Dual-mobility Tripod Cup for Revision Hip Arthroplasty: Long-term (five to Fourteen Years) Evaluation of a New Generation Cementless Implant

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2024 Mar 19

PMID 38499712

Authors

Aurelien Klein

Maxence Bordes

Anthony Viste

Michel Fessy

Affiliations

Soon will be listed here.

Abstract

Purpose: The aims of this study were to evaluate the survivorships of a new generation cementless DMC with tripod additional fixation in revision total hip arthroplasty and complications at a minimum five year follow-up.

Methods: One hundred and fifteen revisions (THA) treated with tripod DMC performed between 2009 and 2015 were included in this retrospective study. Acetabular defects were classified as Paprosky 1 (n = 38, 33%), 2 (n = 75, 65%) or 3 (n = 2, 2%). Unipolar or bipolar revision was performed for the following indications: aseptic acetabular loosening (63%), infection (14%), aseptic bipolar loosening (11%), instability (4%), aseptic femoral loosening (3%), ALVAL (3%) and iliopsoas impingement (2%). Mean follow-up was 9.4 years ± two (range, 5 to 14).

Results: At the final follow-up, a single episode of dislocation occurred within three months after the procedure (0.8%) with no revision. Three cases of aseptic loosening were diagnosed (2.6%). Four infections (3.5%) required reoperation: three required a two stage bipolar revision; one was treated by DAIR procedure. At the latest follow-up, the survivorship of the acetabular cup for aseptic loosening was 98% [95% CI (91.2-99.4)] and for any reasons was 94.4% [95% CI (90.1%-98.9%)]; the mean HHS improved from 60 points (range, 18-94 points) to 83 points (range, 37-100 points) (p < .001).

Conclusion: This study reports a low complication rate in favour of the use of a tripod DMC in revision THA with a satisfactory survivorship at a ten year follow-up.

References

Learmonth I, Young C, Rorabeck C . The operation of the century: total hip replacement. Lancet. 2007; 370(9597):1508-19. DOI: 10.1016/S0140-6736(07)60457-7. View

Kostensalo I, Seppanen M, Virolainen P, Mokka J, Koivisto M, Makela K . Acetabular reconstruction with impaction bone grafting and cemented polyethylene socket in total hip revision arthroplasty. Scand J Surg. 2015; 104(4):267-72. DOI: 10.1177/1457496914568408. View

Giacomo P, Giulia B, Valerio P, Vincenzo S, Pierluigi A . Dual mobility for total hip arthroplasty revision surgery: A systematic review and metanalysis. SICOT J. 2021; 7:18. PMC: 7984151. DOI: 10.1051/sicotj/2021015. View

Simian E, Chatellard R, Druon J, Berhouet J, Rosset P . Dual mobility cup in revision total hip arthroplasty: dislocation rate and survival after 5 years. Orthop Traumatol Surg Res. 2015; 101(5):577-81. DOI: 10.1016/j.otsr.2015.05.002. View

Combes A, Migaud H, Girard J, Duhamel A, Fessy M . Low rate of dislocation of dual-mobility cups in primary total hip arthroplasty. Clin Orthop Relat Res. 2013; 471(12):3891-900. PMC: 3825881. DOI: 10.1007/s11999-013-2929-3. View

Guyen O, Pibarot V, Vaz G, Chevillotte C, Bejui-Hugues J . Use of a dual mobility socket to manage total hip arthroplasty instability. Clin Orthop Relat Res. 2008; 467(2):465-72. PMC: 2628522. DOI: 10.1007/s11999-008-0476-0. View

Philippot R, Adam P, Reckhaus M, Delangle F, Verdot F, Curvale G . Prevention of dislocation in total hip revision surgery using a dual mobility design. Orthop Traumatol Surg Res. 2009; 95(6):407-13. DOI: 10.1016/j.otsr.2009.04.016. View

Delanois R, Gwam C, Mohamed N, Khlopas A, Chughtai M, Malkani A . Midterm Outcomes of Revision Total Hip Arthroplasty With the Use of a Multihole Highly-Porous Titanium Shell. J Arthroplasty. 2017; 32(9):2806-2809. DOI: 10.1016/j.arth.2017.03.065. View

Harwin S, Sultan A, Khlopas A, Chughtai M, Sodhi N, Piuzzi N . Mid-Term Outcomes of Dual Mobility Acetabular Cups for Revision Total Hip Arthroplasty. J Arthroplasty. 2018; 33(5):1494-1500. DOI: 10.1016/j.arth.2017.12.008. View

10.

