Dual-mobility bearings for patients with abductor-trochanteric complex insufficiency

2018 ◽  
Vol 28 (5) ◽  
pp. 491-497 ◽  
Author(s):  
Vahit E Ozden ◽  
Goksel Dikmen ◽  
Burak Beksac ◽  
Remzi Tozun
Keyword(s):  
Acetabular Reconstruction ◽  
Dual Mobility Cup ◽  
Survivorship Analysis ◽  
Dual Mobility ◽  
Total Hip ◽  
Kaplan Meier ◽  
Dual Mobility Cups ◽  
The Mean ◽  
Cemented Cup

Introduction: The purpose of this study was to summarise the performance of dual-mobility cup systems for revision total hip arthroplasty in patients with abductor-trochanteric complex deficiency. Methods: We prospectively followed 17 patients (20 hips) with a mean age of 64.5 years (range 33-89 years) who underwent acetabular reconstruction with dual-mobility cups for aseptic loosening in 12 hips, infection treatment as second or single stage in 6 hips, and instability in 2 hips. All of the patients had abductor insufficiency. We evaluated the clinical Harris Hip scores (HHS) and radiographs for migration, loosening, and osteolysis. The survival of the components was calculated according to Kaplan-Meier survivorship analysis, and failure was defined as any dislocation, acetabular component or total hip revision for any reason. Results: The mean duration of follow-up was 38.1 months (range 24-98 months). There were 2 (12.5%) revisions for cemented cup migration after 11 months and 19 months respectively. There were no dislocations. At the last follow-up, the mean HHS increased from 42 points preoperatively to 86 points. The cumulative survival rate of the dual-mobility cup system was 93% (95% confidence interval 88-98.7%) at 5 years, with any revision as the end point. Conclusion: Dual-mobility cups may provide excellent stability in patients with abductor-trochanteric complex insufficiency.

Minimum 7-Year Outcomes of Dual Mobility Acetabular Cups in Total Hip Arthroplasty Patients

2020 ◽  
Vol 04 (02) ◽  
pp. 090-093
Author(s):  
John M. Tarazi ◽  
Hytham S. Salem ◽  
Joseph O. Ehiorobo ◽  
Nipun Sodhi ◽  
Luke J. Garbarino ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Study Cohort ◽  
Dual Mobility Cup ◽  
Dual Mobility ◽  
Total Hip ◽  
Patient Reported ◽  
Dual Mobility Cups ◽  
Metallic Liner

AbstractModular dual mobility cups have been developed to potentially address postoperative hip instability, which can occur in nearly 20% of all revision total hip arthroplasty (THA) patients. By having a prosthetic construct that contains two points of articulation between the femoral head and liner and between the liner and shell, joint stability can be increased. The purpose of this study was to report on dual mobility cup survivorships, patient satisfaction outcomes, complications, and radiographic outcomes at a minimum 7-year follow-up. A high-volume academic surgeon performed a total of 143 consecutive dual mobility primary THAs on patients who had a minimum follow-up of 7 years (range, 7–8.5 years). The study cohort consisted of 77 females (54%) and 66 males (46%) who had a mean age of 65 years (range, 34–90 years). Aseptic, septic, and all-cause survivorship was determined by Kaplan-Meier analysis. Harris Hip Scores (HHS), postoperative complications, and radiographs were also assessed. No cup failures were observed. Overall, septic survivorship was 99.3% (95% confidence interval [CI]: 0.98–1.0) and all-cause survivorship was 98.6% (95% CI: 0.97–1.0). Two patients (1.4%) required revision surgery unrelated to the use of a modular dual mobility cup. Of these, one patient experienced femoral stem loosening and the other developed a periprosthetic infection that was treated with a two-stage revision. The mean total HHS was above 95 points at the most recent follow-up. Three patients (2.3%) experienced medical complications, including two deep vein thromboses and one for nonfatal pulmonary embolism. Radiographic evidence revealed incomplete seating of the metallic liner in one patient. Dual mobility cups were developed in an attempt to decrease the rate of instability following THA. The results from this study indicate that excellent clinical and patient-reported outcomes can be achieved at 7-year follow-up in patients who undergo THA with a dual mobility cup. Therefore, dual mobility cups appear to be an appropriate treatment option for primary THA.

scholarly journals Early results of total hip arthroplasty using dual-mobility cup in patients with osteonecrosis of the femoral head

