Dual-Mobility Cup and Cemented Femoral Component: 6 Year Follow-Up Results

2011 ◽  
Vol 21 (6) ◽  
pp. 713-717 ◽  
Author(s):  
Jean Louis Prudhon
Keyword(s):  
Femoral Component ◽  
Femoral Stem ◽  
Implant Survival ◽  
Dual Mobility Cup ◽  
Acetabular Cup ◽  
Low Friction ◽  
Dual Mobility ◽  
Primary Hip Arthroplasty ◽  
Lateral Decubitus

Use of a dual-mobility acetabular cup is associated with a lower risk of dislocation compared with conventional hip implants. The seleXys® DS acetabular cup combines the advantages of Charnley low-friction arthroplasty with those of dual mobility. We performed a non-randomised, prospective study of patients receiving primary hip arthroplasty, including an uncemented seleXys® DS dual-mobility acetabular cup with hydroxyapatite coating (Mathys AG, Bettlach, Switzerland) and a cemented femoral component (Stallion femoral stem Groupe Lepine, Lyon, France). The objective of the study was to evaluate longevity of the implant and the risk of dislocation. All operations were performed by a single surgeon using a posterior approach, with patients lying in the lateral decubitus position. The stem had a modular head diameter of 22.2 mm and was cemented in all patients. A total of 53 patients were studied, and the median duration of follow-up was 78.9 months. Implant survival 6 years after surgery was 98.4% (n=47; 95% CI: 89.3–99.8). There was one revision for sepsis 29 months after surgery, and one dislocation. The results of this study appear to demonstrate excellent implant survival and a low rate of dislocation using the chosen implants.

scholarly journals Long-term outcomes of a dual-mobility cup and cementless triple-taper femoral stem combination in total hip replacement: a multicenter retrospective analysis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Alain Cypres ◽  
Arnaud Fiquet ◽  
Philippe Girardin ◽  
David Fitch ◽  
Philippe Bauchu ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Femoral Stem ◽  
Dual Mobility Cup ◽  
Dual Mobility ◽  
Total Hip ◽  
Cementless Femoral Stem

Abstract Background The separate design concepts of dual-mobility cups and triple-taper femoral stems were developed to improve survivorship following total hip replacement (THR) by reducing instability/dislocation and enabling enhanced fixation. Successful outcomes at over two decades have been reported with earlier-generation devices based on these concepts. The current study aimed to provide the first long-term results with a unique pairing of later-generation dual-mobility cup and triple-taper cementless femoral stem after a decade of use in patients undergoing THR. Methods In this retrospective analysis, records were reviewed for all subjects implanted with this dual-mobility cup/cementless femoral stem combination at three centers between 2002 and 2005. Any subject who had not already had follow-up visit beyond 10 years, was not previously revised, and still living were invited for a single follow-up visit consisting of Merle d’Aubgine Scores, the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, and standard radiographs. Results There were 244 THRs available for analysis. At a mean follow-up of 11.9 years, the Kaplan-Meier survivorship (endpoint: revision for any reason) was 99.1% (95% CI, 97.6–99.7) for the stem and 95.9% (95% CI, 93.1–97.6) for the cup. Merle d’Aubigne Scores were significantly improved from baseline and WOMAC scores were in the satisfactory range at the final follow-up. Radiographic analysis revealed no cases of stem subsidence, no cases of bone hypertrophy, 1 (0.4%) case of bone atrophy, and 3 (1.2%) cases of osteolysis around the stem. No subjects had radiolucent lines greater than 1 mm in any femoral Gruen zone. Evidence of cup migration was seen in 1 (0.4%) subject and 1 (0.4%) subject had evidence of osteolysis that was seen in Gruen zones I, II, IV, and V. Conclusions This combination of a later-generation dual-mobility cup and cementless triple-taper stem was associated with excellent survivorship and satisfactory functional outcomes at over 10 years follow-up. Trial registration ClinicalTrials.gov, NCT02648152. Date of registration: January 6, 2016. Retrospectively registered.

