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Comparative Study
. 2014 Jun;38(6):1125-9.
doi: 10.1007/s00264-014-2313-2. Epub 2014 Apr 16.

A comparative and retrospective study of three hundred and twenty primary Charnley type hip replacements with a minimum follow up of ten years to assess whether a dual mobility cup has a decreased dislocation risk

Jacques H Caton  1 , Jean Louis Prudhon, André Ferreira, Thierry Aslanian, Régis Verdier
Affiliations
Comparative Study

A comparative and retrospective study of three hundred and twenty primary Charnley type hip replacements with a minimum follow up of ten years to assess whether a dual mobility cup has a decreased dislocation risk

Jacques H Caton et al. Int Orthop. 2014 Jun.

Abstract

Purpose: Mid- and long-term follow-up of Charnley total hip arthroplasty (THA) demonstrated good functional results with 85 % survivorship at 25-year follow-up. However, dislocation still remains an unsolved problem. Dislocation may occur throughout the patient's and implant's life. The aim of this study is to answer the question: does a dual mobility cup (DMC) decrease the dislocation risk?

Methods: We report comparative results at ten years of follow-up of two groups of primary cemented Charnley-type THA, one with a standard polyethylene cup (group 1, n = 215) and the other one with a DMC (group 2, n = 105).

Results: In group 1, 26 dislocations (12.9 %) occurred. In group 2 only one dislocation (0.9 %) occurred. This dislocation was successfully reduced by closed reduction, without any recurrence. This difference was statistically significant (p = 0.0018). In group 1, the reason for revision was recurrent dislocation in 21 cases. Five patients were revised for other reasons. The global revision rate was 12.9 %. In group 2, two patients needed revision surgery for aseptic loosening. The global revision rate was 2.1 %. This difference was statistically significant (p = 0.054). The goal was reached for the patients of group 2 who had more risks factors for dislocation (age, aetiology, American Society of Anesthesiologists and Devane scores) than those of group 1.

Conclusions: When using a DMC, we observed a low rate of dislocation in primary THA (0.9 %). This surgical choice seems to be a safe and effective technique in Charnley-type THA, especially in a high-risk population.

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Figures

Fig. 1
Fig. 1
Cumulative risk of THA dislocation according to Caton and Merabet [2]
Fig. 2
Fig. 2
André Rambert (left) and Prof. Gilles Bousquet (right) presenting the first DMC (1976) (courtesy of L. Doursounian, Maîtrise orthopédique)
Fig. 3
Fig. 3
Cemented Charnley-type stem with standard polyethylene MBA cup (a) or Quattro® DMC (b)
Fig. 4
Fig. 4
Quattro® DMC with four apical spikes, six fins and bilayer titanium and HA coating
Fig. 5
Fig. 5
a Head impactor. b Dual mobility retaining mechanism. c DMC three joints: 1 larger joint, 2 smaller joint, 3 third joint, 4 chamfer
See this image and copyright information in PMC

References

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    1. Caton J, Merabet Z (2004) Hip dislocation and outcome. In: MCI France (ed) La prothèse totale de hanche, pp 223–227. Lyon
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