Total Hip Arthroplasty Using Dual Mobility Cups for Failed Hip Fracture Fixation

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Geriatric Medicine

Background:

• Conversion total hip arthroplasty (THA) is a common procedure for older adults with failed hip fracture fixation.
• Dislocation rates are higher in conversion THA compared to primary THA for arthritis.
• Dual-mobility (DM) cups have shown promise in reducing dislocation rates in THA.

Purpose of the Study:

• To evaluate the outcomes of conversion THA using DM cups for failed hip fracture fixation.
• To compare the dislocation rates between DM and fixed-bearing (FB) cups in this patient population.

Main Methods:

• A retrospective study included 116 patients undergoing conversion THA for failed hip fracture fixation.
• Patients were divided into two groups: 83 using FB cups and 33 using DM cups.
• Outcomes assessed included reoperation, dislocation, intraprosthetic dissociation (IPD), periprosthetic fracture, deep joint infection, and modified Harris hip score (mHHS).

Main Results:

• No significant differences were observed between FB and DM groups in radiological outcomes, reoperation, IPD, periprosthetic fracture, deep joint infection, or mHHS.
• The dislocation rate was 6.02% in the FB group and 3.03% in the DM group (p = 0.673), with no statistically significant difference.

Conclusions:

• While the DM group showed a lower dislocation rate (relative risk 0.50), the difference was not statistically significant.
• DM implants may offer potential benefits for conversion THA after failed hip fracture fixation.
• Further research is warranted to validate the efficacy of DM cups in reducing dislocation rates in this specific context.