SICOT-J ◽  
2018 ◽  
Vol 4 ◽  
pp. 4 ◽  
Author(s):  
Chahine Assi ◽  
Nadim Kheir ◽  
Camille Samaha ◽  
Pascal Kouyoumdjian ◽  
Kaissar Yammine
Keyword(s):  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Dual Mobility Cup ◽  
Dual Mobility ◽  
Total Hip ◽  
Early Results ◽  
Harris Score ◽  
The Mean

Introduction: Osteonecrosis of the femoral head (ONFH) remains a therapeutic challenge for patients undergoing total hip arthroplasty (THA). The majority of these patients are young with high functional demand, and show an increased risk of dislocation following surgery than patients with osteoarthritis. The use of double mobility cup (DMC) has been linked with lower rates of complications when compared to conservative cups; however, the literature is scarce over DMC results in patients with ONFH. The aim of the study is to report the early outcomes of patients with ONFH treated with THA-DMC. Materials: A retrospective analysis of patients suffering from ONFH who underwent THA using DMC (THA-DMC) from 2006 to 2015 were evaluated for functional status and risk of post-operative complications. Thirty THA-DMC in 26 patients with a mean follow-up of 51 months were evaluated clinically (modified Hip Harris Score) and radiologically. Results: The mean age of the included patients was 54.9 years. At final follow-up, the mean modified Hip Harris score was 98.7 ± 2.7 and no dislocation episodes or revision surgeries were recorded. The radiological assessment revealed no signs of migration/tilting, radiolucent lines, periprosthetic osteolysis or heterotopic ossification over the DMC component and the femoral stem. The survival rate over 51 months of follow-up was 100%. Discussion: The use of the new generation of dual mobility cup in patients with ONFH showed excellent functional early results with no major complications such as dislocation.

Uniformly low serum cobalt levels after modular dual-mobility total hip arthroplasties with ceramic heads

2019 ◽  
Vol 101-B (6_Supple_B) ◽  
pp. 57-61 ◽  
Author(s):  
B. P. Chalmers ◽  
D. G. Mangold ◽  
A. D. Hanssen ◽  
M. W. Pagnano ◽  
R. T. Trousdale ◽  
...  
Keyword(s):  
Femoral Head ◽  
Periprosthetic Femoral Fracture ◽  
Dual Mobility ◽  
Total Hip ◽  
Primary Thas ◽  
Ceramic Femoral Head ◽  
The Mean ◽  
Level 1 ◽  
Tissue Reactions

Aims Modular dual-mobility constructs reduce the risk of dislocation after revision total hip arthroplasty (THA). However, questions about metal ions from the cobalt-chromium (CoCr) liner persist, and are particularly germane to patients being revised for adverse local tissue reactions (ALTR) to metal. We determined the early- to mid-term serum Co and Cr levels after modular dual-mobility components were used in revision and complex primary THAs, and specifically included patients revised for ALTR. Patients and Methods Serum Co and Cr levels were measured prospectively in 24 patients with a modular dual-mobility construct and a ceramic femoral head. Patients with CoCr heads or contralateral THAs with CoCr heads were excluded. The mean age was 63 years (35 to 83), with 13 patients (54%) being female. The mean follow-up was four years (2 to 7). Indications for modular dual-mobility were prosthetic joint infection treated with two-stage exchange and subsequent reimplantation (n = 8), ALTR revision (n = 7), complex primary THA (n = 7), recurrent instability (n = 1), and periprosthetic femoral fracture (n = 1). The mean preoperative Co and Cr in patients revised for an ALTR were 29.7 μg/l (2 to 146) and 21.5 μg/l (1 to 113), respectively. Results Mean Co and Cr levels were 0.30 μg/l and 0.76 μg/l, respectively, at the most recent follow-up. No patient had a Co level ≥ 1 μg/l. Only one patient had a Cr level ≥ 1 μg/l. That patient’s Cr level was 12 μg/l at 57 months after revision THA for ALTR (and decreased ten-fold from a preoperative Cr of 113 μg/l). Conclusion At a mean of four years, no patient with a modular dual-mobility construct and ceramic femoral head had elevated Co levels, including seven patients revised specifically for ALTR. While further studies are required, we support the selective use of a modular dual-mobility construct in revision and complex primary THAs for patients at high risk for instability. Cite this article: Bone Joint J 2019;101-B(6 Supple B):57–61.

scholarly journals 32-mm ceramic-on-ceramic total hip arthroplasty versus 28-mm ceramic bearings: 5- to 15-year follow-up study

2018 ◽  
Vol 29 (1) ◽  
pp. 65-71 ◽  
Author(s):  
Yoshitoshi Higuchi ◽  
Taisuke Seki ◽  
Yukiharu Hasegawa ◽  
Yasuhiko Takegami ◽  
Daigo Morita ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Total Hip ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Average Patient ◽  
The Mean ◽  
Ceramic On Ceramic

