson PD, Jr. (1993) Total hip arthroplasty in cerebral palsy. Long-term follow-up results. Clin Orthop Res (296):148–153
6.
go back to reference Carter AH, Sheehan EC, Mortazavi SM, Purtill JJ, Sharkey PF, Parvizi J (2011) Revision for recurrent instability: what are the predictors of failure? J Arthroplasty 26(6 Suppl):46–52PubMedCrossRef Carter AH, Sheehan EC, Mortazavi SM, Purtill JJ, Sharkey PF, Parvizi J (2011) Revision for recurrent instability: what are the predictors of failure? J Arthroplasty 26(6 Suppl):46–52PubMedCrossRef
7.
go back to reference Carter DR, Tse B (2009) The pathogenesis of osteoarthritis in cerebral palsy. Dev Med Child Neurol 51(Suppl 4):79–83PubMedCrossRef Carter DR, Tse B (2009) The pathogenesis of osteoarthritis in cerebral palsy. Dev Med Child Neurol 51(Suppl 4):79–83PubMedCrossRef
8.
go back to reference Castle ME, Schneider C (1978) Proximal femoral resection-interposition arthroplasty. J Bone Joint Surg Am 60(8):1051–1054 Castle ME, Schneider C (1978) Proximal femoral resection-interposition arthroplasty. J Bone Joint Surg Am 60(8):1051–1054
9.
go back to reference Forsythe ME, Whitehouse SL, Dick J, Crawford RW (2007) Functional outcomes after nonrecurrent dislocation of primary total hip arthroplasty. J Arthroplasty 22(2):227–230PubMedCrossRef Forsythe ME, Whitehouse SL, Dick J, Crawford RW (2007) Functional outcomes after nonrecurrent dislocation of primary total hip arthroplasty. J Arthroplasty 22(2):227–230PubMedCrossRef
10.
go back to reference Fucs PM, Svartman C, Assumpcao RM, Yamada HH, Rancan DR (2011) Is arthrodesis the end in spastic hip disease? J Pediatr Rehabil Med 4(3):163–169PubMed Fucs PM, Svartman C, Assumpcao RM, Yamada HH, Rancan DR (2011) Is arthrodesis the end in spastic hip disease? J Pediatr Rehabil Med 4(3):163–169PubMed
11.
go back to reference 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: 228 patients from the Swedish Hip Arthroplasty Register. Acta Orthopaedica 83(6):566–571PubMedCrossRef 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: 228 patients from the Swedish Hip Arthroplasty Register. Acta Orthopaedica 83(6):566–571PubMedCrossRef
12.
go back to reference Hogan KA, Blake M, Gross RH (2006) Subtrochanteric valgus osteotomy for chronically dislocated, painful spastic hips. J Bone Joint Surg Am 88(12):2624–2631 Hogan KA, Blake M, Gross RH (2006) Subtrochanteric valgus osteotomy for chronically dislocated, painful spastic hips. J Bone Joint Surg Am 88(12):2624–2631
13.
go back to reference Kotwal RS, Ganapathi M, John A, Maheson M, Jones SA (2009) Outcome of treatment for dislocation after primary total hip replacement. J Bone Joint Surg Br 91(3):321–326 Kotwal RS, Ganapathi M, John A, Maheson M, Jones SA (2009) Outcome of treatment for dislocation after primary total hip replacement. J Bone Joint Surg Br 91(3):321–326
14.
go back to reference 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(2):389–395PubMedCrossRef 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(2):389–395PubMedCrossRef
15.
go back to reference Moskal JT, Capps SG (2011) Acetabular component positioning in total hip arthroplasty: an evidence-based analysis. J Arthroplasty 26(8):1432–1437PubMedCrossRef Moskal JT, Capps SG (2011) Acetabular component positioning in total hip arthroplasty: an evidence-based analysis. J Arthroplasty 26(8):1432–1437PubMedCrossRef
16.
go back to reference Muthusamy K, Chu HY, Friesen RM, Chou PC, Eilert RE, Chang FM (2008) Femoral head resection as a salvage procedure for the severely dysplastic hip in nonambulatory children with cerebral palsy. J Pediatr Orthop 28(8):884–889PubMedCrossRef Muthusamy K, Chu HY, Friesen RM, Chou PC, Eilert RE, Chang FM (2008) Femoral head resection as a salvage procedure for the severely dysplastic hip in nonambulatory children with cerebral palsy. J Pediatr Orthop 28(8):884–889PubMedCrossRef
17.
go back to reference Queally JM, Abdulkarim A, Mulhall KJ (2009) Total hip replacement in patients with neurological conditions. J Bone Joint Surg Br 91(10):1267–1273 Queally JM, Abdulkarim A, Mulhall KJ (2009) Total hip replacement in patients with neurological conditions. J Bone Joint Surg Br 91(10):1267–1273
18.