Increase in Safe Zone Area of the Acetabular Cup Using Dual Mobility Cups in THA

2017 ◽  
Vol 27 (4) ◽  
pp. 361-367 ◽  
Author(s):  
Takaaki Ohmori ◽  
Tamon Kabata ◽  
Toru Maeda ◽  
Yoshitomo Kajino ◽  
Tadashi Taga ◽  
...  
Keyword(s):  
Femoral Component ◽  
Acetabular Component ◽  
Safe Zone ◽  
Stable Range ◽  
Dual Mobility Cup ◽  
Acetabular Cup ◽  
Dual Mobility ◽  
Computed Tomography Images ◽  
Revision Tha ◽  
Dual Mobility Cups

Background Dual mobility cup (DMC) inserts reduce the risk of dislocation after total hip arthroplasty (THA). No available research has clearly delineated stability advantages of DMC inserts in primary and revision THA. We investigated: (i) the degree of change in the safe zone of the cup when a DMC insert is used compared to a fixed insert; (ii) the method of selecting candidates for a DMC insert without changing the position of the acetabular (cup) component during revision THA in frequent dislocation cases caused by implant impingement. Methods A model of the pelvis and femur was developed from computed tomography images. The safe zone was defined as the area in the acetabular component, over which conditions for stable range of motion were satisfied. The safe zone was calculated for both a fixed and a DMC insert over a predetermined range of 3-D motion, and the effect of increasing the anteversion position of the femoral component from 5° to 35° was quantified. Results The lowest ratio of the area of the safe zone was about 4.9 at 20° anteverison of the femoral component. Safe zone of DMC inserts zone had increased stability of 10°-15° in both vertical and horizontal directions, compared to fixed inserts. A 5- to10-fold expansion of the safe zone can be expected with the use of DMC insert. Conclusions DMC insert could help to set the acetabular component more accurately in primary and revision THA.

Minimum 10-year follow-up of micro-arc oxidation coating on a cementless grit-blasted tapered-wedge stem of total hip arthroplasty: a multicentre study

2020 ◽  
pp. 112070002097746
Author(s):  
Young-Wook Lim ◽  
Joo-Hyoun Song ◽  
Soon-Yong Kwon ◽  
Yong-Sik Kim ◽  
Young-Seol Byun ◽  
...  
Keyword(s):  
Femoral Component ◽  
Rectangular Cross Section ◽  
Femoral Stem ◽  
Harris Hip Score ◽  
Periprosthetic Femoral Fracture ◽  
Acetabular Cup ◽  
Survivorship Analysis ◽  
Total Hip ◽  
Micro Arc Oxidation

Background: Recently, a femoral stem treated with grit-blasting and micro-arc oxidation (MAO) coating has commercialised but medium-term follow-up studies are lacking. The aim of this study was to report the outcome of a grit-blasted and MAO-coated femoral component designed as a straight, double-wedged, tapered stem with a rectangular cross-section with minimum 10 years follow-up. Methods: Between March 2006 and December 2008, 309 primary total hip arthroplasties using a grit-blasted and MAO-coated femoral component were performed by 3 experienced hip surgeons in 3 hospitals. At minimum 10 years after index THA, 299 hips were living, 10 hips were deceased, and 65 hips were lost to follow-up or had a follow-up period <10 years. Finally, 234 hips were enrolled in this study. Results: Mean duration of clinical follow-up was 129.6 months. The mean Harris Hip Score was improved from 46.9 to 88.4 at the final follow-up. 4 hips were revised for 2 aseptic femoral loosening, 1 aseptic acetabular cup loosening and 1 late infection. 3 hips were revised for a periprosthetic femoral fracture requiring a femoral component revision. The average time to revision was 51.6 (range 0–148) months. Kaplan-Meier survivorship analysis with an end point of revision for any reason demonstrated a survival rate of 97.4% at 10 years. Survival was 98.7% with revision for aseptic loosening as the endpoint. Conclusions: The outcomes of a cementless grit-blasted and MAO-coated tapered-wedge stem of THA were excellent to satisfactory after a follow-up of at least 10 years.