Introduction: This study aimed to compare the clinical and radiographic results of 28-mm ceramic-on-ceramic (CoC) total hip arthroplasty (THA) to those of 32-mm CoC during a 5- to 15-year follow-up period. Methods: 107 joints (95 women and 6 men) underwent 28-mm CoC, and 60 (49 women and 7 men) underwent 32-mm CoC. The average patient age at the time of surgery was 56.1 and 55.7 years in the 28-mm and 32-mm CoC groups, respectively. Clinical and radiologic measurements of all patients were analysed. Results: The mean preoperative Harris hip score (HHS) was similar in the 2 groups (28-mm, 58.9; and 32-mm, 58.5). However, at final follow-up, the mean HHS of the 32-mm CoC (91.8) was significantly better than that of the 28-mm CoC (88.2) ( p = 0.003), as were the ranges of motion (ROM) for flexion (98.3 ± 13.5° vs. 87.3 ± 19.3°, p < 0.001) and abduction (27.8 ± 14.9° vs. 22.1 ± 19.3°, p = 0.007). The mean wear rate was 0.0044 mm/year for the 28-mm CoC and 0.0044 mm/year for the 32-mm CoC. No ceramic fractures were found in the 2 groups. One joint in the 28-mm CoC (0.9%) required revision owing to progressive osteolysis. Kaplan-Meier survival at 10 years, with implant loosening or revision THA as the endpoint, was 98.3% for 28-mm CoC and 100% for 32-mm CoC ( p = 0.465). Conclusion: There was no significant difference in ceramic-related complications between the 2 groups. Our study demonstrated that the 32-mm and 28-mm CoC are safe and are associated with good clinical outcomes.

Acetabular reconstruction using a composite layer of impacted cancellous allograft bone and cement: minimum 5-year follow-up study

2020 ◽  
pp. 112070002094140
Author(s):  
Kanai Garala ◽  
Tarek Boutefnouchet ◽  
Rishanthanan Amblawaner ◽  
Trevor Lawrence
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Bone Grafting ◽  
Composite Layer ◽  
Acetabular Reconstruction ◽  
Total Hip ◽  
Patient Reported ◽  
The Mean ◽  
Composite Bone

Background: Revision total hip arthroplasty (rTHA) is often complex and has a less reliable outcome than primary total hip arthroplasty. Acetabular reconstruction remains a challenge because of the variable amount of bone loss. This study describes and evaluates a novel technique of acetabular reconstruction using composite bone grafting. Patients and methods: Between June 2005 and January 2012, 108 consecutive patients underwent revision hip arthroplasty in which the acetabular component was revised using composite bone grafting. Of these, 24 were lost to follow-up leaving 84 in the study with a minimum 5-year follow-up. There were 54 women and 30 men with a mean age of 70.1 (31–91) years. All patients were assessed clinically and radiologically after a minimum of 5 years. The primary outcome measures were rate of re-revision, patient-reported outcomes and radiological evidence of loosening. Results: The mean follow-up after revision surgery was 6.9 years (5–10). At operation, 60 patients had an acetabular defect of AAOS stage 3 or more. There was no evidence of loosening in 69 revision acetabular components; 12 showed evidence of non-progressive loosening and 3 patients underwent a re-revision procedure (2 for infection, 1 recurrent dislocation). The mean postoperative Hip Disability and Osteoarthritis Outcome Score (HOOS) was 89.11/100 (95% CI, 87.8–90.5). Scores were significantly improved in patients with a more extensive preoperative defect ( p  = 0.006). The overall patient satisfaction rate at final follow-up was very high. Conclusions: Composite impaction grafting using a layered cement and bone graft technique can give satisfactory clinical and radiological outcomes in the medium- to long-term.

Good mid-term clinical results of a cemented dual mobility cup: a single-centre experience

2017 ◽  
Vol 28 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Gregor Kavčič ◽  
Pika Mirt ◽  
Klemen Bedenčič
Keyword(s):  
Final Analysis ◽  
Clinical Results ◽  
Harris Hip Score ◽  
Consecutive Series ◽  
Dual Mobility Cup ◽  
Dual Mobility ◽  
Single Centre Experience ◽  
The Mean ◽  
Hip Arthroplasties

Introduction and methods: From January 2004 to December 2008, 188 total hip arthroplasties were performed using a cemented dual mobility cup. 174 patients were available for final analysis. Their mean age was 76.8 (range 54-98 years). The mean follow-up was 7.7 years (range 5-10 years). Results: There were no dislocations. Survivorship rates of the femoral and acetabular components were 100% at a minimum of 5 years. At the latest follow-up, the mean Harris Hip Score significantly increased from 31.6 (only arthritic patients) points preoperatively to 84.5 points. No patients had progressive osteolysis, component migration, or loosening on radiographs. 2 patients presented with periprosthetic fractures treated conservatively. 2 patients presented with infection treated without implant removal and 1 patient presented with transient femoral palsy. Conclusions: The results of this consecutive series confirmed the good performance of the cemented dual mobility cup at mean 7.7 years follow-up with no revision and no dislocations.

