Cementation of a Dual Mobility Cup in a Fixed Uncemented Cup for the Treatment of Recurrent Dislocation. Short-term Result
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Published:
Oct 24, 2022
Keywords:
Double mobility, total hip replacement, recurrent dislocation
Main Article Content
Abstract
Introduction: Total hip replacement (THR) is the most successful arthroplasty to date, not exempt from complications, such as prosthetic instability. Double mobility (DM) cups are a treatment option in the resolution of THR with recurrent dislocations due to instability. The objective of the study was to evaluate the results of cementing a DM component in a previous, stable uncemented cup, in a patient with recurrent dislocation, undergoing revision THR. A patient with uncemented THR with distal fixation after failedosteosynthesis, who presented episodes of recurrent dislocations, was treated by revision with a cemented DM implant inside a fixed uncemented primary cup and a proximal femoral module with extended offset, preserving tension, length and reducibility of the prosthesis. Resolution of the prosthetic instability was achieved and the patient did not present any episodes of dislocation, obtaining good outcomes in the short term. The hip Harris score went from 4/80 preoperatively to 61/80, 73/80, and 76/80 evaluated at 3, 6, and 9 months postoperatively, respectively.
Conclusion: Cementation of a DM cup in a previously well-fixed cup appears to be a viable option to treat and prevent instability after revision THR.
Conclusion: Cementation of a DM cup in a previously well-fixed cup appears to be a viable option to treat and prevent instability after revision THR.
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How to Cite
Vega, C. A., Moruno, F., & Beleño, M. (2022). Cementation of a Dual Mobility Cup in a Fixed Uncemented Cup for the Treatment of Recurrent Dislocation. Short-term Result. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(5), 703-714. https://doi.org/10.15417/issn.1852-7434.2022.87.5.1590
Section
Case Presentations
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References
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20. Rogers M, Blom AW, Barnett A, et al. Revision for recurrent dislocation of total hip replacement. Hip Int
2009;19:109-13.
21. Hartzler MA, Abdel MP, Sculco PK, et al. Otto Aufranc award: dual-mobility constructs in revision THA reduced
dislocation, rerevision, and reoperation compared with large femoral heads. Clin Orthop Relat Res 2018;476:293-
301. https://doi.org/10.1007/s11999.0000000000000035
22. Brüggemann A, Mallmin H, Hailer NP. Do dual-mobility cups cemented into porous tantalum shells reduce the risk of dislocation after revision surgery? Acta Orthop 2018;89:156-62.
23. Boulat S, Neri T, Boyer B, Philippot R, Farizon F. Dual mobility cups in total hip arthroplasty after failed internal fixation of proximal femoral fractures. Orthop Traumatol Surg Res 2019;105(3):491-5.
https://doi.org/10.1016/j.otsr.2019.01.014
24. Favreaua H, Ehlinger M, Adam P, Bonnomet F. Total hip arthroplasty with exclusive use of dual-mobility cup after failure of internal fixation in trochanteric fracture. Orthop Traumatol Surg Res 2020;106(4):645-9.
https://doi.org/10.1016/j.otsr.2020.02.011
25. Smith A, Denehy K, Ong KL, Lau E, Hagan D, et al. Total hip arthroplasty following failed intertrochanteric hip
fracture fixation treated with a cephalomedullary nail. Bone Joint J 2019;101-B(6_Supple_B):91-6.
https://doi.org/10.1302/0301-620X.101B6.BJJ-2018-1375.R1
(9597): 1508-19. https://doi.org/10.1016/S0140-6736(07)60457-7
2. Vajapey SP, Fideler KL, Lynch D, Li M. Use of dual mobility components in total hip arthrop: Indications and
outcomes. J Clin Orthop Trauma 2020;11(Suppl 5):S760-5. https://doi.org/10.1016/j.jcot.2020.07.035
3. Prudhon JL, Ferreira F, Verdier R. Dual mobility cup: Dislocation rate and survivorship at ten years of follow-up. Int Orthop 2013;37(12):2345-50. https://doi.org/10.1007/s00264-013-2067-2
4. Carter AH, Sheehan EC, Mortazavi SM, Purtill JJ, Sharkey PF, et al. Revision for recurrent instability: what are the predictors of failure? J Arthroplasty 2011;26(6 Suppl):46-52. https://doi.org/10.1016/j.arth.2011.03.021
5. Wetters NG, Muray TG, Moric M, Sporer SM, Paprosky WG, et al. Risk factors for dislocation after revisión total
hip arthroplasty. Clin Orthop Relat Res 2013;471(2):410-6. https://doi.org/10.1007/s11999-012-2561-7
6. Garbuz DS, Masri BA, Duncan CP, et al. The Frank Stinchfield award: Dislocation in revisión THA: Do large
heads (36 and 40mm) result in reduced dislocation rates in a randomized clinical trial? Clin Orthop Relat Res
2012;470(2):351-6. https://doi.org/10.1007/s11999-011-2146-x
7. Della Valle CJ, Chang D, Sporer S, Berger RA, Rosenberg AG, et al. High failure rateo f constrained acetabular liner in revisión total hip arthroplasty. J Arthroplasty 2005;20(Suppl. 3):103-7. https://doi.org/10.1016/j.arth.2005.05.005
8. Philippot R, Adam P, Reckhaus M, Verdot FX, G Curvale G, et al. Prevention of dislocation in total hip revisión
surgery using a dual mobility design. Orthop Traumatol Surg Res 2009;95(6):407-13. https://doi.org/10.1016/j.otsr.2009.04.016
9. Mohaddes M, Cnudde P, Rolfson O, Wall, Kärrholm J. Use of dual mobility cup in revision hip arthroplasty reduces the risk for further dislocation: analysis of seven hundred and ninety-one first-time revisions performed due to dislocation, reported to the Swedish Hip Arthroplasty Register. Int Orthop 2017;41(3):583-8.
