The placement of the patellar component during TKA differs from one patella to another. Thus, by defining the OCPP on a patient-by-patient basis, the surgeon should be able to reproduce the functional anatomy of the native patella.

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The patella remains one of the main sources of post-operative complication following total knee arthroplasty surgery. Optimal positioning of the patellar component is still a controversy with no clear-cut guidelines. Instead of choosing an empirical position, we described a novel surgical technique to better locate the patellar button based on the individual patellar anatomy of each patient.

Introduction: Osteonecrosis of the femoral head (ONFH) remains a therapeutic challenge for patients undergoing total hip arthroplasty (THA). The majority of these patients are young with high functional demand, and show an increased risk of dislocation following surgery than patients with osteoarthritis. The use of double mobility cup (DMC) has been linked with lower rates of complications when compared to conservative cups; however, the literature is scarce over DMC results in patients with ONFH. The aim of the study is to report the early outcomes of patients with ONFH treated with THA-DMC. Materials: A retrospective analysis of patients suffering from ONFH who underwent THA using DMC (THA-DMC) from 2006 to 2015 were evaluated for functional status and risk of post-operative complications. Thirty THA-DMC in 26 patients with a mean follow-up of 51 months were evaluated clinically (modified Hip Harris Score) and radiologically. Results: The mean age of the included patients was 54.9 years. At final follow-up, the mean modified Hip Harris score was 98.7 ± 2.7 and no dislocation episodes or revision surgeries were recorded. The radiological assessment revealed no signs of migration/tilting, radiolucent lines, periprosthetic osteolysis or heterotopic ossification over the DMC component and the femoral stem. The survival rate over 51 months of follow-up was 100%. Discussion: The use of the new generation of dual mobility cup in patients with ONFH showed excellent functional early results with no major complications such as dislocation.

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