Research article

The association of dual-mobility total hip arthroplasty with dislocation compared to conventional hip arthroplasty for neck of femur fracture

  • Received: 07 May 2023 Revised: 20 September 2023 Accepted: 31 October 2023 Published: 07 November 2023
  • Introduction 

    Neck of femur fractures are extremely common worldwide and have a mortality rate of 15% at 1 year. Dual-mobility cups (DMCs) have demonstrated a reduction in dislocation and revision rates for elective total hip arthroplasty (THA) but the benefits of DMC use in neck of femur fractures are less clear. The aim of this study was to compare the rate of dislocation between conventional and DMC THA following neck of femur fracture.

    Materials and methods 

    Data was retrospectively collected for patients who received either DMCs or standard acetabular components for neck of femur fractures at our institution. Patients were excluded if they had less than 2 years follow-up. Dislocation and revision rates were collected for all patients in addition to radiographic analysis to assess for loosening.

    Results 

    Data was collected for 39 patients with DMCs and 95 patients with conventional THA. Two patients with DMCs suffered a dislocation (5.1%) compared to 7 patients (7.3%) who underwent a conventional THA (p = 0.49). Both patients in the DMC group had additional risk factors for dislocation. One DMC patient required revision surgery for dislocation and one conventional THA patient underwent a revision for aspetic loosening. There were no cases of radiographic loosening in the DMC group.

    Conclusions 

    Our study showed a trend towards lower dislocation rates in patients treated with a DMC compared to conventional THA. Although there are potential issues associated with DMC implants and cost implications, this study suggests they may be advantageous in patients at high risk for dislocation.

    Citation: Matthew C.A. Arnold, John W. Kennedy, Evan Wright, Madeleine Reece, R.M. Dominic Meek. The association of dual-mobility total hip arthroplasty with dislocation compared to conventional hip arthroplasty for neck of femur fracture[J]. AIMS Medical Science, 2023, 10(4): 304-309. doi: 10.3934/medsci.2023023

    Related Papers:

  • Introduction 

    Neck of femur fractures are extremely common worldwide and have a mortality rate of 15% at 1 year. Dual-mobility cups (DMCs) have demonstrated a reduction in dislocation and revision rates for elective total hip arthroplasty (THA) but the benefits of DMC use in neck of femur fractures are less clear. The aim of this study was to compare the rate of dislocation between conventional and DMC THA following neck of femur fracture.

    Materials and methods 

    Data was retrospectively collected for patients who received either DMCs or standard acetabular components for neck of femur fractures at our institution. Patients were excluded if they had less than 2 years follow-up. Dislocation and revision rates were collected for all patients in addition to radiographic analysis to assess for loosening.

    Results 

    Data was collected for 39 patients with DMCs and 95 patients with conventional THA. Two patients with DMCs suffered a dislocation (5.1%) compared to 7 patients (7.3%) who underwent a conventional THA (p = 0.49). Both patients in the DMC group had additional risk factors for dislocation. One DMC patient required revision surgery for dislocation and one conventional THA patient underwent a revision for aspetic loosening. There were no cases of radiographic loosening in the DMC group.

    Conclusions 

    Our study showed a trend towards lower dislocation rates in patients treated with a DMC compared to conventional THA. Although there are potential issues associated with DMC implants and cost implications, this study suggests they may be advantageous in patients at high risk for dislocation.



    加载中


    Conflict of interest



    All authors declare no conflicts of interest in this paper.

