Midterm Clinical and Radiographic Outcomes of a Contemporary Monoblock Dual-Mobility Cup in Uncemented Total Hip Arthroplasty

Fessy, Michel‐Henri; Jacquot, Laurent; Rollier, Jean-Charles; Chouteau, Julien; Aït-Si-Selmi, Tarik; Bothorel, Hugo; Chatelet, Jean-Christophe

doi:10.1016/j.arth.2019.07.026

Cited by 25 publications

(26 citation statements)

References 51 publications

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“…20 Uncemented DM cups are effective at preventing hip dislocations while granting satisfactory long-term clinical outcomes and survival rates. [8][9][10] They are designed with a thin metal shell, with porous coating on the outer surface to favour bone ingrowth, and mirror-polished at the inner surface to optimise articulation against a large-diameter PE insert, which assembles with a small retentive femoral head. [11][12][13] Unlike conventional cups, DM cups have articular surfaces, and the use of additional fixation in only recommended for cases with osteoporosis, bone loss or substantial deformities.…”

Section: Discussionmentioning

confidence: 99%

“…The present study is nevertheless the first to compare the outcomes of two dualmobility cup designs fixed by simple press-fit versus supplementary screws, and could provide the equipoise and rationale for a randomised controlled trial to provide greater evidence on the issue of fixation in DM cups that are implanted increasingly worldwide. 10…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] Uncemented DM cups have proven effective at preventing hip dislocations while granting satisfactory long-term clinical outcomes and survival rates. [8][9][10] Uncemented DM cups have a thin metal shell, with porous coating on the outer surface to favour bone ingrowth, and mirrorpolished at the inner surface to minimize articular friction against a large-diameter polyethylene (PE) insert, which in-turn assembles with a small-diameter retentive femoral head. [11][12][13] Unlike conventional cups that serve as a metal-backing for static PE inserts, DM cups have articular surfaces that accommodate mobile PE inserts.…”

Section: Introductionmentioning

confidence: 99%

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Early outcomes of THA using uncemented dual-mobility cups with additional fixation screws

Rollier

Chouteau

Nover

et al. 2021

MRAJ

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Background: The use of fixation screws with uncemented cups is controversial particularly for dual mobility (DM) cups where perforation of the articular surface could compromise implant longevity. We aimed to compare outcomes of total hip arthroplasty (THA) using uncemented DM cups with supplementary screw fixation versus simple press-fit fixation. Methods: From 235 consecutive THAs performed using uncemented DM cups, 203 were fixed by simple press-fit and 32 fixed with additional screws. The Oxford hip score (OHS) and EuroQol 5 Dimensions (EQ-5D) score were available at 3.3±1.1 years. To enable direct comparison, each screw fixation cup was matched to three simple press-fit cups using propensity scores, based on age, sex and bone quality. Results: The two groups had equivalent age, body mass index, gender distribution, femoral morphology and bone quality. Compared to the press-fit group (n=96), the screw fixation group had more surgical antecedents (p=0.032), higher femoral neck angles (p=0.028), and received slightly larger cups (p=0.036). Revision was required for two (6%) screw fixation cups (only one implant-related) and one (1%) press-fit cup (none implant-related). There were no differences between OHS (19±8 vs 18±7, p=0.682) nor EQ-5D (0.63±0.37, p=0.257). Conclusions: Revision rates were greater for DM cups fixed with additional screws than for those fixed by simple press-fit, but clinical scores were equivalent. There was only one implant-related revision (acetabular fracture) in the screw fixation group and it is unclear whether this is related to the additional screws or to patient/surgical factors. Level of evidence: Level IV, retrospective case series.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Early outcomes of THA using uncemented dual-mobility cups with additional fixation screws

Rollier

Chouteau

Nover

et al. 2021

MRAJ

Self Cite

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“…2,7,8 The use of small cups can lead to prosthesis loosening or instability instigated by large forces, 9 which are associated with poor outcomes of THA and the markedly high incidence of revision THA, as well as the short time between failures. [10][11][12] Although THA has become less preferred, surgeons have attempted to overcome this issue of dislocation using diverse strategies to decrease the risk of post-surgical dislocation, including using large cups, modular components that can be exchanged, or components made of cross-linked polyethylene. 3,[13][14][15] The dual-mobility THA(DM-THA) has exceptional dislocation-free survivorship in primary or revision THA, ranging from 95% at 5 years to 80% at 15 years after primary THA and more than 95% at 10 years after revision THA; therefore, it has been used increasingly more frequently in clinical practice in recent decades.…”

Section: Introductionmentioning

confidence: 99%

“… 11 , 16 DM-THA is another procedure that is performed to reduce the rate of post-surgical dislocation. 10 Through the unique DM design, with the femoral head captured within polyethylene, DM cups can maximize the impingement-free arc of motion, have a superior head-to-neck ratio, and increase the safety area required for dislocation. 2 , 13 Theoretically, it is a safe, effective and durable solution for preventing dislocation.…”

Section: Introductionmentioning

confidence: 99%

Dual-Mobility Cup Total Hip Arthroplasty for Displaced Femoral Neck Fractures: A Retrospective Study With a Median Follow-Up of 5 Years

Zhang

Cao

et al. 2021

Geriatr Orthop Surg Rehabil

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Introduction: Patient outcomes following modern dual-mobility cup total hip arthroplasty (DM-THA) remains a concern. Few reports have focused on the use of modern DM-THA in the setting of Asian populations for displaced osteoporotic femoral neck fractures (FNFs). This study aimed to investigate the outcomes of Chinese population with displaced osteoporotic FNFs initially treated with modern DM-THA. Materials and Methods: Data from 112 consecutive patients (112 hips) with displaced osteoporotic FNFs initially treated with modern DM-THA during 2011-2018 were retrospectively analyzed. Follow-ups were performed at 3 months, 6 months, 12 months, and then every 1 year after surgery. The primary endpoint was the Harris Hip Score (HHS); the secondary endpoint was the main orthopedic complication rate. Results: The mean HHS improved from 58.62 (±15.79) prior to surgery to 86.13 (±9.92) at the final follow-up. The main complication rate was 14.2% (16/112). Sixteen complications in 10 patients were recorded. Of the 16 complications, there were 2 (1.7%) cases requiring revision DM-THA, 3 (2.6%) cases of loosening, 2 (1.7%) cases of migration, 3 (2.6%) intra-prosthetic dislocation (IPD), 4 (3.5%) cases of tilting, and 2 (1.7%) cases of severe wear. The need for revision was attributed to prosthesis loosening associated with poor bony quality. Conclusion: In patients with displaced osteoporotic FNFs, DM-THA may yield favorable functional outcomes and a low rate of main orthopedic complications, in particular, a low dislocation rate.

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Obesity and Osteoarthritis of the Hip

Miller,

Vincent,

Murphy

2024

Musculoskeletal Disease and Obesity

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Midterm Clinical and Radiographic Outcomes of a Contemporary Monoblock Dual-Mobility Cup in Uncemented Total Hip Arthroplasty

Cited by 25 publications

References 51 publications

Early outcomes of THA using uncemented dual-mobility cups with additional fixation screws

Early outcomes of THA using uncemented dual-mobility cups with additional fixation screws

Dual-Mobility Cup Total Hip Arthroplasty for Displaced Femoral Neck Fractures: A Retrospective Study With a Median Follow-Up of 5 Years

Obesity and Osteoarthritis of the Hip

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