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Review
. 2023 Apr 17;31(spe1):e256913.
doi: 10.1590/1413-785220233101e256913. eCollection 2023.

THE CEMENTED DOUBLE MOBILITY CUP IN HIP REVISION: DIFFERENT POSSIBILITIES OF USE

Jaime José Morales de Cano  1 , Estela Trias  1
Affiliations
Review

THE CEMENTED DOUBLE MOBILITY CUP IN HIP REVISION: DIFFERENT POSSIBILITIES OF USE

Jaime José Morales de Cano et al. Acta Ortop Bras. .

Abstract
in English, Portuguese

Introduction: The aim of our work is to review those patients who underwent prosthetic hip revision surgery in our hospital considered to be patients at high risk of dislocation or recurrent dislocation, and who underwent a double mobility cemented cup (CMD). Analyzing the different ways to place these cups and the clinical results and reluxations.

Material and methods: The 69 cases comprised 34 men and 35 women with a mean age of 77,39 years. The mean follow-up was 4.7536 years. The type of intervention performed varied according to the cause of the intervention, the acetabular bone stock and the state of the primary cup. In the cases in which there was a good fixation of the primary metalback, we opted to carry out a cementation of the cemented DMC into the existing well-fixed metal acetabular shell, this occurred in 23 cases. In the cases where there was loosening of the primary cup but there was a good bone stock, a CMD was cemented into the bone (21 cases). In the cases where there was a Paprosky type III we cemented a DMC to a Bursch-Schneider reinforcement ring together with the placement of a cancellous bone graft (25 cases).

Results: The clinical evaluation at the end of the follow-up, according to the MD Scale, showed the mean value was 16.454 (SD 0.79472), with a survival at the end of the follow-up of 100% of the placed DMC.

Conclusion: The use of cemented DMC is a good solution in the replacement of THA, especially in cases of reluxation or risk of dislocation due to personal or technical predisposing factors. The use of these DMC cemented can be directly to the bone, into the existing well-fixed metal Shell, or cemented to a reinforcing ring, depending on the acetabular defect. Evidence Level III; Comparative Case Series .

Introdução: Revisar os pacientes que foram submetidos à cirurgia de revisão protética de quadril neste hospital, considerados como pacientes com alto risco de luxação ou luxação recorrente, submetidos a cirurgia por acetábulo cimentado de dupla mobilidade (CMD). Analisando as diferentes formas de posicionamento desses copos, seus resultados clínicos e reluxações.

Material e métodos: Os 69 casos correspondiam a 34 homens e 35 mulheres com uma idade média de 77,39 anos. O tempo médio de acompanhamento foi de 4,7536 anos. O tipo de intervenção realizada variou de acordo com a causa da intervenção, o estoque ósseo acetabular e o estado do copo primário. Nos casos em que houve uma boa fixação do metal primário, optouse por realizar uma cimentação do DMC cimentado na cúpula acetabular metálica firme existente, o que ocorreu em 23 casos. Nos casos em que houve um afrouxamento acetabular primário com um bom estoque ósseo disponível, cimentou-se um CMD (21 caixas). Nos casos em que havia um Paprosky tipo III, cimentou-se um DMC a um anel de reforço Bursch-Schneider juntamente com a colocação de um enxerto ósseo esponjoso (25 caixas).

Resultados: A avaliação clínica realizada no final do acompanhamento, de acordo com a Escala MD, mostrou que o valor médio foi de 16,454 (DP 0,79472), com uma sobrevivência ao final do acompanhamento de 100% do DMC inserido.

Conclusão: O uso do DMC cimentado pode ser uma boa solução para substituição do THA, especialmente em casos de reluxação ou risco de deslo-camento devido a fatores de predisposição pessoais ou técnicos. O uso destes DMC cimentados pode ser realizado diretamente ao osso, dentro da cúpula metálica fixa existente, ou cimentados a um anel de reforço, dependendo do defeito acetabular. Nível de Evidência III; Série de Casos Comparativos .

Keywords: Follow-Up Studies; Hip Replacement; Operative Surgical; Procedures; Reoperation; Total.

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Conflict of interest statement

All authors declare no potential conflict of interest related to this article.

Figures

Figure 1
Figure 1. The case of an 86-year-old woman operated on for right PTC infection, with replacement of both prosthetic components. Placement of cemented DMC to the bone.
Figure 2
Figure 2. The case of a 79-year-old man with septic loosening of total hip arthroplasty (A). Placement of cemented DMC into DMC into the existing well-fixed metal shell (B).
Figure 3
Figure 3. The case of an 82-year-old woman with aseptic acetabular loosening. Placement of cemented DMC into the Bursch-Schneider ring.
See this image and copyright information in PMC

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