go back to reference Raphael BS, Dines JS, Akerman M, Root L (2010) Long-term followup of total hip arthroplasty in patients with cerebral palsy. Clin Orthop Relat Res 468(7):1845–1854PubMedCrossRef Raphael BS, Dines JS, Akerman M, Root L (2010) Long-term followup of total hip arthroplasty in patients with cerebral palsy. Clin Orthop Relat Res 468(7):1845–1854PubMedCrossRef
19.
go back to reference Reid SM, Carlin JB, Reddihough DS (2011) Using the Gross Motor Function Classification System to describe patterns of motor severity in cerebral palsy. Dev Med Child Neurol 53(11):1007–1012PubMedCrossRef Reid SM, Carlin JB, Reddihough DS (2011) Using the Gross Motor Function Classification System to describe patterns of motor severity in cerebral palsy. Dev Med Child Neurol 53(11):1007–1012PubMedCrossRef
20.
go back to reference Root L (2009) Surgical treatment for hip pain in the adult cerebral palsy patient. Dev Med Child Neurol 51(Suppl 4):84–91PubMedCrossRef Root L (2009) Surgical treatment for hip pain in the adult cerebral palsy patient. Dev Med Child Neurol 51(Suppl 4):84–91PubMedCrossRef
21.
go back to reference Root L, Goss JR, Mendes J (1986) The treatment of the painful hip in cerebral palsy by total hip replacement or hip arthrodesis. J Bone Joint Surg Am 68(4):590–598 Root L, Goss JR, Mendes J (1986) The treatment of the painful hip in cerebral palsy by total hip replacement or hip arthrodesis. J Bone Joint Surg Am 68(4):590–598
22.
go back to reference Sarmiento A, Ebramzadeh E, Gogan WJ, McKellop HA (1990) Cup containment and orientation in cemented total hip arthroplasties. J Bone Joint Surg Br 72(6):996–1002 Sarmiento A, Ebramzadeh E, Gogan WJ, McKellop HA (1990) Cup containment and orientation in cemented total hip arthroplasties. J Bone Joint Surg Br 72(6):996–1002
23.
go back to reference Schejbalova A, Havlas V, Trc T (2009) Irreducible dislocation of the hip in cerebral palsy patients treated by Schanz proximal femoral valgus osteotomy. Int Orthop 33(6):1713–1717PubMedCrossRef Schejbalova A, Havlas V, Trc T (2009) Irreducible dislocation of the hip in cerebral palsy patients treated by Schanz proximal femoral valgus osteotomy. Int Orthop 33(6):1713–1717PubMedCrossRef
24.
go back to reference Schorle CM, Fuchs G, Manolikakis G (2006) Total hip arthroplasty in cerebral palsy. Der Orthopäde 35(8):823–833PubMedCrossRef Schorle CM, Fuchs G, Manolikakis G (2006) Total hip arthroplasty in cerebral palsy. Der Orthopäde 35(8):823–833PubMedCrossRef
25.
go back to reference Schroeder K, Hauck C, Wiedenhofer B, Braatz F, Aldinger PR (2010) Long-term results of hip arthroplasty in ambulatory patients with cerebral palsy. Int Orthop 34(3):335–339PubMedCrossRef Schroeder K, Hauck C, Wiedenhofer B, Braatz F, Aldinger PR (2010) Long-term results of hip arthroplasty in ambulatory patients with cerebral palsy. Int Orthop 34(3):335–339PubMedCrossRef
26.
go back to reference Vasukutty NL, Middleton RG, Matthews EC, Young PS, Uzoigwe CE, Minhas TH (2012) The double-mobility acetabular component in revision total hip replacement: the United Kingdom experience. J Bone Joint Surg Br 94(5):603–608 Vasukutty NL, Middleton RG, Matthews EC, Young PS, Uzoigwe CE, Minhas TH (2012) The double-mobility acetabular component in revision total hip replacement: the United Kingdom experience. J Bone Joint Surg Br 94(5):603–608
27.
go back to reference Weber M, Cabanela ME (1999) Total hip arthroplasty in patients with cerebral palsy. Orthopedics 22(4):425–427PubMed Weber M, Cabanela ME (1999) Total hip arthroplasty in patients with cerebral palsy. Orthopedics 22(4):425–427PubMed
28.
go back to reference Woo RY, Morrey BF (1982) Dislocations after total hip arthroplasty. J Bone Joint Surg Am 64(9):1295–1306 Woo RY, Morrey BF (1982) Dislocations after total hip arthroplasty. J Bone Joint Surg Am 64(9):1295–1306
Metadata
Title
The use of a dual-mobility concept in total hip arthroplasty patients with spastic disorders
No dislocations in a series of ten cases at midterm follow-up
Authors
Rick J. M. Sanders
Bart A. Swierstra
Jon H. M. Goosen
Publication date
01-07-2013
Publisher
Springer-Verlag
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 7/2013
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-013-1759-9

Other articles of this Issue 7/2013

Archives of Orthopaedic and Trauma Surgery 7/2013 Go to the issue