Dual mobility cup for prevention of early total hip arthroplasty dislocation in patients with neurological disorders

Abstract

Patients with neurologic disorders are at a higher risk for hip arthroplasty dislocation. This can be attributed to hip muscle weakness, especially the abductor group. We inquired into the use of dual mobility acetabular component for the prevention of early hip dislocation in these patients. Thirty patients with documented neurological disorders and muscle weakness affecting the operated side underwent dual mobility total hip arthroplasty in the period between December 2012 and January 2014. The neurological disorders were cerebrovascular stroke, weakness due to brain tumors, Parkinsonism, old poliomyelitis, and multiple sclerosis. Twelve cases underwent primary dual mobility cup total hip arthroplasty as a treatment for proximal femoral fractures. Eighteen patients were revision to dual mobility total hip arthroplasty either due to failure of proximal femoral fracture fixation or failure of previous arthroplasty. All patients were ambulant (assisted walking) before the primary incident (either surgery or trauma). All patients were operated upon through the lateral approach. All the cups used were cemented. The mean age group of the patients was 64.6 years old. No definite postoperative infection occurred. The mean follow-up period was 13.2 months. One case died 6 months postoperative due to another cerebrovascular stroke. Functionally, all our patients could ambulate (assisted walking) postoperatively. No dislocation was recorded during the follow-up period. The dual mobility cup is effective in the prevention of early dislocation in patients with muscle weakness due to neurological disorders. Long-term follow-up is needed for the assessment of late dislocation, as well as the rate of loosening in this group of patients.