Total hip arthroplasty with dual mobility cup in osteonecrosis of the femoral head in young patients: over ten years of follow-up

Abstract

Osteonecrosis of the femoral head affects mainly young patients with high functional needs this increases the risk of dislocation. Dual mobility cups known for low rate of dislocation and high mobility range seems indicated. We evaluate functional efficiency, survival and dislocation rate of dual mobility cup for total hip arthroplasty for osteonecrosis in young patients. Monocentric retrospective clinical study, from 2000 to 2008. With a clinical analysis in pre-operative and over ten years of follow-up of one cohort of patients under 55 years old with an indication of THA for ONFH. The judgement criteria was: clinical scores at the maximal follow-up, the dislocation rate, and the cumulate survival rate over ten years follow-up. Forty THA in 31 patients, nine bilateral cases, 23 males and eight females with average age of 44 (±4) years old. In pre-operative: PMA 11 (±3.3), HHS 50,8 (±15.5). At the final follow-up of 129.8 (±33.8) months: PMA (17.4 ± 1.12), HHS (95.7 ± 6.9), no dislocation. We had 11 deaths on average at 95.2 ± 47.3 months. The cumulate survival rate over ten years follow-up is 100% without revisions or long-term dislocation. Analysis concludes to very significant functional improvement without any dislocation despite the young population with high level of activity. Thus, dual mobility cups is a reliable choice preventing dislocation with a very good survival rate without premature wear, preserving mobility and activity.

Early results of total hip arthroplasty using dual-mobility cup in patients with osteonecrosis of the femoral head

“…This study demonstrated no episode of dislocation and an excellent survivorship of 100% with a mean follow-up of 51 months. This is in line with the study of Martz et al (2017) who reported same survival rate at a mean follow-up of 109 months [ 8 ]. Similarly, no other major post-operative complications occurred in our series as well; there were no signs of implant loosening or peri-prosthetic osteolysis [ 8 ].…”

“…It has been also reported that dislocation is the most common cause of THA revision surgery during the first five years and those with ONFH had the highest risk for revision surgery [ 7 ]. Thus, it is critical to choose the appropriate THA implant for this population, which ensures stability, mobility, solidity, and longevity [ 8 ].…”

“…However, with recent advancements in the 2 nd and 3 rd generations DMCs' design they have proven to yield lower mechanical complications when compared to conventional cups (CC) [ 16 ]. The only study published by Martz et al showed that young patients suffering from ONFH who underwent THA with DMC showed a survival rate of 100% at 10 years follow-up [ 8 ].…”

The Current Role of Dual Mobility Articulations in Total Hip Arthroplasty

“…Clinical function and patient satisfaction were also excellent in this cohort. 41 A separate review by Assi et al corroborated these findings, with no dislocations and 100% implant survival at 4.25-year follow-up. 42…”

Dual-mobility cup: a new French revolution

“…Good results are also established for specific categories of patients requiring a THA: those with femoralhead osteonecrosis [20], the obese [21], patients with high risk of dislocation (younger, active individuals) [22], or after hip fractures [23]. Regardless, taking in account the efficiency of DMC against instability, its use even with hip musculoskeletal oncology is emphasised by Zocalli et al [24].…”