Excellent mid-term outcomes with a hemispheric titanium porous-coated acetabular component for total hip arthroplasty: 7–10 year follow-up

2021 ◽  
pp. 112070002110401
Author(s):  
David Yeroushalmi ◽  
Vivek Singh ◽  
Nolan Maher ◽  
Jonathan A Gabor ◽  
Joseph D Zuckerman ◽  
...  
Keyword(s):  
Survival Rate ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Acetabular Cup ◽  
Tertiary Referral Centre ◽  
Survivorship Analysis ◽  
Total Hip ◽  
Kaplan Meier ◽  
Wide Range

Introduction: Third-generation hemispheric, titanium porous-coated (HTPC) acetabular cups have been shown to achieve good biologic fixation through enhanced porous ingrowth surfaces. They also allow for a wide range of bearing options, including polyethylene, dual-mobility, and ceramic liners. The purpose of the study is to review the mid-term clinical outcomes an HTPC acetabular cup with a minimum of 7-year follow-up. Methods: A retrospective, observational study was conducted on all consecutive patients who underwent total hip arthroplasty (THA) with an HTCP acetabular cup at an urban, tertiary referral centre. Descriptive statistics were used describe baseline patient characteristics. Outcomes collected included postoperative complications, survival free of reoperations, and presence of osteolysis at latest imaging follow-up. Implant survival was analysed using the Kaplan-Meier method. Results: 118 cases (114 primary, 4 revision) underwent THA with the HTCP acetabular cup at an average follow-up of 8.16 ± 0.85 years (range 7.02–10.28 years). Mean patient age at the time of surgery was 61.29 ± 12.04 years. All cases utilised a high-molecular-weight polyethylene (HMWPE) liner. None of the acetabular cups showed loosening or migration at the latest follow-up. There were 2 revisions in our study, 1 for abductor mechanism disruption and 1 due to surgical site infection where the acetabular cup was revised. Kaplan-Meier survivorship analysis for all-cause revision at 7 and 10-year follow-up showed a survival rate of 99.1% (95% confidence interval, 94.1–99.9%). Survivorship analysis for aseptic acetabular revision at 10-year follow-up showed a survival rate of 100%. Conclusions: At long-term follow-up, no radiologic and minimal clinical complications were identified in this series. The HTPC acetabular cup system, used in conjunction with a HMWPE liner, demonstrates excellent outcomes and survivorship when compared to earlier mid-term studies published in the literature.

Clinical Results and Radiologic Findings Four to Eight Years after Total Hip Replacement with the Link RS Endoprosthesis System

1994 ◽  
Vol 4 (3-4) ◽  
pp. 137-142
Author(s):  
S. Savilahti ◽  
I. Myllyneva ◽  
K.J.J. Pajamäki ◽  
J. Nevalainen ◽  
T.S. Lindholm
Keyword(s):  
Clinical Results ◽  
Survivorship Analysis ◽  
Hip Prostheses ◽  
Total Hip ◽  
Probability Of Survival ◽  
Radiologic Findings ◽  
Kaplan Meier ◽  
Total Hip Prostheses ◽  
Component Migration

A total of 102 uncemented Link Rippen System (RS) total hip prostheses were implanted in 100 patients whose mean age was 57 years. The Merle d'Aubigné hip score was 9.3 preoperatively and 15.3 at the latest follow-up. The thigh was painful in 56 per cent; 5 per cent had moderate or severe pain. Forty-five per cent of patients had a slight limp and 9 per cent a severe limp at the most recent follow-up. Fifteen per cent still needed a cane. A Kaplan-Meier survivorship analysis revealed a 74 per cent probability of survival at 6 years. Serial radiographic evaluations revealed that 16 per cent of patients (non-revised hips) had acetabular component migration, 10 per cent had continuous femoral radiolucen-cies, 14 per cent had subsidence and 31 per cent progressive varus migration.

Sign in / Sign up

Export Citation Format

Share Document