Absence of instabilities and intra-prosthetic dislocations at 7 to 11\u2009years following THA using a fourth-generation cementless dual mobility acetabular cup

Julien Chouteau,Mo Saffarini,Jean-Charles Rollier,Jean-Christophe Chatelet,Michel P Bonnin,Luca Nover,Laurent Jacquot

doi:10.1186/s40634-020-00265-3

Julien Chouteau, Mo Saffarini + Show 5 more

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https://doi.org/10.1186/s40634-020-00265-3

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Abstract

PurposeDual-mobility (DM) cups are increasingly used in total hip arthroplasty (THA) but there lacks literature on their long-term results. We aimed to investigate outcomes of a fourth-generation cementless DM acetabular cup at 7–11 years.MethodsWe retrospectively evaluated 240 consecutive hips that received cementless THA using the same dual mobility cup (Novae Sunfit TH) and femoral stem (Corail). Patients were recalled at ≥7 years to collect Oxford hip scores (OHS), Harris hip scores (HHS), and inspect for radiolucent lines and granulomas. Multi-variable analyses were performed to determine whether HHS or OHS were associated with pre- or intra-operative variables.ResultsAt 8.4 ± 0.8 years (range, 7–11), 6 hips were revised (2.5%), 54 deceased (22.5%), and 14 could not be reached (5.8%). Four revisions (2 cup+stem, 2 liners only) were due to sepsis (1.7%), one (cup and stem) for trauma (0.4%), and one (stem) due to aseptic loosening (0.4%). For the remaining 166 hips, HHS was 83.6 ± 13.2 and OHS was 20.3 ± 6.7. Multi-variable analysis confirmed that HHS (β = − 0.38; p = 0.039) and OHS (β = 0.36; p < 0.001) worsened with age, and that OHS was worse for Charnley C patients (β = 3.17; p = 0.009). Neither granulomas nor radiolucenies were observed around any cups, but radiolucenies were seen around 25 stems (20.3%).ConclusionsThis fourth-generation DM cup demonstrated satisfactory outcomes at 7–11 years, with no instabilities or cup revisions due to aseptic loosening. Better OHS was observed for younger patients and those presenting higher Charnley grade.Level of evidenceLevel IV, retrospective case study.

Highlights

Dislocation after total hip arthroplasty (THA) is a burdensome complication, observed in up to 10% of cases [2, 23, 36, 38], though one must consider heterogeneity among studied population, follow-up, and other confounding factors
Fourth-generation Dual mobility (DM) cups have proved effective at preventing intra-prosthetic dislocations (IPD) [11, 34, 46] and demonstrated promising complication and survival rates [18, 38, 39]
The authors evaluated a consecutive series of 240 THAs (225 patients) performed over three consecutive years (June 2007 to June 10) using the same cementless dual mobility cup (Novae Sunfit TH, Serf, Décines, France) (Fig. 1) withthe same femoral stem (Corail, Depuy, Leeds, UK) by 3 surgeons (LJ, JCR, JCC)

Summary

Introduction

Dislocation after total hip arthroplasty (THA) is a burdensome complication, observed in up to 10% of cases [2, 23, 36, 38], though one must consider heterogeneity among studied population, follow-up, and other confounding factors. While originally intended for patients at risk of subluxation and dislocation, notably geriatric patients [1, 3] and those with femoral neck fractures [3, 24, 27, 28, 33, 41, 46] or neuromuscular deficit [9, 49], DM cups are increasingly used in younger and more active cohorts [31, 40, 49]. The secondary goal was to identify demographic and operative factors that could compromise clinical scores and optimise future patient selection and surgical choices

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