Superior functional outcome with dual mobility THR as compared to conventional THR in fracture neck femur: a prospective cohort study

Abstract

Introduction: Total Hip Replacement (THR) in displaced Fracture Neck of Femur (FNOF) is associated with higher dislocation rates. Conventional THR with a large femoral head and anterior approach has reduced the instability, but it remains higher than THR done for other aetiology. Recent studies have shown reduced dislocation rates with dual mobility THR (DMTHR) for FNOF; however, there is a lack of comparative research to show its superiority over conventional THR. Further, its role in the Asian subcontinent, where the patient requires sitting cross-legged or squatting, has not been studied. Methods: A prospective cohort study of 103 elderly patients with displaced FNOF with a minimum follow-up of 1-year. Fifty-two patients were operated on with DMTHR and fifty-one patients with conventional THR. Both the groups were matched in terms of demographic data, surgical approach, and postoperative protocol. Radiological and functional outcomes in terms of Harris Hip Score (HHS), Range of motion, Patient Reported Outcome Measures (PROM), and Dislocation rate were compared between the two groups. Results: Mean HHS of the DMTHR group was 76.37 at three months and 87.02 at the end of the 1-year postoperatively, which was significantly better than the conventional THR group 65.65 at three months and 72.96 at 1-year. The range of motion was significantly better in the DMTHR group than the conventional THR group. There was no significant difference in radiological outcomes and postoperative dislocation rate between the two groups. Conclusion: Dual mobility implants give better results than conventional implants for primary THA in elderly patients of displaced FNOF regarding better function and greater range of motion.

An early experience of the use of dual mobility cup uncemented total hip arhroplasty in young patients with avascular necrosis of the femoral head

“…In view of this emerging new evidence, we chose to perform DMC THA in this cohort of patients (patients<55 years of age) with stage 4 Ficat-Arlet AVN of the hip. Studies by Agarwala S et al and Agarwala Sanjay et al 26,27 have demonstrated an excellent track record of the implant type used in our study. Both these studies reported excellent patient reported outcome measure (Harris Hip Score).…”

Outcome of dual mobility Acetabular cup for instability in total hip Arthroplasty

“…Fifty-two patients were treated with DM and 51 patients were treated with FB. There was no dislocation occurred in both groups, but the range of motion was significantly better in DM group (21) . Comparing the series of dual mobility cups in the treatment of displaced fractures of the femoral neck to recent series of bipolar hemiarthroplasties, the relative risk of dislocation appears 4-4.7 times higher for hemiarthroplasties.…”

The use of Dual Mobility cups in primary Total Hip Arthroplasty: a bicentric, retrospective study of 196 implants

“…The objectives of this design are to reduce wear and loosening forces, to use a physiological system and to increase joint range without compromising intra-prosthetic stability [21,22].…”

“…A review of comparative results, where the main parameter to be evaluated is stability, showed that dual mobility cups have excellent short and medium term results compared to standard implants in pTHR [22].…”