Iatrogenic Intraprosthetic Dislocation of Dual Mobility Cup. Case Study

2021 ◽  
Vol 23 (1) ◽  
pp. 51-57
Author(s):  
Kamil Kurczyński ◽  
Artur Pepłoński ◽  
Piotr Cieślik ◽  
Marta Burbul(
Keyword(s):  
Closed Reduction ◽  
Rare Complication ◽  
Medical Institute ◽  
Dual Mobility Cup ◽  
Acetabular Cup ◽  
Dual Mobility ◽  
First Case ◽  
The Military ◽  
Intraprosthetic Dislocation

Intra-prosthetic dislocation of the dual-mobile acetabular cup is a rare complication. Most often, it is the result of wear of the polyethylene liner. It can also occur during a closed reduction of a dislocated dual-mobile cup. It is extremely important to recognize this complication immediately in order to avoid the consequences. This paper presents the first case of iatrogenic intraprosthetic dislocation at the Traumatology and Orthopaedics Department of the Military Medical Institute, our management of the case and suggestions for treating patients with a dislocation of the dual-mobile acetabular cup.

scholarly journals Spontaneous Early Intraprosthetic Dislocation of 22 mm Skirted Femoral Head in Dual Mobility Hip Prosthesis: A Case Report

2021 ◽  
Vol 11 (5) ◽  
Author(s):  
Gur Aziz Singh Sidhu ◽  
Amit Kotecha ◽  
Sanjay Mulay ◽  
Neil Ashwood
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Revision Surgery ◽  
Hip Prosthesis ◽  
Weight Bearing ◽  
Femoral Stem ◽  
Acetabular Cup ◽  
Dual Mobility ◽  
Metal Head ◽  
Intraprosthetic Dislocation

Introduction: There is a trend for increasing use of dual mobility hip designs for both primary and revision hip arthroplasty settings. It provides dual articular surfaces along with increased jump distance to increase the stability of construct. However, this design has some unique complications of its own which surgeons should be aware of especially intraprosthetic dislocation (IPD). Case Report: A 76-year-old lady presented to clinic with painful hip hemiarthroplasty after fracture neck of femur. She underwent revision surgery with dual mobility uncemented acetabular cup and femoral stem was retained as it was well fixed. She was mobilizing well and around 5 weeks post her surgery, developed pain in hip region and difficulty in weight-bearing. Radiographs showed eccentric position of femoral neck in the socket. A diagnosis of IPD was established and revision surgery was planned. Intraoperatively, metal head had dislocated from the polyethylene head and both components were resting in the acetabular socket. No macroscopic erosion of acetabulum was noticed. The polyethylene component and femoral head were retrieved. With previous failed dual mobility, decision was made to achieve stability with larger head size and lipped liner posteriorly. Conclusion: IPD is a rare occurrence and unique complication to dual mobility implants. This report highlights that patients can have IPD without fall or trauma. Keywords: Intraprosthetic dislocation, dual mobility cup, dislocation, total hip replacement.

Boneloc versus Simplex Cement for Fixation of Femoral Components. An Interim Report of a Prospective Randomized Study of THRs with a 2,5 Year Mean Follow-Up Time

1996 ◽  
Vol 6 (3) ◽  
pp. 112-118 ◽  
Author(s):  
H. Klyver ◽  
K Jacobsen ◽  
H. Kofoed
Keyword(s):  
Femoral Component ◽  
Randomized Study ◽  
Femoral Stem ◽  
Prospective Randomized Study ◽  
Bone Cements ◽  
Interim Report ◽  
Short Term ◽  
Cement Interface ◽  
The Mean

A prospective randomized study of femoral stem fixation comparing Boneloc and Simplex cements was carried out. A collarless double-tapered femoral component was used in all cases. The material consisted of 94 patients representing 97 THRs (3 bilateral cases). Their mean age was 76 years (range 58-88). Clinico-radiographic follow-ups were carried out after 3 months, 12 months and 2 to 3 years. The mean follow up time was 2.5 years. Clinically there was no difference between the groups. Radiolucencies at the bone-cement interface and metal-cement interface, cement cracks, and subsidence of the femoral component were compared. No significant differences could be proven between the fixation patterns of the bone cements during this short-term follow-up.

