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Dislocation after Revision Total Hip Arthroplasty: A Comparison between Dual Mobility and Conventional Total Hip Arthroplasty

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Purpose: The objective of this study was to analyze the results from a cohort of patients who underwent a revision total hip arthroplasty (THA) using a dual mobility cup (DMC) implant. Materials and Methods: A retrospective review of revised THAs was conducted using the database from a single tertiary referral hospital. A total of 91 revision THAs from 91 patients were included in the study. There were 46 male hips and 45 female hips. The mean age was 56.3±14.6 years, and the mean follow-up period was 6.4± 5.9 years. In performance of revision THAs, the DMC implants were used in 18 hips (19.8%), and the conventional implants were used in 73 hips (80.2%). Results: During the follow-up period, three dislocations were identified, and the overall dislocation rate was 3.3%. Early dislocation (at one month postoperatively) occurred in one patient, while late dislocation (at a mean of 7.5 years) occurred in two patients. There was no occurrence of dislocation in the DMC group (0%), and three dislocations were detected in the conventional group (4.1%). However, no significant difference in the rate of dislocation was observed between the two groups (P=0.891). Conclusion: Although the rate of dislocation was higher in the conventional group, there were no statistically significant differences between the two groups due to the small number of patients. Nevertheless, we believe that the dual mobility design is advantageous in terms of reducing dislocation rate and can be recommended as an option for a revision THA.

Abstract

Purpose: The objective of this study was to analyze the results from a cohort of patients who underwent a revision total hip arthroplasty (THA) using a dual mobility cup (DMC) implant. Materials and Methods: A retrospective review of revised THAs was conducted using the database from a single tertiary referral hospital. A total of 91 revision THAs from 91 patients were included in the study. There were 46 male hips and 45 female hips. The mean age was 56.3±14.6 years, and the mean follow-up period was 6.4± 5.9 years. In performance of revision THAs, the DMC implants were used in 18 hips (19.8%), and the conventional implants were used in 73 hips (80.2%). Results: During the follow-up period, three dislocations were identified, and the overall dislocation rate was 3.3%. Early dislocation (at one month postoperatively) occurred in one patient, while late dislocation (at a mean of 7.5 years) occurred in two patients. There was no occurrence of dislocation in the DMC group (0%), and three dislocations were detected in the conventional group (4.1%). However, no significant difference in the rate of dislocation was observed between the two groups (P=0.891). Conclusion: Although the rate of dislocation was higher in the conventional group, there were no statistically significant differences between the two groups due to the small number of patients. Nevertheless, we believe that the dual mobility design is advantageous in terms of reducing dislocation rate and can be recommended as an option for a revision THA.

참고문헌 (12)

  1. GREGORY M. ALBERTON, "DISLOCATION AFTER REVISION TOTAL HIP ARTHROPLASTY", The Journal of Bone and Joint Surgery-American Volume, 84(10), pp.1788~1792 (2002), Ovid Technologies (Wolters Kluwer Health)[DOI]
  2. Nathan G. Wetters, "Risk Factors for Dislocation After Revision Total Hip Arthroplasty", Clinical Orthopaedics & Related Research, 471(2), pp.410~416 (2013), Ovid Technologies (Wolters Kluwer Health)[DOI]
  3. Steven T. Woolson, "Risk factors for dislocation during the first 3 months after primary total hip replacement", The Journal of Arthroplasty, 14(6), pp.662~668 (1999), Elsevier BV[DOI]
  4. Kevin J Bozic, "The Epidemiology of Revision Total Hip Arthroplasty in the United States", The Journal of Bone and Joint Surgery-American Volume, 91(1), pp.128~133 (2009), Ovid Technologies (Wolters Kluwer Health)[DOI]
  5. R. Philippot, "Prevention of dislocation in total hip revision surgery using a dual mobility design", Orthopaedics & Traumatology: Surgery & Research, 95(6), pp.407~413 (2009), Elsevier BV[DOI]
  6. Parvizi J, "Revision total hip arthroplasty for instability : surgical techniques and principles", J Bone Joint Surg Am, 90, pp.1134~1142 (2008)
  7. Bertrand Boyer, "Primary total hip arthroplasty with dual mobility socket to prevent dislocation: a 22-year follow-up of 240 hips", International Orthopaedics, 36(3), pp.511~518 (2011), Springer Science and Business Media LLC[DOI]
  8. Molly A. Hartzler, "Otto Aufranc Award: Dual-mobility Constructs in Revision THA Reduced Dislocation, Rerevision, and Reoperation Compared With Large Femoral Heads", Clinical Orthopaedics & Related Research, 476(2), pp.293~301 (2018), Ovid Technologies (Wolters Kluwer Health)[DOI]
  9. Brian P. Chalmers, "Conversion of Hip Hemiarthroplasty to Total Hip Arthroplasty Utilizing a Dual-Mobility Construct Compared With Large Femoral Heads", The Journal of Arthroplasty, 32(10), pp.3071~3075 (2017), Elsevier BV[DOI]
  10. Nicolas Reina, "Dual-Mobility Constructs in Primary and Revision Total Hip Arthroplasty: A Systematic Review of Comparative Studies", The Journal of Arthroplasty, 34(3), pp.594~603 (2019), Elsevier BV[DOI]
  11. I. De Martino, "Dislocation following total hip arthroplasty using dual mobility acetabular components", The Bone & Joint Journal, 99-B(1_Supple_A), pp.18~24 (2017), British Editorial Society of Bone & Joint Surgery[DOI]
  12. Ji-hyo Hwang, "Dislocations after use of dual-mobility cups in cementless primary total hip arthroplasty: prospective multicentre series", International Orthopaedics, 42(4), pp.761~767 (2017), Springer Science and Business Media LLC[DOI]

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