scholarly journals Dual mobility total hip dislocation—femoral stem loosening while attempting closed reduction: a cautionary note

2018 ◽  
pp. bcr-2017-222408
Author(s):  
Sharukh Dotivala ◽  
Ross Coomber ◽  
Majid Chowdhry ◽  
Andrew D Carrothers
Keyword(s):  
Closed Reduction ◽  
Femoral Stem ◽  
Hip Dislocation ◽  
Cautionary Note ◽  
Dual Mobility ◽  
Total Hip ◽  
Stem Loosening

Intraprosthetic Dislocation of Modular Dual-Mobility Total Hip Arthroplasty Components During Closed Reduction: A Report of Two Cases

2017 ◽  
Vol 01 (04) ◽  
pp. 205-210
Author(s):  
Ovninder Johal ◽  
Blake Eyberg ◽  
Russell Meldrum ◽  
J. Walker
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Closed Reduction ◽  
Hip Dislocation ◽  
Dual Mobility ◽  
Total Hip ◽  
Unique Mode ◽  
Mode Of Failure ◽  
Hip Disease ◽  
Intraprosthetic Dislocation

AbstractDual-mobility bearing total hip arthroplasty offers several advantages over traditional prosthesis designs in the treatment of degenerative hip disease. Over decades of use, they have shown proven benefits in both durability and stability. However, despite their practical and theoretical advantages, they present a unique mode of failure not seen with other implants. In this report, the authors present two patients who sustained intraprosthetic dislocation of their dual-mobility total hip arthroplasty components during closed reduction of a hip dislocation.

Displacement of Femoral Stem during Closed Reduction of Total Hip Arthroplasty

1997 ◽  
Vol 7 (3) ◽  
pp. 125-127
Author(s):  
J. Cordes ◽  
K. Sperling ◽  
M. Kramhøft
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Closed Reduction ◽  
Femoral Stem ◽  
Stem Design ◽  
Total Hip ◽  
Straight Stem ◽  
Image Intensification

In the literature, only one case of displacement of a cemented femoral stem from its cement bed during closed reduction of a dislocation has been reported. In that case, it was suggested that the stem design may in part be the explanation for the displacement. Another case with a cemented Müller straight stem is now presented, emphasizing the use of image intensification if reduction proves difficult.

scholarly journals Iatrogenic Obturator Hip Dislocation with Intrapelvic Migration

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Shachar Kenan ◽  
Spencer Stein ◽  
Robert Trasolini ◽  
Daniel Kiridly ◽  
Bruce A. Seideman
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Closed Reduction ◽  
Hip Dislocation ◽  
High Energy ◽  
Early Assessment ◽  
Obturator Foramen ◽  
Total Hip ◽  
Joint Biomechanics ◽  
Hip Abductor

Obturator hip dislocations are rare, typically resulting from high-energy trauma in native hips. These types of dislocations are treated with closed reduction under sedation. Open reduction and internal fixation may be performed in the presence of associated fractures. Still rarer are obturator hip dislocations that penetrate through the obturator foramen itself. These types of dislocations have only been reported three other times in the literature, all within native hips. To date, there have been no reports of foraminal obturator dislocations after total hip arthroplasty. We report of the first periprosthetic foraminal obturator hip dislocation, which was caused iatrogenically during attempts at closed reduction of a posterior hip dislocation in the setting of a chronic greater trochanter fracture. Altered joint biomechanics stemming from a weak hip abductor mechanism rendered the patient vulnerable to this specific dislocation subtype, which ultimately required open surgical intervention. An early assessment and identification of this dislocation prevented excessive closed reduction maneuvers, which otherwise could have had detrimental consequences including damage to vital intrapelvic structures. This case report raises awareness to this very rare, yet potential complication after total hip arthroplasty.

scholarly journals Dislocation of a Polished Femoral Stem following a Cemented Total Hip Arthroplasty: A Report of 2 Cases

2005 ◽  
Vol 13 (1) ◽  
pp. 73-75 ◽  
Author(s):  
VS Pai
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Open Reduction ◽  
Femoral Stem ◽  
Hip Dislocation ◽  
Total Hip ◽  
Proximal Migration ◽  
Cemented Total Hip Arthroplasty

We report 2 cases of hip dislocation after a total hip arthroplasty, which could not be successfully reduced by closed method. Post-manipulation radiographs revealed proximal migration of the prosthesis in both cases, which required open reduction. The pathogenesis and treatment of this hip dislocation is discussed.

