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Dual mobility design use in preventing total hip replacement dislocation following tumor resection
J-M Philippeau1, J-M Durand, J-P Carret
1Orthopedics Department, Hôtel-Dieu Hospital, place A.-Ricordeau, 44035 Nantes cedex 01, France. Bone Resorption and Primitive Bone Tumor Physiopathology Research Laboratory, EA 3822, Inserm U957, School of Medicine,Nantes University, rue Gaston-Veil, 44000 Nantes, France. jmphilippeau@hotmail.com
Dual mobility cups reduce total hip replacement dislocation after hip tumor resection, particularly for bone metastases. However, dislocation risk remains higher in primary bone tumors involving abductor muscle or nerve resection.
Area of Science:
- Orthopedic Surgery
- Oncology
- Biomedical Engineering
Background:
- Total hip replacement (THR) after hip tumor resection has a high risk of dislocation.
- Dual mobility cups are a potential solution to improve THR stability in these complex cases.
Purpose of the Study:
- To assess the dislocation incidence and functional outcomes of dual mobility cups in THR following hip tumor resection.
- To evaluate the effectiveness of dual mobility cups in reducing THR instability in patients with primary bone tumors and bone metastases.
Main Methods:
- A retrospective study of 71 patients undergoing dual mobility cup THR after hip tumor resection.
- Analysis of dislocation rates based on tumor type (primary bone tumor vs. bone metastasis) and surgical management of the abductor system.
- Functional outcomes assessed using pain scales (WHO), assisted walking status, and Musculoskeletal Tumor Society (MSTS) scores.
Main Results:
- An overall dislocation rate of 9.8% was observed.
- Dislocation rates were 5.2% for bone metastases and 15% for primary bone tumors.
- Surgical management of the abductor system significantly impacted dislocation risk, with higher rates associated with abductor muscle or nerve resection (18%).
- Functional improvements were noted, with a mean MSTS score of 68.1% for bone metastases and 59.6% for primary bone tumors.
Conclusions:
- Dual mobility cups demonstrate lower dislocation rates compared to literature benchmarks for THR after hip tumor resection.
- These cups are particularly effective in bone metastasis cases and for consolidation surgery.
- For primary bone tumors, especially with acetabular and abductor involvement, dislocation prevention remains challenging, though rates are improved with limited resections.
