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Dual mobility cups for preventing early hip arthroplasty dislocation in patients at risk: experience in a county
Sebastian S Mukka1, Sarwar S Mahmood, Göran O Sjödén
1Department of Orthopaedics, Sundsvall Teaching Hospital; Department of Surgical and Perioperative Science, Umeå University , Sweden.
Insights
Dual mobility cups (DMC) offer good early hip stability for patients at high risk of dislocation after hip arthroplasty. Careful management of complications like infection is crucial for optimal outcomes.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Hip arthroplasty is prone to dislocation, a significant complication.
- Dual mobility cups (DMC) are designed to enhance hip joint stability.
Purpose of the Study:
- To evaluate the efficacy of cemented dual mobility cups (DMC) in improving early hip stability.
- To assess functional outcomes and quality of life in patients receiving DMC for high-risk hip instability.
Main Methods:
- A cohort of 34 patients (21 female, 13 male) received cemented DMC between 2009 and 2012.
- DMC were used for hip revisions due to recurrent dislocation or primary procedures in unstable hips.
- Functional outcomes were measured using the Harris Hip Score (HHS) and quality of life with EQ-5D.
Main Results:
- Cemented DMC provided stability in 94% of patients.
- Seven patients (20%) required re-operation due to infection.
- One patient experienced a periprosthetic fracture.
- Mean follow-up was 18 months (range 6-36 months).
- Mean HHS was 67 (SD 14), and mean EQ-5D was 0.76 (SD 0.12).
Conclusions:
- Cemented dual mobility cups demonstrate effectiveness in achieving hip stability for high-risk patients.
- Postoperative infection is a notable complication requiring careful management.
- DMC implantation can lead to satisfactory functional outcomes and quality of life, despite potential complications.
Abstract:
Dislocation remains a major concern after hip arthroplasty. We asked whether dual mobility cups (DMC) would improve early hip stability in patients with high risk of dislocation. We followed 34 patients (21 females, 13 males) treated between 2009 and 2012 with cemented DMC for hip revisions caused recurrent hip prosthetic dislocation or as a primary procedure in patients with high risk of instability. Functional outcome and quality of life were evaluated using Harris Hip Score and EQ-5D respectively. We found that the cemented DMC gave stability in 94%. Seven patients (20%) were re-operated due to infection. One patient sustained a periprosthetic fracture. At follow-up (6 to 36 months, mean 18), the mean Harris hip score was 67 (standard deviation: 14) and mean EQ-5D was 0.76 (standard deviation: 0.12). We concluded that treating patients with high risk of dislocation with DMC can give good stability. However, complications such as postoperative infection can be frequent and should be managed carefully.