Displacement of a Cemented Femoral Stem During Attempted Closed Reduction of a Dislocated Total Hip Arthroplasty

2010 ◽  
Vol 25 (4) ◽  
pp. 658.e11-658.e15 ◽  
Author(s):  
Rehan-Ul Haq ◽  
Kyung Soon Park ◽  
Hyun Kee Yang ◽  
Keun Bae Lee ◽  
Taek Rim Yoon
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Closed Reduction ◽  
Femoral Stem ◽  
Total Hip

scholarly journals Long-term outcomes of a dual-mobility cup and cementless triple-taper femoral stem combination in total hip replacement: a multicenter retrospective analysis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Alain Cypres ◽  
Arnaud Fiquet ◽  
Philippe Girardin ◽  
David Fitch ◽  
Philippe Bauchu ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Stem ◽  
Dual Mobility Cup ◽  
Dual Mobility ◽  
Total Hip ◽  
Cementless Femoral Stem

Abstract Background The separate design concepts of dual-mobility cups and triple-taper femoral stems were developed to improve survivorship following total hip replacement (THR) by reducing instability/dislocation and enabling enhanced fixation. Successful outcomes at over two decades have been reported with earlier-generation devices based on these concepts. The current study aimed to provide the first long-term results with a unique pairing of later-generation dual-mobility cup and triple-taper cementless femoral stem after a decade of use in patients undergoing THR. Methods In this retrospective analysis, records were reviewed for all subjects implanted with this dual-mobility cup/cementless femoral stem combination at three centers between 2002 and 2005. Any subject who had not already had follow-up visit beyond 10 years, was not previously revised, and still living were invited for a single follow-up visit consisting of Merle d’Aubgine Scores, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, and standard radiographs. Results There were 244 THRs available for analysis. At a mean follow-up of 11.9 years, the Kaplan-Meier survivorship (endpoint: revision for any reason) was 99.1% (95% CI, 97.6–99.7) for the stem and 95.9% (95% CI, 93.1–97.6) for the cup. Merle d’Aubigne Scores were significantly improved from baseline and WOMAC scores were in the satisfactory range at the final follow-up. Radiographic analysis revealed no cases of stem subsidence, no cases of bone hypertrophy, 1 (0.4%) case of bone atrophy, and 3 (1.2%) cases of osteolysis around the stem. No subjects had radiolucent lines greater than 1 mm in any femoral Gruen zone. Evidence of cup migration was seen in 1 (0.4%) subject and 1 (0.4%) subject had evidence of osteolysis that was seen in Gruen zones I, II, IV, and V. Conclusions This combination of a later-generation dual-mobility cup and cementless triple-taper stem was associated with excellent survivorship and satisfactory functional outcomes at over 10 years follow-up. Trial registration ClinicalTrials.gov, NCT02648152. Date of registration: January 6, 2016. Retrospectively registered.

Modular dual mobility total hip arthroplasty is a viable option for young, active patients

2021 ◽  
Vol 103-B (7 Supple B) ◽  
pp. 73-77
Author(s):  
Charles Murray Lawrie ◽  
Robert L. Barrack ◽  
Ryan M. Nunley
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Metal Ion ◽  
Femoral Stem ◽  
Dual Mobility ◽  
Total Hip ◽  
The Mean ◽  
Active Patients ◽  
Cobalt Chrome

