Capsular Sparing Total Hip Replacement Technique Applied with a Dual-mobility Cup to Reduce Dislocations

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Reconstructive Surgery

Background:

• Postoperative dislocation remains a significant complication following total hip replacement (THR).
• Advancements like larger femoral heads have decreased dislocation rates.
• Further reduction may be achievable by combining technology with specific soft tissue repair techniques.

Purpose of the Study:

• To evaluate the efficacy of a posterior surgical approach combined with a capsule-sparing repair technique and dual-mobility implants in preventing dislocation after primary total hip replacement.

Main Methods:

• A single surgeon performed 513 primary total hip replacements using a posterior approach.
• Cementless dual-mobility cups and femoral stems were utilized.
• The posterior capsule was incised, retracted, repaired with reinforced sutures, and the superior border was reattached to enhance femoral head containment.

Main Results:

• Zero dislocations were recorded in any of the 513 primary total hip replacements.
• Patient follow-up ranged from one to five years post-implantation.
• The technique successfully incarcerated the femoral head, preventing dislocation.

Conclusions:

• The combination of large dual-mobility femoral heads and a capsule-sparing soft tissue repair technique significantly reduces dislocation rates in total hip replacement.
• This approach offers a promising strategy for improving outcomes in posterior THR surgery.