Dual mobility device reduces the risk of prosthetic hip instability for patients with degenerated spine: A case-control study

Dagneaux, Louis; Marouby, Stanislas; Maillot, Cédric; Canovas, François; Rivière, Charles

doi:10.1016/j.otsr.2018.12.003

Cited by 44 publications

(52 citation statements)

References 22 publications

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“…Currently, data surrounding the use of DM prostheses specifically in patients with abnormal spinopelvic relationships are somewhat limited. However, in a cohort of 116 patients, Dagneaux et al [14] identified lower rates of dislocation in a DM prosthesis cohort relative to a traditional implant cohort despite similar acetabular positioning and a relatively equal prevalence of abnormal spinopelvic relationships between cohorts. The authors postulated that DM constructs may be able to provide a protective (ie, minimize the risk of dislocation) benefit to primary THA in patients with severe spinal degeneration [14].…”

Section: Discussionmentioning

confidence: 97%

“…However, in a cohort of 116 patients, Dagneaux et al [14] identified lower rates of dislocation in a DM prosthesis cohort relative to a traditional implant cohort despite similar acetabular positioning and a relatively equal prevalence of abnormal spinopelvic relationships between cohorts. The authors postulated that DM constructs may be able to provide a protective (ie, minimize the risk of dislocation) benefit to primary THA in patients with severe spinal degeneration [14]. Vermersch et al [18] evaluated a cohort of 100 patients who underwent primary THA with a dual-mobility construct; patients in this cohort had a mean age of 73 ± 11 years with a mean BMI of 26 ± 5 kg/m 2 .…”

Section: Discussionmentioning

confidence: 97%

“…Abnormal spinopelvic relationships are becoming increasingly recognized as a potential source of instability after primary THA [1][2][3][5][6][7][8][9]13]. Patients with spinopelvic imbalance and decreased motion at the spinopelvic junction who undergo primary THA are thought to be among those at the highest risk for dislocation postoperatively [2,[6][7][8][9]14]. In a study of 1000 primary THAs, Esposito et al [3] identified 12 patients who had a dislocation, 11 of whom (91.7%) had multilevel degenerative changes in the lumbar spine or a history of a prior PSF.…”

Section: Discussionmentioning

confidence: 99%

“…Eight of 9 (88.9%) patients who had anterior dislocations and 10 of 11 (90.9%) patients who had posterior dislocations had abnormal spinopelvic dynamics, with the direction of dislocation being directly related to the combined sagittal indexda measure of motion of the lumbar spine, pelvis, and femur when transitioning from sitting to standing [5]. To minimize the risk of THA dislocation in patients with abnormal spinopelvic relationships, several potential solutions have been proposed: undergo PSF before primary THA to restore sagittal plane balance (and therefore baseline acetabular orientation) [7,9,15], the use of computer navigation to obtain unique and specific acetabular versions based on the patient's individual spinopelvic parameters, and the use of dual mobility (DM) prostheses [6][7][8][9]14,16,17]. In a 2017 study, Stefl et al [7] evaluated a cohort of 160 hips before and after primary THA.…”

Section: Discussionmentioning

confidence: 99%

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The Prevalence of Abnormal Spinopelvic Relationships in Patients Presenting for Primary Total Hip Arthroplasty

et al. 2020

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Background: The prevalence of an abnormal spinopelvic relationship in patients presenting for primary total hip arthroplasty (THA) is not well known. The purpose of this study was to identify the prevalence of abnormal spinopelvic relationships in patients presenting for primary THA. Methods: A retrospective chart review of 338 consecutive, nonselected patients undergoing primary THA from the practice of 2 fellowship-trained adult reconstruction surgeons was performed (J.E.O. and T.S.B.). Sitting and standing radiographs were measured for lumbar lordosis (LL), pelvic incidence (PI), sacral slope (SS stand), and pelvic tilt; the sacral slope was also measured on sitting radiographs (SS sit). Patients were assessed for the presence of spinopelvic imbalance, defined as PIeLL>10 , and decreased spinopelvic motion, defined as SS stand eSS sit < 10. Descriptive statistics were reported. Results: A cohort of 338 patients was identified; 110 were excluded. In total, 228 unique patients underwent measurement. One hundred one of 228 patients (44.3%) in the cohort were female. The mean age of the cohort was 60.0 ± 13 years, with the mean body mass index of 31 ± 7 mg/kg 2. Spinopelvic imbalance (PIeLL > 10) was present in 142 of 228 patients (62.3%). Decreased motion at the spinopelvic junction (SS stand eSS sit < 10) was present in 78 of 228 patients (34.2%). Fifty (21.9%) patients had both spinopelvic imbalance and decreased spinopelvic motion. Conclusions: In a cohort of 228 patients presenting for primary THA, the prevalence of spinopelvic imbalance was 62.3%, the prevalence of decreased spinopelvic motion was 34.2%, and the prevalence of both spinopelvic imbalance and decreased spinopelvic motion was 22%. Hip surgeons are likely to encounter patients with abnormal spinopelvic relationships.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Prevalence of Abnormal Spinopelvic Relationships in Patients Presenting for Primary Total Hip Arthroplasty