Dual-mobility bearings for patients with abductor-trochanteric complex insufficiency

2018 ◽  
Vol 28 (5) ◽  
pp. 491-497 ◽  
Author(s):  
Vahit E Ozden ◽  
Goksel Dikmen ◽  
Burak Beksac ◽  
Remzi Tozun
Keyword(s):  
Acetabular Reconstruction ◽  
Dual Mobility Cup ◽  
Survivorship Analysis ◽  
Dual Mobility ◽  
Total Hip ◽  
Kaplan Meier ◽  
Dual Mobility Cups ◽  
The Mean ◽  
Cemented Cup

Introduction: The purpose of this study was to summarise the performance of dual-mobility cup systems for revision total hip arthroplasty in patients with abductor-trochanteric complex deficiency. Methods: We prospectively followed 17 patients (20 hips) with a mean age of 64.5 years (range 33-89 years) who underwent acetabular reconstruction with dual-mobility cups for aseptic loosening in 12 hips, infection treatment as second or single stage in 6 hips, and instability in 2 hips. All of the patients had abductor insufficiency. We evaluated the clinical Harris Hip scores (HHS) and radiographs for migration, loosening, and osteolysis. The survival of the components was calculated according to Kaplan-Meier survivorship analysis, and failure was defined as any dislocation, acetabular component or total hip revision for any reason. Results: The mean duration of follow-up was 38.1 months (range 24-98 months). There were 2 (12.5%) revisions for cemented cup migration after 11 months and 19 months respectively. There were no dislocations. At the last follow-up, the mean HHS increased from 42 points preoperatively to 86 points. The cumulative survival rate of the dual-mobility cup system was 93% (95% confidence interval 88-98.7%) at 5 years, with any revision as the end point. Conclusion: Dual-mobility cups may provide excellent stability in patients with abductor-trochanteric complex insufficiency.

scholarly journals Charnley femoral cemented stem with a permeable and resorbable cement restrictor and low-viscosity cement

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 39
Author(s):  
Jean-Louis Prudhon ◽  
Jacques H. Caton ◽  
Thierry Aslanian
Keyword(s):  
Survival Rate ◽  
Femoral Component ◽  
First Year ◽  
Low Friction ◽  
Low Viscosity ◽  
Kaplan Meier ◽  
Cemented Stem ◽  
Component Revision ◽  
Cement Restrictor

Introduction: In 1979, in his first book dealing with low-friction arthroplasty (LFA), Charnley highlighted the use of a cement restrictor. Breusch and Malchau described in 2005 the “second-generation cementing technique.” The main objective of this study was to report on the clinical survival of 100 cases of Charnley femoral component implanted in 2007 and 2008 using a permeable and resorbable cement restrictor and a low-viscosity antibiotic-loaded cement. The secondary objectives were to analyze the complications and side effects and the accuracy of the device positioning. Material and methods: This was a monocentric retrospective review of a prospectively compiled database. Diaphyseal restrictor was biodegradable and permeable to gas, blood, and fluids to avoid intramedullary over pression during cementation. The cement was a low-viscosity antibiotic-loaded cement. Among 3555 patients, we selected the first continuous 100 cases of patients where we implanted the device. Survival probability was computed according to Kaplan–Meier method. Results: Mean follow-up was 6.55 ± 2.6 (range 1–11). Considering femoral component revision as the endpoint, survival rate was 100%. No patients died intraoperatively, none in the first month and the first year after surgery. No early periprosthetic fractures have been reported. Discussion: As described initially by Charnley, the use of a cement restrictor was highly recommended through the different generations of cementing techniques. Hypotensive episodes and cardiac arrest have been reported during cement insertion. In our series, we did not deplore any adverse effect related to the cementation. Conclusion: Our study demonstrates a 100% survival rate of a cemented femoral component without adverse effects when using routinely a resorbable and permeable cement restrictor and a low-viscosity cement. Bone cement is still a fantastic ally for the surgeon and the patients.

Low friction arthroplasty and dual mobility cup: a new gold standard

2016 ◽  
Vol 41 (3) ◽  
pp. 563-571 ◽  
Author(s):  
Jean Louis Prudhon ◽  
Régis Verdier ◽  
Jacques H. Caton
Keyword(s):  
Gold Standard ◽  
Dual Mobility Cup ◽  
Low Friction ◽  
Dual Mobility
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