Moussa Hamadouche1, David J Biau, Denis Huten, Thierry Musset, François Gaucher. 1. The Clinical Orthopaedic Research Centre, Department of Reconstructive and Orthopaedic Surgery, Service A, Centre Hospitalo-Universitaire Cochin-Port Royal, Université René Descartes, Hôpital Cochin (AP-HP), 75014, Paris, France. moussah@club-internet.fr
Abstract
BACKGROUND: The treatment of recurrent dislocation after total hip arthroplasty remains challenging. Dual mobility sockets have been associated with a low rate of dislocation but it is not known whether they are useful for treating recurrent dislocation. QUESTIONS/PURPOSES: We therefore asked whether a cemented dual mobility socket would (1) restore hip stability following recurrent dislocation; (2) provide a pain-free and mobile hip; and (3) show durable radiographic fixation. METHODS: We retrospectively reviewed 51 patients treated with a cemented dual mobility socket for recurrent dislocation after total hip arthroplasty between August 2002 and June 2005. The mean age at the time of the index procedure of was 71.3 years. Of the 51 patients, 47 have had complete clinical and radiographic evaluation data at a mean followup of 51.4 months (range, 25-76.3 months). RESULTS: The cemented dual mobility socket restored complete stability of the hip in 45 of the 47 patients (96%). The mean Merle d'Aubigné hip score was 16 ± 2 at the latest followup. Radiographic analysis revealed no or radiolucent lines less than 1 mm thick located in a single acetabular zone in 43 of 47 hips (91.5%). The cumulative survival rate of the acetabular component at 72 months using revision for dislocation and/or mechanical failure as the end point was 96% ± 4% (95% confidence interval, 90%-100%). CONCLUSIONS: A cemented dual mobility socket was able to restore hip stability in 96% of recurrent dislocating hips. However, longer-term followup is needed to ensure that dislocation and loosening rates will not increase.
BACKGROUND: The treatment of recurrent dislocation after total hip arthroplasty remains challenging. Dual mobility sockets have been associated with a low rate of dislocation but it is not known whether they are useful for treating recurrent dislocation. QUESTIONS/PURPOSES: We therefore asked whether a cemented dual mobility socket would (1) restore hip stability following recurrent dislocation; (2) provide a pain-free and mobile hip; and (3) show durable radiographic fixation. METHODS: We retrospectively reviewed 51 patients treated with a cemented dual mobility socket for recurrent dislocation after total hip arthroplasty between August 2002 and June 2005. The mean age at the time of the index procedure of was 71.3 years. Of the 51 patients, 47 have had complete clinical and radiographic evaluation data at a mean followup of 51.4 months (range, 25-76.3 months). RESULTS: The cemented dual mobility socket restored complete stability of the hip in 45 of the 47 patients (96%). The mean Merle d'Aubigné hip score was 16 ± 2 at the latest followup. Radiographic analysis revealed no or radiolucent lines less than 1 mm thick located in a single acetabular zone in 43 of 47 hips (91.5%). The cumulative survival rate of the acetabular component at 72 months using revision for dislocation and/or mechanical failure as the end point was 96% ± 4% (95% confidence interval, 90%-100%). CONCLUSIONS: A cemented dual mobility socket was able to restore hip stability in 96% of recurrent dislocating hips. However, longer-term followup is needed to ensure that dislocation and loosening rates will not increase.
Authors: Devon D Goetz; Barron R B Bremner; John J Callaghan; William N Capello; Richard C Johnston Journal: J Bone Joint Surg Am Date: 2004-11 Impact factor: 5.284