2023, Number 4
<< Back Next >>
Acta Ortop Mex 2023; 37 (4)
Clinical results in hip replacement surgery with mild acetabular defects: a retrospective comparative study of cups with dual mobility and monopolar cups
Marquina-Moraleda V, Diranzo J, Estrems V, Marco L, Jara F, Hernández L
Language: Spanish
References: 24
Page: 221-226
PDF size: 202.32 Kb.
ABSTRACT
Introduction: hip revision arthroplasty surgery is a surgical procedure that has been growing in recent years. Revision total hip arthroplasty (THA) is a notable surgical challenge due to the technical difficulty of the surgery itself. Complications of revision surgery includes dislocation, aseptic loosening, and infection.
Objective: to compare the clinical-radiological results, as well as the incidence of complications, of two independent samples of patients who underwent revision total hip arthroplasty (rTHA) with mild-moderate acetabular defects using dual mobility implants compared to monopolar implants.
Material and methods: retrospective comparative study of two cohorts of 30 patients who underwent acetabular revision surgery using large 36 mm monopolar heads or dual mobility respectively. All patients had Paprosky type I or II acetabular defects. The results on the VAS scale, WOMAC, and Harry hip score (HHS) were evaluated pre and postoperatively in both cohorts. Likewise, the incidence of postoperative complications and the survival rate between both groups were analyzed.
Results: mean follow-up was 5.8 years (1-10.3 years). The difference between the pre and postoperative results in each cohort was significant for the VAS, WOMAC and HHS scale. The differences obtained in these scales between the different study groups did not find significant differences. The incidence of postoperative complications between both cohorts was similar, without finding significant differences.
Conclusions: we consider that dual mobility does not provide superiority in terms of clinical-functional results and incidence of postoperative complications with respect to monopolar assemblies in acetabular revision surgery with mild-moderate defects.
REFERENCES
Schmidt A, Batailler C, Fary C, Servien E, Lustig S. Dual mobility cups in revision total hip arthroplasty: efficient strategy to decrease dislocation risk. J Arthroplasty. 2020; 35(2): 500-7.
Badarudeen S, Shu AC, Ong KL, Baykal D, Lau E, Malkani AL. Complications after revision total hip arthroplasty in the medicare population. J Arthroplasty. 2017; 32(6): 1954-8.
Viste A, Desmarchelier R, Fessy MH. Dual mobility cups in revision total hip arthroplasty. Int Orthop. 2017; 41(3): 535-42.
Schneider L, Philippot R, Boyer B, Farizon F. Revision total hip arthroplasty using a reconstruction cage device and a cemented dual mobility cup. Orthop Traumatol Surg Res. 2011; 97(8): 807-13.
Civinini R, Carulli C, Matassi F, Nistri L, Innocenti M. A Dual-mobility cup reduces risk of dislocation in isolated acetabular revisions. Clin Orthop Relat Res. 2012; 470(12): 3542-8.
Paprosky WG, Perona PG, Lawrence JM. Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation. J Arthroplasty. 1994; 9(1): 33-44.
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988; 15(12): 1833-40.
Pardo C, Muñoz T, Chamorro C. Monitorización del dolor: Recomendaciones del grupo de trabajo de analgesia y sedación de la SEMICYUC. Med Intensiva. 2006; 30(8): 379-85.
Mahomed NN, Arndt DC, McGrory BJ, Harris WH. The Harris hip score: comparison of patient self-report with surgeon assessment. J Arthroplasty. 2001; 16(5): 575-80.
DeLee JG, Charnley J. Radiological demarcation of cemented sockets in total hip replacement. Clin Orthop. 1976; (121): 20-32.
Knight JL, Fujii K, Atwater R, Grothaus L. Bone-grafting for acetabular deficiency during primary and revision total hip arthroplasty. A radiographic and clinical analysis. J Arthroplasty. 1993; 8(4): 371-82.
Abdel MP, Miller LE, Hanssen AD, Pagnano MW. Cost analysis of dual-mobility versus large femoral head constructs in revision total hip arthroplasty. J Arthroplasty. 2019; 34(2): 260-4.
Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009; 91(1): 128-33.
Karrholm J, Rogmark C, Naucler E, Vinblad J, Mohaddes M, Rolfson O. Swedish hip arthroplasty register annual report 2018. 2019.
Aguado-Maestro I, de Blas-Sanz I, Sanz-Peñas AE, Campesino-Nieto SV, Diez-Rodríguez J, Valle-López S, et al. Dual mobility cups as the routine choice in total hip arthroplasty. Medicina (Kaunas). 2022; 58(4): 528.
Hernandez NM, Hinton ZW, Wu CJ, Lachiewicz PF, Ryan SP, Wellman SS. Is there a problem with modular dual mobility acetabular components in revision total hip arthroplasty at mid-term follow-up? Bone Joint J. 2021; 103-B(7 Supple B): 66-72.
French JMR, Bramley P, Scattergood S, Sandiford NA. Adverse reaction to metal debris due to fretting corrosion between the acetabular components of modular dual-mobility constructs in total hip replacement: a systematic review and meta-analysis. EFORT Open Rev. 2021; 6(5): 343-53.
Gkiatas I, Sharma AK, Greenberg A, Duncan ST, Chalmers BP, Sculco PK. Serum metal ion levels in modular dual mobility acetabular components: A systematic review. J Orthop. 2020; 21: 432-7.
Hartzler MA, Abdel MP, Sculco PK, Taunton MJ, Pagnano MW, Hanssen AD. 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(2): 293-301.
Wetters NG, Murray TG, Moric M, Sporer SM, Paprosky WG, Della Valle CJ. Risk factors for dislocation after revision total hip arthroplasty. Clin Orthop Relat Res. 2013; 471(2): 410-6.
Gonzalez AI, Bartolone P, Lubbeke A, Dupuis Lozeron E, Peter R, Hoffmeyer P, et al. Comparison of dual-mobility cup and unipolar cup for prevention of dislocation after revision total hip arthroplasty. Acta Orthop. 2017; 88(1): 18-23.
Plummer DR, Christy JM, Sporer SM, Paprosky WG, Della Valle CJ. Dual-mobility articulations for patients at high risk for dislocation. J Arthroplasty. 2016; 31(9 Suppl): 131-5.
Alberton GM, High WA, Morrey BF. Dislocation after revision total hip arthroplasty: an analysis of risk factors and treatment options. J Bone Joint Surg Am. 2002; 84(10): 1788-92.
De Martino I, Triantafyllopoulos GK, Sculco PK, Sculco TP. Dual mobility cups in total hip arthroplasty. World J Orthop. 2014; 5(3): 180-7.
EVIDENCE LEVEL
III