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In Vivo Quantification of Hip Arthrokinematics during Dynamic Weight-bearing Activities using Dual Fluoroscopy
Published on: July 2, 2021
Intraprosthetic dislocation: a specific complication of the dual-mobility system
Remi Philippot1, Bertrand Boyer, Frederic Farizon
1Department of Orthopaedic Surgery, University Hospital Center of Saint Etienne, Saint Étienne Cedex 2 42055, France. remi.philippot@chu-st-etienne.fr
Clinical Orthopaedics and Related Research
|October 12, 2012
Summary
Intraprosthetic dislocation (IPD) after total hip arthroplasty can be classified into three types, aiding surgeons in planning revision procedures. Understanding IPD mechanisms improves patient outcomes and implant longevity.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Medical device engineering
Background:
- Dual-mobility cups aim to prevent dislocation but can lead to intraprosthetic dislocation (IPD).
- IPD involves femoral head escape from the polyethylene liner due to rim failure.
- Factors contributing to IPD and its failure mechanisms remain poorly understood.
Purpose of the Study:
- To classify different types of intraprosthetic dislocation (IPD).
- To identify factors influencing the timing of IPD after total hip arthroplasty (THA).
Main Methods:
- Analysis of 81 IPD cases from 1960 primary THAs (1985-1998).
- Classification based on perioperative (arthrofibrosis, loosening, liner wear) and radiographic (loosening, migration, ossification) features.
- Evaluation of stem design's impact on IPD timing.
Main Results:
- Three IPD types identified: pure IPD (n=26), IPD with liner blocking (n=41), and IPD with cup loosening (n=14).
- Mean onset times were 11, 8, and 9 years post-THA, respectively.
- No significant difference in IPD timing was observed based on stem design.
Conclusions:
- A novel IPD classification system aids in anticipating revision surgery conditions.
- This classification facilitates surgical planning, including cup removal, liner exchange, and synovectomy.
- Implant characteristics and the new classification explain variations in IPD occurrence timing.
