Abstract
BackgroundDuring revision total hip arthroplasty (THA), the “double-socket” technique has been proposed as a straightforward solution in order to reduce the overall perioperative morbidity in patients with high surgical risk. However, the option of cementing a dual mobility cup into an existing well-fixed metal shell was sparsely reported. Therefore, this study aimed to evaluate the outcome of a “double-socket” technique performed with a cemented dual mobility cup in revision THA for late instability. MethodsTwenty-eight revision THAs (28 patients) were performed for wear-related recurrent dislocation using a “double-socket” technique with a cemented dual mobility cup and retrospectively reviewed. The age at revision averaged 82 years (range 74-93). According to the American Society of Anesthesiologists (ASA) physical status classification, 12 patients (43%) were ASA II and 16 patients (57%) were ASA III before revision. ResultsAt a mean follow-up of 3.5 years (range 2-5), the mean preoperative to postoperative functional outcome improved significantly (P < .01). The mean operative time was 107 minutes (range 75-140). The mean intraoperative bleeding was 200 mL (range 110-420). No postoperative complication, reoperation, or re-revision was reported. Importantly, no dislocation, dissociation of the cemented dual mobility cup construct, or aseptic loosening of the retained metal shell was observed. ConclusionThe “double-socket” technique with a dual mobility cup cemented into an existing well-fixed and well-positioned metal shell ensured a straightforward and blood-sparing revision technique that was efficient to restore stability and provide a secure acetabular construct in frail patients with high surgical risk and/or older than their natural life expectancy.
Highlights
During revision total hip arthroplasty (THA), the “double-socket” technique has been proposed as a straightforward solution in order to reduce the overall perioperative morbidity in patients with high surgical risk
Operative and anesthesiology reports were reviewed for assessment of the size of the implants, operative time from the skin incision to wound dressing, intraoperative bleeding by measuring fluid accumulation in the suction device after subtracting irrigation and weighing gauze swabs, and intraoperative complication
Postoperative complications, dislocation, dissociation of the cemented dual mobility cup construct at the metal shell/ cement interface, reoperation, or re-revision data were collected through retrospective chart review
Summary
During revision total hip arthroplasty (THA), the “double-socket” technique has been proposed as a straightforward solution in order to reduce the overall perioperative morbidity in patients with high surgical risk. This study aimed to evaluate the outcome of a “doublesocket” technique performed with a cemented dual mobility cup in revision THA for late instability. Methods: Twenty-eight revision THAs (28 patients) were performed for wear-related recurrent dislocation using a “double-socket” technique with a cemented dual mobility cup and retrospectively reviewed. Conclusion: The “double-socket” technique with a dual mobility cup cemented into an existing wellfixed and well-positioned metal shell ensured a straightforward and blood-sparing revision technique that was efficient to restore stability and provide a secure acetabular construct in frail patients with high surgical risk and/or older than their natural life expectancy
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