Lian Y, Yoo M, Pei F, Kim K, Chun S, Cheng J . Cementless hemispheric acetabular component for acetabular revision arthroplasty: a 5- to 19-year follow-up study. J Arthroplasty. 2008; 23(3):376-82. DOI: 10.1016/j.arth.2007.03.018. View

11.

Geerdink C, Schaafsma J, Meyers W, Grimm B, Tonino A . Cementless hemispheric hydroxyapatite-coated sockets for acetabular revision. J Arthroplasty. 2007; 22(3):369-76. DOI: 10.1016/j.arth.2006.04.025. View

12.

Wegrzyn J, Tebaa E, Jacquel A, Carret J, Bejui-Hugues J, Pibarot V . Can Dual Mobility Cups prevent Dislocation in All Situations After Revision Total Hip Arthroplasty?. J Arthroplasty. 2014; 30(4):631-40. DOI: 10.1016/j.arth.2014.10.034. View

13.

Ameztoy Gallego J, Cruz Pardos A, Gomez Luque J, Cuadrado Rubio L, Fernandez Fernandez R . Dislocation and survival rate of dual mobility cups in revision total hip arthroplasty in patients with high risk of instability. Int Orthop. 2023; 47(7):1757-1764. DOI: 10.1007/s00264-023-05816-8. View

14.

Hernigou P, Tannyeres P, Barbier O, Chenaie P . Revision hip arthroplasty dislocation risk calculator: when to select dual mobility, large heads, constrained liners, or a standard head size? Testing one hundred thousand hip revisions with artificial intelligence. Int Orthop. 2023; 47(8):2003-2011. DOI: 10.1007/s00264-023-05856-0. View

15.

Hsu J, Chang C, Huang H, Zobitz M, Chen W, Lai K . The number of screws, bone quality, and friction coefficient affect acetabular cup stability. Med Eng Phys. 2006; 29(10):1089-95. DOI: 10.1016/j.medengphy.2006.11.005. View

16.

Tabata T, Kaku N, Hara K, Tsumura H . Initial stability of cementless acetabular cups: press-fit and screw fixation interaction--an in vitro biomechanical study. Eur J Orthop Surg Traumatol. 2014; 25(3):497-502. PMC: 4363363. DOI: 10.1007/s00590-014-1571-4. View

17.

Pakvis D, Luites J, van Hellemondt G, Spruit M . A cementless, elastic press-fit socket with and without screws. Acta Orthop. 2012; 83(5):481-7. PMC: 3488174. DOI: 10.3109/17453674.2012.720116. View

18.

Delaunay C, Hamadouche M, Girard J, Duhamel A . What are the causes for failures of primary hip arthroplasties in France?. Clin Orthop Relat Res. 2013; 471(12):3863-9. PMC: 3825891. DOI: 10.1007/s11999-013-2935-5. View

19.

Bozic K, Kurtz S, Lau E, Ong K, Vail T, Berry D . The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am. 2009; 91(1):128-33. DOI: 10.2106/JBJS.H.00155. View

20.

Wilson J, Maradit-Kremers H, Abdel M, Berry D, Mabry T, Pagnano M . Comparative Survival of Contemporary Cementless Acetabular Components Following Revision Total Hip Arthroplasty. J Arthroplasty. 2023; 38(7S):S194-S200. PMC: 10330048. DOI: 10.1016/j.arth.2023.03.093. View