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Acetabular revision using a press-fit dual mobility cup.

P Massin¹, L Besnier

¹CHU Bichat-Claude-Bernard, 46, rue Henri-Huchard, 75877 Paris cedex 18, France. philippe.massin@bch.aphp.fr

Orthopaedics & Traumatology, Surgery & Research : OTSR

|February 23, 2010

Summary

Dual mobility cups offer satisfactory stability in total hip arthroplasty revision without cement or screws. This approach simplifies surgery and reduces dislocation risk when abductor muscles are intact.

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Area of Science:

Orthopedic Surgery
Arthroplasty

Background:

Dual mobility cups are indicated for total hip replacement revision due to higher instability risk.
Primary cup fixation in revision surgery is often uncertain without screws.

Purpose of the Study:

To evaluate the stability of impacted dual mobility cups without cement, screws, or pegs in total hip arthroplasty acetabular component revision.
To determine if this fixation method prevents instability complications.

Main Methods:

Prospective study of 23 patients undergoing acetabular component revision with a Collégia dual mobility cup.
Mean follow-up of 4.5 years (range, 2-10 years) for patients with SOFCOT grade-1 and grade-2 bone loss.

Main Results:

Six clinically poor results (Merle D'Aubigné scale) were observed.

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One early migration occurred in a multioperated acetabulum.

One isolated and one recurrent dislocation were noted, with the latter associated with greater trochanter nonunion.

Conclusions:

Impacted dual mobility cups without cement or screws can simplify revision surgery and reduce dislocation risk if abductor muscles are continuous.
This technique is suitable for defects up to a wall-contained cavitary defect, even with moderate medial wall defects.
Longer-term follow-up is necessary to confirm these medium-term findings.