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Short-term primary and revision modular dual-mobility cup total hip arthroplasty outcomes in high-risk dislocation
Martta Ruusiala1, Hannu Miettinen2, Jukka Kettunen2
1Faculty of Health Sciences, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland.
Insights
Modular dual-mobility cups (MDMCs) show excellent short-term survival in primary total hip arthroplasty (THA) and moderate survival in revision THA. MDMC use in hip fracture patients significantly reduced dislocation rates.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Arthroplasty Research
Background:
- Modular dual-mobility cups (MDMCs) are increasingly used in total hip arthroplasty (THA) to mitigate dislocation risk.
- Assessing the performance of MDMCs in diverse patient populations, including hip fracture cases and revision surgeries, is crucial for optimizing outcomes.
Purpose of the Study:
- To evaluate implant survivorship, complication rates (especially dislocation), and revision rates for primary and revision THAs utilizing MDMCs.
- To assess mortality associated with MDMC surgery.
- To determine if the introduction of MDMCs at Kuopio University Hospital impacted the institutional dislocation rate.
Main Methods:
- A retrospective cohort study of 101 patients who underwent MDMC implantation between April 2018 and June 2020.
- Minimum 2-year follow-up to assess implant survival, complications, and mortality.
- Utilized the Finnish Hospital Discharge Register to analyze yearly THA dislocation rates before and after MDMC implementation.
Main Results:
- Two-year cumulative implant survival was 97% for primary THA and 90% for revision THA.
- Dislocation occurred in 1.4% of primary THA and 12.9% of revision THA cases.
- Two-year cumulative mortality was 13% in both primary and revision THA groups.
- Post-MDMC implementation, re-hospitalizations due to THA dislocation decreased by 46%.
Conclusions:
- MDMCs demonstrate excellent short-term survival and low complication rates in primary THA, with moderate outcomes in revision THA.
- The adoption of MDMC THA for hip fracture patients appears effective in reducing dislocation rates within a short follow-up period.
Purpose:
Modular dual-mobility cups (MDMCs) have a lower risk for dislocation after total hip arthroplasty (THA). The primary aims of our study were to analyze implant survivorship and to determine complications, especially dislocation, and revision rates of primary THAs used for hip fracture patients and for revision THAs. Secondary aims were to evaluate mortality after MDMC surgery and to find out if introduction of MDMC at our institution (Kuopio University Hospital, Finland) have decreased dislocation rate.
Methods:
This retrospective cohort study consisted of 101 MDMC patients who were consecutively operated at our institution between April 1, 2018 and June 30, 2020. The implant survival rate, complications and mortality were evaluated with minimum of 2-year follow-up. Finnish Hospital Discharge Register was used to find out yearly dislocation rates following THA at our institution.
Results:
The cumulative estimate implant survival after MDMC in the primary THA group was 97% at 2 years, and in the revision THA group, it was 90% at 2 years. Dislocation was a rare complication in the primary THA group (1.4%), while it was common in revision THA group (12.9%). The cumulative estimate for mortality after MDMC in the primary THA group was 13% at 2 years, and in the revision group, it was also 13% at 2 years. The yearly number of patients who had re-hospitalization period due to THA dislocation decreased 46% after implementation of MDMC.
Conclusion:
Short-term survival and complication rates after MDMC were excellent after primary THA and moderate after revision THA. Implementation of MDMC THA for hip fracture patients seems to have effectively decrease dislocation rate during a short follow-up.
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