https://doi.org/10.1007/s00264-016-3381-2
10. Moreta J, Uriarte I, Foruria X, Urra U, Aguirre U, et al. Cementation of a dual-mobility cup into a well-fixed
cementless Shell in patients with high risk of dislocation of dislocation undergoing revision total hip arthroplasty.
Hip Int 2021;31(1):97-102. https://doi.org/10.1177/1120700019873617
11. Vielpeau C, Lebel B, Ardouin L, Burdin G, Lautridou C. The dual mobility socket concept: experience with 668
cases. Int Orthop 2011;35(2):225-30. https://doi.org/10.1007/s00264-010-1156-8
12. Liaw CK, Hou SM, Yang RS, et al. A new tool for measuring cup orientation in total hip arthroplasties from plain radiographs. Clin Orthop Relat Res. 2006;451:134-9.
13. Bonner KF, Delanois RE, Harbach G, Bushelow M, Mont MA. Cementation of a polyethylene liner into a metal
shell. Factors related to mechanical stability. J Bone Joint Surg Am 2002;84-A:1587-93. https://doi.org/10.2106/00004623-200209000-00011
14. Engh Ch, Massin P, Suther K. Roentgenographic assesment of biologic fixation of porous-surface femoral
components. Clin Orthop Relat Res 1990;257:107-28. PMID: 2199114.
15. Huddleston JI III, Tetreault MW, Yu M, Bedair H, Hansen VJ, et al. Is there a benefit to modularity in “simpler”
femoral revisions? Clin Orthop Rel Res 2016;474:415-20. https://doi.org/10.1007/s11999-015-4474-8
16. Bellova P, Koch F, Stiehler M, Hartmann A, Fritzsche H, Günther KP, Goronzy J. Cementation of a dual mobility
cup in a well-fixed acetabular component a reliable option in revision total hip arthroplasty? BMC Musculoskelet
Disord 2021;22:982 https://doi.org/10.1186/s12891-021-04835-z
17. Wegrzyn J, Saugy CA, Guyen O, Antoniadis A. Cementation of a dual mobility cup into an existing well-fixed metal shell: a reliable option to manage wear-related recurrent dislocation in patients with high surgical. J Arthroplasty 2020;35(9):2561-66. https://doi.org/10.1016/j.arth.2020.05.001
18. Lange JK, Spiro SK, Westrich GH. Utilizing dual mobility components for first-time revisión total hip arthroplasty for instability. J Arthroplasty 2018;33(2):505-9. https://doi.org/10.1016/j.arth.2017.09.029
19. Wera GD, Ting NT, Moric M, Paprosky WG, Sporer SM, et al. Classification and management of the unstable total hip arthroplasty. J Arthroplasty 2012;27(5):710-5. https://doi.org/10.1016/j.arth.2011.09.010
20. Rogers M, Blom AW, Barnett A, et al. Revision for recurrent dislocation of total hip replacement. Hip Int
2009;19:109-13.
21. Hartzler MA, Abdel MP, Sculco PK, et al. Otto Aufranc award: dual-mobility constructs in revision THA reduced
dislocation, rerevision, and reoperation compared with large femoral heads. Clin Orthop Relat Res 2018;476:293-
301. https://doi.org/10.1007/s11999.0000000000000035
22. Brüggemann A, Mallmin H, Hailer NP. Do dual-mobility cups cemented into porous tantalum shells reduce the risk of dislocation after revision surgery? Acta Orthop 2018;89:156-62.
23. Boulat S, Neri T, Boyer B, Philippot R, Farizon F. Dual mobility cups in total hip arthroplasty after failed internal fixation of proximal femoral fractures. Orthop Traumatol Surg Res 2019;105(3):491-5.
https://doi.org/10.1016/j.otsr.2019.01.014
24. Favreaua H, Ehlinger M, Adam P, Bonnomet F. Total hip arthroplasty with exclusive use of dual-mobility cup after failure of internal fixation in trochanteric fracture. Orthop Traumatol Surg Res 2020;106(4):645-9.
https://doi.org/10.1016/j.otsr.2020.02.011
25. Smith A, Denehy K, Ong KL, Lau E, Hagan D, et al. Total hip arthroplasty following failed intertrochanteric hip
fracture fixation treated with a cephalomedullary nail. Bone Joint J 2019;101-B(6_Supple_B):91-6.
https://doi.org/10.1302/0301-620X.101B6.BJJ-2018-1375.R1