scholarly journals Dual-Mobility Cup Total Hip Arthroplasty for Displaced Femoral Neck Fractures: A Retrospective Study With a Median Follow-Up of 5 Years

2021 ◽  
Vol 12 ◽  
pp. 215145932110132
Author(s):  
Zhenfa Zhang ◽  
Guixing Xu ◽  
Lei Cao ◽  
Wei Sun ◽  
Xianshang Zeng ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Complication Rate ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Dual Mobility Cup ◽  
Dual Mobility ◽  
Total Hip

Introduction: Patient outcomes following modern dual-mobility cup total hip arthroplasty (DM-THA) remains a concern. Few reports have focused on the use of modern DM-THA in the setting of Asian populations for displaced osteoporotic femoral neck fractures (FNFs). This study aimed to investigate the outcomes of Chinese population with displaced osteoporotic FNFs initially treated with modern DM-THA. Materials and Methods: Data from 112 consecutive patients (112 hips) with displaced osteoporotic FNFs initially treated with modern DM-THA during 2011-2018 were retrospectively analyzed. Follow-ups were performed at 3 months, 6 months, 12 months, and then every 1 year after surgery. The primary endpoint was the Harris Hip Score (HHS); the secondary endpoint was the main orthopedic complication rate. Results: The mean HHS improved from 58.62 (±15.79) prior to surgery to 86.13 (±9.92) at the final follow-up. The main complication rate was 14.2% (16/112). Sixteen complications in 10 patients were recorded. Of the 16 complications, there were 2 (1.7%) cases requiring revision DM-THA, 3 (2.6%) cases of loosening, 2 (1.7%) cases of migration, 3 (2.6%) intra-prosthetic dislocation (IPD), 4 (3.5%) cases of tilting, and 2 (1.7%) cases of severe wear. The need for revision was attributed to prosthesis loosening associated with poor bony quality. Conclusion: In patients with displaced osteoporotic FNFs, DM-THA may yield favorable functional outcomes and a low rate of main orthopedic complications, in particular, a low dislocation rate.

scholarly journals Preliminary Results of Total Hip Arthroplasty in Subjects at Risk for Dislocation Using a Novel Modular Cementless Dual-Mobility Cup. A Single-Center Prospective Study

Prosthesis ◽  
2021 ◽  
Vol 3 (1) ◽  
pp. 53-60
Author(s):  
Giuseppe Solarino ◽  
Filippo Simone ◽  
Antonello Panella ◽  
Arianna Carlet ◽  
Flavia Riefoli ◽  
...  
Keyword(s):  
At Risk ◽  
Total Hip Arthroplasty ◽  
Prospective Study ◽  
Hip Arthroplasty ◽  
Mean Value ◽  
Harris Hip Score ◽  
Dual Mobility Cup ◽  
Dual Mobility ◽  
Total Hip

Nowadays total hip arthroplasty (THA) is widely considered the operation of the century in orthopedic and traumatological fields. Despite this fact, instability and dislocation after THA are a common reason for revision surgery. The purpose of this prospective study is to evaluate the preliminary clinical and radiological results of a novel dual mobility cup. We evaluated 32 consecutive cases of patients who underwent THA using a novel dual mobility cup—with holes in the cup, a modular metallic inlay and a crosslinked polyethylene. All of them were considered at risk of instability of the implant due to primary or concomitant diagnosis. The preoperative Harris hip score was 54.7 on average. At a minimum 2 years follow-up, the mean HHS raised up to a mean value of 88.4; this improvement was statistically significant (p < 0.0001). None of the patients enrolled in this study sustained a postoperative dislocation at a mean follow-up of 39.6 months. Furthermore, no patients sustained modular liner dissociation or an intraprosthetic dislocation. As such, survivorship free from dislocation was 100% at both 2 and 5 years. This study demonstrates that the modular dual mobility (DM) socket provides dual articulation, larger jump distance, and greater range of motion before impingement, which significantly reduce the rate of dislocation.

scholarly journals Revision Rates After Surgical Treatment for Femoral Neck Fractures: Results of 2-Year Follow-up

Medicina ◽  
2013 ◽  
Vol 49 (3) ◽  
pp. 22
Author(s):  
Jaunius Kurtinaitis ◽  
Narūnas Porvaneckas ◽  
Giedrius Kvederas ◽  
Tomas Butėnas ◽  
Valentinas Uvarovas
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Internal Fixation ◽  
Hip Arthroplasty ◽  
Revision Surgery ◽  
Femoral Neck Fractures ◽  
Total Hip ◽  
Significant Difference ◽  
Surgery Rates

