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Dual Mobility Cups as the Routine Choice in Total Hip Arthroplasty

Background and Objectives: Total hip arthroplasty (THA) is considered the most successful surgical procedure in orthopedics. However, dislocation remains the main indication for surgical revision. New designs of dual mobility cups (DMC) have lowered the classical complications and have extended the...

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Autores principales: Aguado-Maestro, Ignacio, de Blas-Sanz, Inés, Sanz-Peñas, Ana Elena, Campesino-Nieto, Silvia Virginia, Diez-Rodríguez, Jesús, Valle-López, Sergio, Espinel-Riol, Alberto, Fernández-Díez, Diego, García-Alonso, Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9029134/
https://www.ncbi.nlm.nih.gov/pubmed/35454367
http://dx.doi.org/10.3390/medicina58040528
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author Aguado-Maestro, Ignacio
de Blas-Sanz, Inés
Sanz-Peñas, Ana Elena
Campesino-Nieto, Silvia Virginia
Diez-Rodríguez, Jesús
Valle-López, Sergio
Espinel-Riol, Alberto
Fernández-Díez, Diego
García-Alonso, Manuel
author_facet Aguado-Maestro, Ignacio
de Blas-Sanz, Inés
Sanz-Peñas, Ana Elena
Campesino-Nieto, Silvia Virginia
Diez-Rodríguez, Jesús
Valle-López, Sergio
Espinel-Riol, Alberto
Fernández-Díez, Diego
García-Alonso, Manuel
author_sort Aguado-Maestro, Ignacio
collection PubMed
description Background and Objectives: Total hip arthroplasty (THA) is considered the most successful surgical procedure in orthopedics. However, dislocation remains the main indication for surgical revision. New designs of dual mobility cups (DMC) have lowered the classical complications and have extended the indications of DMC in elective surgeries. Our aim is to assess the trend of DMC indications in THA as well as the incidence of their dislocation. Materials and Methods: We retrospectively reviewed all patients undergoing THA with DMC during the years 2015 and 2021. The original indication for DMC included patients sustaining neck of femur fractures (NOF#) and associated risk factors for dislocations. Five years later, DMC was considered our standard of care in total hip arthroplasty. The approach (anterolateral or posterolateral) was chosen by the surgeon according to his/her preferences, as was the implant. Data collected included patients’ demographics, diagnosis, admission time, surgical approach, cup models, and inclination and complications. Patients sustaining a hip dislocation were prospectively reviewed and assessed for treatment received, new dislocations, and need for surgical revision. Two groups were created for the analysis according to the presence or absence of dislocation during follow-up. Results: In the analysis, 531 arthroplasties were included (mean age 72.2 years) with a mean follow-up of 2.86 years. The trend of indications for DMC increased from 16% of THA in 2015 to 78% of THA in 2021. We found a total of 8 dislocations (1.5%), none of them associated with elective surgery. Closed reduction was unsatisfactory in four cases (50%). There was one case of intraprosthetic dislocation. Dislocations were associated to smaller heads (22 mm) (1.5% vs. 25%, p = 0.008) and cups (51.2 mm vs. 48.7 mm, p = 0.038) and posterior approach (62.5% vs. 37.5%, p = 0.011). Conclusion: Dual mobility cups are a great option to reduce the risk of dislocation after a THA both in the neck of femur fractures and elective cases. The use of an anterolateral approach in THA after a neck or femur fracture might considerably decrease the risk of dislocation.
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spelling pubmed-90291342022-04-23 Dual Mobility Cups as the Routine Choice in Total Hip Arthroplasty Aguado-Maestro, Ignacio de Blas-Sanz, Inés Sanz-Peñas, Ana Elena Campesino-Nieto, Silvia Virginia Diez-Rodríguez, Jesús Valle-López, Sergio Espinel-Riol, Alberto Fernández-Díez, Diego García-Alonso, Manuel Medicina (Kaunas) Article Background and Objectives: Total hip arthroplasty (THA) is considered the most successful surgical procedure in orthopedics. However, dislocation remains the main indication for surgical revision. New designs of dual mobility cups (DMC) have lowered the classical complications and have extended the indications of DMC in elective surgeries. Our aim is to assess the trend of DMC indications in THA as well as the incidence of their dislocation. Materials and Methods: We retrospectively reviewed all patients undergoing THA with DMC during the years 2015 and 2021. The original indication for DMC included patients sustaining neck of femur fractures (NOF#) and associated risk factors for dislocations. Five years later, DMC was considered our standard of care in total hip arthroplasty. The approach (anterolateral or posterolateral) was chosen by the surgeon according to his/her preferences, as was the implant. Data collected included patients’ demographics, diagnosis, admission time, surgical approach, cup models, and inclination and complications. Patients sustaining a hip dislocation were prospectively reviewed and assessed for treatment received, new dislocations, and need for surgical revision. Two groups were created for the analysis according to the presence or absence of dislocation during follow-up. Results: In the analysis, 531 arthroplasties were included (mean age 72.2 years) with a mean follow-up of 2.86 years. The trend of indications for DMC increased from 16% of THA in 2015 to 78% of THA in 2021. We found a total of 8 dislocations (1.5%), none of them associated with elective surgery. Closed reduction was unsatisfactory in four cases (50%). There was one case of intraprosthetic dislocation. Dislocations were associated to smaller heads (22 mm) (1.5% vs. 25%, p = 0.008) and cups (51.2 mm vs. 48.7 mm, p = 0.038) and posterior approach (62.5% vs. 37.5%, p = 0.011). Conclusion: Dual mobility cups are a great option to reduce the risk of dislocation after a THA both in the neck of femur fractures and elective cases. The use of an anterolateral approach in THA after a neck or femur fracture might considerably decrease the risk of dislocation. MDPI 2022-04-09 /pmc/articles/PMC9029134/ /pubmed/35454367 http://dx.doi.org/10.3390/medicina58040528 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Aguado-Maestro, Ignacio
de Blas-Sanz, Inés
Sanz-Peñas, Ana Elena
Campesino-Nieto, Silvia Virginia
Diez-Rodríguez, Jesús
Valle-López, Sergio
Espinel-Riol, Alberto
Fernández-Díez, Diego
García-Alonso, Manuel
Dual Mobility Cups as the Routine Choice in Total Hip Arthroplasty
title Dual Mobility Cups as the Routine Choice in Total Hip Arthroplasty
title_full Dual Mobility Cups as the Routine Choice in Total Hip Arthroplasty
title_fullStr Dual Mobility Cups as the Routine Choice in Total Hip Arthroplasty
title_full_unstemmed Dual Mobility Cups as the Routine Choice in Total Hip Arthroplasty
title_short Dual Mobility Cups as the Routine Choice in Total Hip Arthroplasty
title_sort dual mobility cups as the routine choice in total hip arthroplasty
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9029134/
https://www.ncbi.nlm.nih.gov/pubmed/35454367
http://dx.doi.org/10.3390/medicina58040528
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