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. 2015 Mar;16(1):15-20.
doi: 10.1007/s10195-014-0318-7. Epub 2014 Sep 24.

Dual mobility acetabular component in revision total hip arthroplasty for persistent dislocation: no dislocations in 50 hips after 1-5 years

M van Heumen  1 , P J C Heesterbeek, B A Swierstra, G G Van Hellemondt, J H M Goosen
Affiliations

Dual mobility acetabular component in revision total hip arthroplasty for persistent dislocation: no dislocations in 50 hips after 1-5 years

M van Heumen et al. J Orthop Traumatol. 2015 Mar.

Abstract

Background: A dual mobility cup has the theoretic potential to improve stability in primary total hip arthroplasty (THA) and mid-term cohort results are favorable. We hypothesized that use of a new-generation dual mobility cup in revision arthroplasty prevents dislocation in patients with a history of recurrent dislocation of the THA.

Materials and methods: We performed a retrospective cohort study of patients receiving an isolated acetabular revision with a dual mobility cup for recurrent dislocation of the prosthesis with a minimum follow-up of 1 year. Kaplan-Meier survival analyses were performed with dislocation as a primary endpoint and re-revision for any reason as a secondary endpoint.

Results: Forty-nine consecutive patients (50 hips) were included; none of the patients was lost to follow-up. The median follow-up was 29 months (range 12-66 months). Two patients died from unrelated causes. Survival after 56 months was 100 % based on dislocation and 93 % (95 % CI 79-98 %) based on re-revision for any reason. Radiologic analysis revealed no osteolysis or radiolucent lines around the acetabular component during the follow-up period.

Conclusion: The dual mobility cup is an efficient solution for instability of THA with a favorable implant survival at 56 months.

Level of evidence: Level 4, retrospective case series.

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Figures

Fig. 1
Fig. 1
The biomechanical concept of the dual mobility cup consists of a double articulation—between femoral head and liner and between liner and cup. The first motion occurs between the small femoral head and the inside of the polyethylene liner, until the neck of the femoral stem comes into contact with the liner. The secondary motion occurs between the outside of the polyethylene liner and the metal acetabular cup, when a larger range of motion is required. Here the polyethylene liner acts as a large femoral head
Fig. 2
Fig. 2
The cemented version of the dual mobility cup (Avantage®)
Fig. 3
Fig. 3
Cumulative survival of 50 prostheses with dislocation defined as failure event. The small vertical spikes represent censored data
Fig. 4
Fig. 4
Cumulative survival of 50 prostheses with revision for any reason defined as failure event. The small vertical spikes represent censored data
See this image and copyright information in PMC

References

    1. van der Grinten M, Verhaar JAN. Dislocation of total hip prostheses: risk factors and treatment. Ned Tijdschr Gen. 2003;147:286–290. - PubMed
    1. Khatod M, Barber T, Paxton E, Namba R, Fithian D. An analysis of the risk of hip dislocation with a contemporary total joint registry. Clin Orthop Relat Res. 2006;447:19–23. doi: 10.1097/01.blo.0000218752.22613.78. - DOI - PubMed
    1. Byström S, Espehaug B, Furnes O, Havelin LI. Femoral head size is a risk factor for total hip luxation: a study of 42,987 primary hip arthroplasties from the Norwegian Arthroplasty Register. Acta Orthop Scand. 2003;74:514–524. doi: 10.1080/00016470310017893. - DOI - PubMed
    1. Jolles BM, Zangger P, Leyvraz PF. Factors predisposing to dislocation after primaru total hip arthroplasty: a multivariate analysis. J Arthroplasty. 2002;17:282–288. doi: 10.1054/arth.2002.30286. - DOI - PubMed
    1. Alberton GM, High WA, Morrey BF. Dislocation after revision total hip arthroplasty: an analysis of risk factors and treatment options. J Bone Joint Surg (Am) 2002;84:1788–1792. - PubMed