Background and Objective. Intracapsular fractures of the femoral neck account for a major share of fractures in the elderly. Open reduction and internal fixation has been shown to have a higher rate of revision surgery than arthroplasty. The aim of this study was to assess and compare the rates of revision surgery performed after internal fixation and primary total hip arthroplasty. Material and Methods. Between 2004 and 2006, 681 intracapsular femoral neck fractures in 679 consecutive patients were treated with internal fixation or total hip arthroplasty at our institution. Revision surgery rates were evaluated at 1-, 3-, 6-, 12-, and 24-month follow-up. Results. There was no significant difference in the ratio of internal fixation to total hip arthroplasty during 2004–2006 (P=0.31). The mean rate of total hip arthroplasty was 19.1% with a lower rate being among patients younger than 60 years. Revision surgery rates at the 2-year followup were higher in the internal fixation group compared with total hip arthroplasty group (28.9% vs. 7.0%, P<0.001). Patients who underwent internal fixation were at a 4-fold greater risk of having revision surgery at the 2-year follow-up than those who underwent total hip arthroplasty (odds ratio, 4.11; 95% CI, 1.95–8.65; P<0.001). Age was a significant risk factor for revision surgery after total hip arthroplasty (hazard ratio, 0.93; 95% CI, 0.87–0.98; P=0.02), but not significant after the internal fixation (P=0.86). Conclusions. Higher revision surgery rates after internal fixation favors arthroplasty as a primary choice of treatment for the femoral neck fractures.

scholarly journals Comparing total hip arthroplasty and hemiarthroplasty for the treatment of displaced femoral neck fracture in the active elderly over 75 years old: a systematic review and meta-analysis of randomised control trials

2019 ◽  
Author(s):  
Liu Yijun ◽  
Chen Xiaokun ◽  
Zhang Peixun ◽  
Jiang Baoguo
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Hip Arthroplasty ◽  
Femoral Neck Fractures ◽  
Cochrane Library ◽  
Total Hip ◽  
Displaced Femoral Neck Fractures ◽  
Operation Rate

Abstract Background: Displaced femoral neck fractures (DFNF) are increasingly common in elderly patients. Repair of DFNF can be completed using two methods, hemiarthroplasty (HA) or total hip Arthroplasty (THA). However, there is much controversy regarding whether HA or THA is superior in active elderly patients over 75 years old. Methods: We conducted the literature search by searching PubMed, Embase, the Cochrane Library, ClinicalTrials.gov, and Web of Science from the inception dates to June 1, 2019. Randomised controlled trials (RCT) were included according to the inclusion and exclusion criteria. Included studies were analysed according to Cochrane review methods. Results: Nine studies met the inclusion criteria totalling 631 participants (301 THA and 330 HA）. Four of the studies conducted were identical to a previous study but look at different follow up measures. The analysis of previously collected data revealed that the THA group had a lower erosion rate, higher total pain and function HHS, and higher EQ-5Dindex. The re-operation rate was significantly lower in the THA group after five years of follow up after adding the patients with painful symptoms to the group of patients revised. However, THA had longer operative time and a higher dislocation rate in the first three years compared to the HA procedure. Moreover, there was an insignificant difference in mortality rate, general complications, wound infection, duration of hospital stay, and VTE prevalence among the two procedures. Conclusions: THA may be a preferred management option for active elderly patients over 75 years old, after careful evaluation of patients’ general condition and tolerance of surgery. Strict management and follow up protocols should be followed to prevent dislocation within the first three years following a THA. Trial registration: This study was registered at the International Prospective Register of Systematic Reviews (CRD42019139135). The date of registration is 16-06-2019. Keywords: displaced femoral neck fractures; total hip arthroplasty; hemiarthroplasty;

scholarly journals Dual mobility in primary total hip arthroplasty: current concepts

2019 ◽  
Vol 4 (11) ◽  
pp. 640-646 ◽  
Author(s):  
Rory Cuthbert ◽  
James Wong ◽  
Philip Mitchell ◽  
Parag Kumar Jaiswal
Keyword(s):  
High Risk ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
High Risk Patient ◽  
Femoral Neck Fractures ◽  
Risk Patient ◽  
Functional Improvement ◽  
Dual Mobility ◽  
Total Hip

