Experience with double mobility cups in patients with high risk of dislocation.
Report of 60 cases
Keywords:
Artroplastia total de caderaAbstract
Dislocation is a serious complication, which in the case of primary arthroplasties occurs between 0.5 and 7%; and in revision surgeries it reaches a frequency of up to 30%.
The tripolar cup is considered the best antiluxant implant.
The objective of our work was to study the results of the use of the double mobility system in a series of patients who required a total hip arthroplasty and had risk factors associated with for postoperative dislocation.
Material and methods
A prospective work was carried out on a homogeneous longitudinal cohort using a double mobility cup system (Hip’n Go dual mobility, FH Orthopedics France) in a total of 60 hip arthroplasties.
The patients included were ambulatory, aged between 70 and 96 years, they required a total hip arthroplasty, and had risk factors associated with dislocation of their ATC.
All the patients were operated by the same surgical team through a posterolateral approach. Clinical evaluation, the Harris Score and the radiographic studies were used for the postoperative control. The minimum follow-up was one year after surgery.
The radiologic evaluation consisted in the angle of acetabular inclination, the Barrack criteria in the cemented femoral stems and the Engh criteria for osseo integration of the in the different areas described by Gruen.
Results
We found a clinical improvement in pain and in the ability to develop activities of daily living, which resulted in a Harris score of 77 average points.
Regarding the radiographic assessment, the angle of acetabular inclination averaged 47 degrees.
In the cases where we used cemented femoral stems, we found that 30 corresponded to grade A and 10 to B of the Barrack classification.
In those where cementless stems were implanted, we determined that they were all fixed according to the Engh criteria.
In the follow-up, no infections or wound dehiscences were detected, and as a non-symptomatic finding we found an intraprosthetic dislocation.
Conclusions
The use of Double Mobility cups is effective to minimize the risk of instability after primary hip arthroplasty in high-risk patients. Longer term studies and more patients are needed to confirm the advantages obtained in this series.
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