scholarly journals Lower 5-year cup re-revision rate for dual mobility cups compared with unipolar cups: report of 15,922 cup revision cases in the Dutch Arthroplasty Register (2007–2016)

2019 ◽  
Vol 90 (4) ◽  
pp. 338-341 ◽  
Author(s):  
Esther M Bloemheuvel ◽  
Liza N van Steenbergen ◽  
Bart A Swierstra
Keyword(s):  
Revision Rate ◽  
Arthroplasty Register ◽  
Dual Mobility ◽  
Dual Mobility Cups ◽  
Cup Revision

scholarly journals What Is the Dislocation and Revision Rate of Dual-mobility Cups Used in Complex Revision THAs?

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Niklas Unter Ecker ◽  
Hakan Kocaoğlu ◽  
Akos Zahar ◽  
Carl Haasper ◽  
Thorsten Gehrke ◽  
...  
Keyword(s):  
Revision Rate ◽  
Dual Mobility ◽  
Revision Thas ◽  
Dual Mobility Cups

scholarly journals Higher risk of 2-year cup revision of ceramic-on-ceramic versus ceramic-on-polyethylene bearing: analysis of 33,454 primary press-fit total hip arthroplasties registered in the Dutch Arthroplasty Register (LROI)

2022 ◽  
pp. 112070002110649
Author(s):  
Justin van Loon ◽  
Inger N Sierevelt ◽  
Anneke Spekenbrink-Spooren ◽  
Kim TM Opdam ◽  
Rudolf W Poolman ◽  
...  
Keyword(s):  
Revision Rate ◽  
Head Size ◽  
Arthroplasty Register ◽  
Total Hip ◽  
Press Fit ◽  
Kaplan Meier ◽  
Randomised Controlled ◽  
Cup Revision ◽  
Over Time ◽  
Ceramic On Ceramic

Background and purpose: The influence of bearing on short-term revision in press-fit total hip arthroplasty (THA) remains under-reported. The aim of this study was to describe 2-year cup revision rates of ceramic-on-ceramic (CoC) and ceramic-on-polyethylene (CoPE). Patients and methods: Primary press-fit THAs with one of the three most used cups available with both CoC or CoPE bearing recorded in the Dutch Arthroplasty Register (LROI) were included (2007–2019). Primary outcome was 2-year cup revision for all reasons. Secondary outcomes were: reasons for revision, incidence of different revision procedures and use of both bearings over time. Results: 2-year Kaplan-Meier cup revision rate in 33,454 THAs (12,535 CoC; 20,919 CoPE) showed a higher rate in CoC (0.67% [95% CI, 0.54–0.81]) compared to CoPE (0.44% [95% CI, 0.34–0.54]) ( p = 0.004). Correction for confounders (age, gender, cup type, head size) resulted in a hazard ratio (HR) of 0.64 [95%CI, 0.48–0.87] ( p = 0.019). Reasons for cup revision differed only by more cup revision due to loosening in CoC (26.2% vs.1 3.2%) ( p = 0.030). For aseptic loosening a revision rate of 0.153% [95% CI, 0.075–0.231] was seen in CoC and 0.058% [95%CI 0.019–0.097] in CoPE ( p = 0.007). Correction for head size resulted in a HR of 0.475 [95% CI, 0.197–1.141] ( p = 0.096). Incidence of different revision procedures did not differ between bearings. Over time the use of CoPE has increased and CoC decreased. Conclusions: A higher 2-year cup revision rate in press-fit THA was observed in CoC compared to CoPE. Cup loosening was the only significantly different reason for revision and seen more often in CoC and mostly aseptic. Future randomised controlled trials need to confirm causality, since the early cup revision data provided has the potential to be useful when choosing the bearing in press-fit THA, when combined with other factors like bone quality and patient and implant characteristics.

scholarly journals What Factors Reduce the Incidence of Early Dislocations in Aseptic Total Hip Revisions with Stem Retention?

2021 ◽  
Author(s):  
Jesus M. Villa ◽  
Tejbir S. Pannu ◽  
Preetesh D. Patel ◽  
Wael K. Barsoum ◽  
Carlos A. Higuera ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Surgical Approach ◽  
Preoperative Diagnosis ◽  
Pearson Correlation ◽  
Dual Mobility ◽  
Total Hip ◽  
Stem Retention ◽  
Postoperative Dislocation ◽  
Skin To Skin ◽  
Cup Revision

AbstractIt is unclear which factors are the most important protectors for early postoperative dislocation in aseptic total hip arthroplasty (THA) revisions with stem retention. Therefore, we sought to determine what factors reduce the incidence of dislocations among these patients. Single institution retrospective review was made of 83 consecutive aseptic THA revisions of the head/liner and/or cup performed by five surgeons between 2017 and 2020. Periprosthetic infections and femoral component revisions were excluded. Demographics, preoperative diagnosis, revision type, surgical approach, use of dual mobility systems, length of stay, skin-to-skin time, transfusions, complications, and dislocations were assessed. Pearson correlation/logistic regression analyses were used to determine association/independent predictors of dislocation; α was set at 0.05. The overall dislocation rate was 12%. In Pearson correlation, only preoperative diagnosis (instability vs. other, −0.241, p = 0.028) and revision type (only liner vs. cup, −0.304, p = 0.005) were significantly associated with dislocations. In logistic regression, only preoperative diagnosis other than instability (odds ratio [OR] = 0.235, p = 0.038) and cup revision (OR = 0.130, p = 0.014) were found significant protectors against dislocation. Surgical approach and dual mobility systems were not independent predictors of dislocations (p = 0.184 and p = 0.083, respectively). Dislocation rates were significantly different between those cases that had the cup revised (4.0%) and those that did not (24.2%; p = 0.012). Preoperative diagnosis other than instability and cup revision seemed to be protective against early dislocation. Revision of the cup, in particular, seemed to be the most important factor to avoid dislocations while use of dual mobility liners per se did not significantly reduce that risk. The role of isolated liner exchanges in revision THA continues to evolve and should be reserved for appropriately selected patients.

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