Total hip arthroplasty (THA) is one of the most successful surgical procedures – reducing pain and providing functional improvement. However, THA instability is a disabling condition and remains the most common indication for revision THA. To combat the risk of instability, the concept of dual mobility (DM) was developed. This article provides a comprehensive review of DM in the literature. Widespread use of first-generation DM was limited due to concern regarding wear of the polyethylene head and the unique complication of intraprosthetic dislocation (IPD). Implant modifications using highly cross-linked, durable polyethylene and a smooth, cylindrical femoral neck have all but eliminated IPD in contemporary DM. In multiple studies, DM demonstrates statistically significant reductions in dislocation rates comparative to standard bearing primary THA. These results have been particular promising in high-risk patient populations and femoral neck fractures – where low dislocation rates and improved functional outcomes are a recurrent theme. From an economic perspective, DM is equally exciting – with lower accrued costs and higher accrued utility comparative to standard bearing THA. Longer-term clinical evidence and higher-quality prospective comparative studies are required to strengthen current research. Dual mobility may well represent the future gold standard for THA in high-risk patient populations and femoral neck fractures, but due diligence of long-term performance is needed before recommendations for widespread use can be justified. Cite this article: EFORT Open Rev 2019;4:640-646. DOI: 10.1302/2058-5241.4.180089

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 Uncemented versus cemented total hip arthroplasty for displaced femoral neck fractures in elderly patients with osteoporosis: A retrospective analysis

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094466
Author(s):  
Xiang Zhou ◽  
Meiji Chen ◽  
Weiguang Yu ◽  
Guowei Han ◽  
Junxing Ye ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Elderly Patients ◽  
Hip Arthroplasty ◽  
Periprosthetic Fracture ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Total Hip ◽  
The Mean ◽  
Cemented Total Hip Arthroplasty

Objective This study was performed assess the clinical outcomes of elderly patients with osteoporotic femoral neck fractures (FNFs) (AO/OTA: 31B/C) treated by initial uncemented total hip arthroplasty (UTA) or cemented total hip arthroplasty (CTA). Methods This study involved consecutive elderly patients with osteoporotic FNFs (AO/OTA: 31B/C) treated by initial UTA or CTA in our medical centre from 2010 to 2015. The primary outcomes were the Harris hip score (HHS) and the rates of revision, loosening, periprosthetic fracture, and dislocation. Results In total, 224 patients were included in the final analysis (UTA, n = 114; CTA, n = 110). The mean follow-up duration was 60 months (range, 32–68 months). The mean HHS was 75.34 ± 18.82 for UTA and 80.12 ± 17.83 for CTA. Significant dissimilarities were detected in the rates of revision, loosening, and periprosthetic fracture between UTA and CTA (14.0% vs. 5.5%, 20.2% vs. 10.0%, and 12.3% vs. 4.5%, respectively). A significant difference was also detected in the probability of revision between the two groups. Conclusion Elderly patients with osteoporotic FNFs (AO/OTA: 31B/C) treated with CTA show greater improvements in functional outcomes and key orthopaedic complications than those treated with UTA.

scholarly journals The usefulness of dual mobility cups in primary total hip arthroplasty patients at a risk of dislocation

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Nam Hoon Moon ◽  
Min Uk Do ◽  
Jung Shin Kim ◽  
Jae Seung Seo ◽  
Won Chul Shin
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Harris Hip Score ◽  
Dual Mobility ◽  
Total Hip ◽  
Early Results ◽  
Patient Reported ◽  
Primary Total Hip Arthroplasty

AbstractThis study aimed to evaluate the early results of primary total hip arthroplasty (THA) using dual mobility (DM) cups in patients at a risk of dislocation and compare them with that of fixed bearing (FB) THA. This retrospective study included patients who had undergone primary THA between January 2016 and December 2018 and were at a risk of dislocation. A propensity score-matched analysis was conducted for 63 THA procedures with vitamin-E infused highly cross-linked polyethylene (VEPE) DM bearing and 63 THA procedures performed with FB from the same manufacturer for a mean follow-up period of 3.1 and 3.5 years, respectively. The radiologic outcomes at the last follow-up and incidence of postoperative complications were evaluated and compared statistically between the two groups. The modified Harris hip score (mHHS) was used to assess patient-reported outcomes. Postoperative dislocation occurred in 4 cases (6.3%) in the FB group, but did not occur in the DM group (p = 0.042). There was no difference in the radiologic outcomes and postoperative complications between the two groups. The mHHS at the last follow-up showed satisfactory outcomes in both the groups (DM group, 90.5; FB group, 88.1), without a statistical difference between the groups. The early results of THA using VEPE DM bearing showed better outcomes than that of THA with FB for patients at a risk of dislocation. A longer follow-up period is recommended to assess the stability and overall outcomes.

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