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Minimum Five-Year Results of Acetabular Revision Using Uncemented Monoblock Dual-Mobility Cups for Moderate-to-Severe
Antoine Piercecchi1, Christophe Jacquet2, Omar Rajillah1
1Department of Orthopedic and Traumatological Surgery, Hôpital François Mitterrand, CHU, Dijon, France; INSERM, UMR1093-CAPS, University Bourgogne Franche-Comté, UB, Dijon, France.
Background:
Acetabular revision in the setting of moderate-to-severe bone loss is associated with high risks of instability and mechanical failure. Uncemented monoblock dual-mobility (UMDM) cups combine biological fixation with enhanced stability, but data beyond 5 years in complex revision settings remain limited. This study evaluated implant survivorship, complications, and clinical and radiographic outcomes of a UMDM cup used for acetabular revision with moderate-to-severe bone loss.
Methods:
This retrospective single-center study included 60 acetabular revisions performed between 2009 and 2019 using a UMDM cup in patients who had Paprosky ≥ IIA defects and a minimum follow up of five years. The primary endpoint was aseptic acetabular loosening. The secondary endpoints included acetabular rerevision, complications, functional outcomes (Harris Hip Score, Postel-Merle d'Aubigné), and radiographic assessment of acetabular reconstruction, including restoration of the hip center of rotation. The mean follow up was 8.6 years (range, 0 to 15.3), with a mean patient age of 77 years (range, 44 to 91). Bone loss was classified as Paprosky IIA (23%), IIB (30%), IIC (33%), IIIA (5%), and IIIB (8%).
Results:
There were six hips (10%) that met the criteria for aseptic loosening, including four requiring revision. Implant survivorship free from revision for aseptic loosening was 100% at 5 years and 93.0% at 10 years (95% confidence interval, 85.7 to 100). Survivorship free from revision for any cause was 98.2% at 5 years and 84.6% at 10 years (95% confidence interval, 74.5 to 96.0). The dislocation rate was 5%, with no recurrent instability. Radiographic analysis demonstrated satisfactory restoration of the hip center of rotation in most cases. Functional outcomes improved significantly, with a mean Harris Hip Score of 89 ± 7 and a Postel-Merle d'Aubigné score of 16.9 ± 1.6.
Conclusions:
The use of UMDM cups provided reliable fixation and stability in acetabular revision for moderate-to-severe bone loss, with low dislocation rates and satisfactory reconstruction quality at a minimum 5-year follow up.
Level Of Evidence:
Level IV - retrospective cohort study.