et al. 2020

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“…I unfortunately have a large clinical experience with symptomatic mechanically assisted crevice corrosion (MACC) in a series of non-recalled, titanium alloy stem/trunnion, metal-onpolyethylene THAs [2]. The original cohort patients had newonset symptoms with prior well-functioning THAs, and many patients underwent revision surgery with a high rate of complications [3], as the authors describe in their article. More recently, I have noted a high incidence of asymptomatic serum cobalt (Co) elevation in a portion of the original population [4].…”

Section: Letter To the Editor On "Cobalt And Chromium Ion Release In mentioning

confidence: 99%

Response to Letter to the Editor on “Effects of Sagittal Spinal Alignment on Postural Pelvic Mobility in Total Hip Arthroplasty Candidates”

Buckland

Vigdorchik

2020

The Journal of Arthroplasty

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To the Editor Considerable attention was given to the study by Buckland et al [1] on postural changes in the pelvis based on pelvic incidence (PI)e lumbar lordosis (LL), which are as follows: >10 (flat back), À10 to 10 (balanced sagittal alignment), and <À10 (hyperlordosis). They concluded that patients with hyperlordosis likely utilize their spines, whereas patients with flat back use their hips. Definitions of "physiological" and "nonphysiological" spinopelvic conditions should be considered. Physiological states are defined based on the anatomical parameters of PI and anatomical acetabular anteversion angle (AAA) [2]. A small PI and high anatomical AAA are associated with a low LL and small sagittal pelvic range of motion during sitting or squatting, making patients use more of each hip's cone of mobility (physiological hip users) [2]. However, patients with a large PI and small anatomical AAA are likely to have a high LL and large sagittal pelvic range of motion using more of the flexible spine during postural changes (physiological spine users) [2]. Therefore, as shown by Buckland et al [1], balanced sagittal alignment may be "physiological states." Considering the lumbopelvic complex, nonphysiological states are determined through positional parameters: LL and positional AAA [3]. Patients having very small PI and acetabular undercoverage are considered to have a "pathoanatomy" and are likely to have a fixed flexion deformity of the hip resulting in decreased positional AAA [4]; therefore, pelvic anteversion and its associated increased LL (nonphysiological spine users) are required. In patients with high PI and stiff degenerated spine, decreased LL and its associated pelvic retroversion are noted, resulting in high positional AAA (nonphysiological hip users) [3]. Therefore, as described by Buckland et al [1], the spine users with hyperlordosis and hip users due to flat back may be in "nonphysiological states." In conclusion, future research should focus not only on sagittal spinopelvic kinematics but also on AAA to further understand hip anatomy and its relation to the development of hip osteoarthritis.

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Kinematic Alignment Technique for Total Hip Arthroplasty

Rivière¹,

Harman²,

Boughton³

et al. 2020

Personalized Hip and Knee Joint Replacement

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Dual mobility device reduces the risk of prosthetic hip instability for patients with degenerated spine: A case-control study

Cited by 44 publications

References 22 publications

The Prevalence of Abnormal Spinopelvic Relationships in Patients Presenting for Primary Total Hip Arthroplasty

The Prevalence of Abnormal Spinopelvic Relationships in Patients Presenting for Primary Total Hip Arthroplasty

Response to Letter to the Editor on “Effects of Sagittal Spinal Alignment on Postural Pelvic Mobility in Total Hip Arthroplasty Candidates”

Kinematic Alignment Technique for Total Hip Arthroplasty

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