Aims Dual mobility (DM) implants have been shown to reduce the dislocation rate after total hip arthroplasty (THA), but there remain concerns about the use of cobalt chrome liners inserted into titanium shells. The aim of this study was to assess the clinical outcomes, metal ion levels, and periprosthetic femoral bone mineral density (BMD) at mid-term follow-up in young, active patients receiving a modular DM THA. Methods This was a prospective study involving patients aged < 65 years, with a BMI of < 35 kg/m2, and University of California, Los Angeles activity score of > 6 who underwent primary THA with a modular cobalt chrome acetabular liner, highly cross-linked polyethylene mobile bearing, and a cementless titanium femoral stem. Patient-reported outcome measures, whole blood metal ion levels (μg/l), and periprosthetic femoral BMD were measured at baseline and at one, two, and five years postoperatively. The results two years postoperatively for this cohort have been previously reported. Results A total of 43 patients were enrolled. At minimum follow-up of five years, 23 (53.4%) returned for clinical and radiological review, 25 (58.1%) had metal ion analysis performed, 19 (44.2%) underwent dual energy x-ray absorptiometry scans, and 25 (58%) completed a pain-drawing questionnaire. The mean modified Harris Hip Scores improved significantly from 54.8 (SD 19) preoperatively to 93.08 (SD 10.5) five years postoperatively (p < 0.001). One patient was revised for aseptic acetabular loosening. The mean cobalt levels increased from 0.065 μg/l (SD 0.03) to 0.08 (SD 0.05) and the mean titanium levels increased from 0.35 (SD 0.13) to 0.78 (SD 0.29). The femoral BMD ratio decreased in Gruen Zone 1 (91.9%) at five years postoperatively compared with the baseline scores at six weeks potoperatively. The femoral BMD ratio was maintained in Gruen zones 2 to 7. Conclusion The use of a modular DM component and a cementless, tapered femoral stem shows excellent mid-term survivorship with minimal concerns for corrosion and metal ion release in a cohort of young, active patients undergoing primary THA. Cite this article: Bone Joint J 2021;103-B(7 Supple B):73–77.

scholarly journals Outcome of dual mobility total hip arthroplasty in patients who are at high risk for dislocation

2021 ◽  
Author(s):  
Basavaraj S. Kyavater ◽  
Rafeeq M. D. ◽  
Sathish Kumar ◽  
Hemanth P. Hallinalli
Keyword(s):  
High Risk ◽  
Total Hip Arthroplasty ◽  
Total Hip Replacement ◽  
Hip Arthroplasty ◽  
Hip Replacement ◽  
Hip Dislocation ◽  
Dual Mobility ◽  
Total Hip ◽  
A Prospective Study

<p><strong>Background: </strong>Dislocation after total hip arthroplasty (THA) remains a major concern, because it is reported to range from 1% to 5%. The concept of dual mobility articulation was developed in 1970 by Bousquet to decrease dislocation risk. Several studies have looked at the outcome of dual mobility articulation in primary THA and in revision THA.<strong></strong></p><p><strong>Methods: </strong>This is a prospective study of 33 patients undergoing dual mobility THA during 24 months period from October 2017 to September 2019. Patients undergoing total hip replacement (THR) to have dual mobility cup (DMC) were those at high risk of dislocation. Patients were followed up for a mean period of 18 months.<strong></strong></p><p><strong>Results: </strong>33 patients (mean age 67 years) underwent DMC THA. 27 patients underwent primary hip replacement. The follow-up of our cases has ranged from 13 months to 3 years with a mean follow-up of 18 months. none of the patients had hip dislocation.</p><p><strong>Conclusions</strong>: The DMC is an effective solution for the management of high-risk cases undergoing total hip replacement to reduce the incidence of postoperative instability.</p>

An oblique osteotomy is better for subtrochanteric shortening in total hip arthroplasty for high hip dislocation: a mechanical comparison of four techniques

2020 ◽  
pp. 112070002095799
Author(s):  
Dogan Atlihan ◽  
Cem Yildirim ◽  
Osman Gorkem Muratoglu ◽  
Duran Can Muslu ◽  
Mazhar Tokgözoğlu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Femoral Stem ◽  
Hip Dislocation ◽  
Developmental Dysplasia ◽  
Torsional Stiffness ◽  
Test Model ◽  
Total Hip ◽  
Oblique Osteotomy ◽  
Femoral Shortening

Background: Subtrochanteric femoral shortening is used during total hip arthroplasty for high hip dislocation in developmental dysplasia of hip patients. Methods: We mechanically tested the stability of various commonly used subtrochanteric osteotomy techniques. As the equivalent of a femoral stem placed in a shortened femur without any stable fixation at the osteotomy line, 2 polyvinylchloride pipes were loosely intertwined. 4 different osteotomies (Z-subtrochanteric osteotomy, oblique-45° osteotomy, double Chevron-90° and 120° subtrochanteric osteotomy) were simulated. Torsional and axial loads were applied, and torsional stiffness was calculated for each test model. Results: Z, double Chevron-90° and 120° subtrochanteric osteotomy models demonstrated lower mean torsional stiffness than oblique-45° osteotomy. With the highest torsional stiffness oblique-45° provides the best stability for treatment of high dislocation hips when a subtrochanteric osteotomy is added. Conclusions: This matches our previous clinical experience. Oblique osteotomy may also provide higher contact surfaces in the osteotomy lines to promote bone healing.

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