    [1] Morri M, Ambrosi E, Chiari P, et al. (2019) one-year mortality after hip fracture surgery and prognostic factors: A prospective cohort study. Sci Rep 9: 18718. https://doi.org/10.1038/s41598-019-55196-6
    [2] Royal College of Physicians, Facing new challenges—The National Hip Fracture Database report on 2020. London Royal College of Physicians, 2021. Available from: https://www.nhfd.co.uk/FFFAP/Reports.nsf/0/220AC3A08F5AC22080258789007CCC92/$file/NHFD_2021_Report.pdf
    [3] Iorio R, Healy WL, Lemos DW, et al. (2001) Displaced femoral neck fractures in the elderly: Outcomes and cost effectiveness. Clin Orthop Relat Res 383: 229-242. https://doi.org/10.1097/00003086-200102000-00027
    [4] Tarasevicius S, Busevicius M, Robertsson O, et al. (2010) Dual mobility cup reduces dislocation rate after arthroplasty for femoral neck fracture. BMC Musculoskelet Disord 11: 175. https://doi.org/10.1186/1471-2474-11-175
    [5] De Martino I, Triantafyllopoulos GK, Sculco PK, et al. (2014) Dual mobility cups in total hip arthroplasty. World J Orthop 5: 180-187. https://doi.org/10.5312/wjo.v5.i3.180
    [6] Yang S, Xie F, Cui W, et al. (2021) A review of the clinical and engineering performance of dual-mobility cups for total hip arthroplasty. Am J Transl Res 13: 9383-9394.
    [7] De Martino I, D'Apolito R, Soranoglou VG, et al. (2017) Dislocation following total hip arthroplasty using dual mobility acetabular components: A systematic review. Bone Joint J 99: 18-24. https://doi.org/10.1302/0301-620X.99B1.BJJ-2016-0398.R1
    [8] Adam P, Philippe R, Ehlinger M, et al. (2012) Dual mobility cups hip arthroplasty as a treatment for displaced fracture of the femoral neck in the elderly. A prospective, systematic, multicenter study with specific focus on postoperative dislocation. Orthop Traumatol Surg Res 98: 296-300. https://doi.org/10.1016/J.OTSR.2012.01.005
    [9] Slover J, Hoffman MV, Malchau H, et al. (2009) A cost-effectiveness analysis of the arthroplasty options for displaced femoral neck fractures in the active, healthy, elderly population. J Arthroplasty 24: 854-860. https://doi.org/10.1016/J.ARTH.2008.05.008
    [10] Hudson JI, Kenzora JE, Hebel JR, et al. (1998) Eight-year outcome associated with clinical options in the management of femoral neck fractures. Clin Orthop Relat Res 348: 59-66. https://doi.org/10.1097/00003086-199803000-00011
    [11] Canton G, Moghnie A, Cleva M, et al. (2019) Dual mobility total hip arthroplasty in the treatment of femoral neck fractures: A retrospective evaluation at mid-term follow-up. Acta Biomed 90: 98-103. https://doi.org/10.23750/abm.v90i1-S.8070
    [12] Tarasevičius S, Robertsson O, Dobozinskas P, et al. (2013) A comparison of outcomes and dislocation rates using dual articulation cups and THA for intracapsular femoral neck fractures. 23: 22-26. https://doi.org/10.5301/HIP.2013.10632
    [13] Bensen AS, Jakobsen T, Krarup N (2014) Dual mobility cup reduces dislocation and re-operation when used to treat displaced femoral neck fractures. Int Orthop 38: 1241-1245. https://doi.org/10.1007/S00264-013-2276-8
    [14] Mufarrih SH, Qureshi NQ, Masri B, et al. (2021) Outcomes of total hip arthroplasty using dual-mobility cups for femoral neck fractures: A systematic review and meta-analysis. HIP Int 31: 12-23. https://doi.org/10.1177/1120700020926652
    [15] Nich C, Vandenbussche E, Augereau B, et al. (2016) Do dual-mobility cups reduce the risk of dislocation in total hip arthroplasty for fractured neck of femur in patients aged older than 75 years?. J Arthroplasty 31: 1256-1260. https://doi.org/10.1016/j.arth.2015.11.041
    [16] Canton G, Moghnie A, Ratti C, et al. (2018) Dual mobility total hip arthroplasty in the treatment of femoral neck fracture: A systematic review of the literature. Recent Adv Arthroplast 2: 32-38.
    [17] Cha YH, Yoo JI, Kim JT, et al. (2020) Dual mobility total hip arthroplasty in the treatment of femoral neck fractures. Bone Joint J 102: 1457-1466. https://doi.org/10.1302/0301-620X.102B11.BJJ-2020-0610.R2
    [18] Farey JE, Masters J, Cuthbert AR, et al. (2022) Do dual-mobility cups reduce revision risk in femoral neck fractures compared with conventional THA designs? An international meta-analysis of arthroplasty registries. Clin Orthop Relat Res 480: 1912-1925. https://doi.org/10.1097/CORR.0000000000002275
    [19] Lecuire F, Benareau I, Rubini J, et al. (2004) Intra-prosthetic dislocation of the Bousquet dual mobility socket. Rev Chir Orthop Reparatrice Appar Mot 90: 249-255. https://doi.org/10.1016/S0035-1040(04)70101-4 (Article in French language)
    [20] Kobayashi S, Takaoka K, Tsukada A, et al. (1998) Polyethylene wear from femoral bipolar neck-cup impingement as a cause of femoral prosthetic loosening. Arch Orthop Trauma Surg 117: 390-391. https://doi.org/10.1007/S004020050274
    [21] Neri T, Boyer B, Geringer J, et al. (2019) Intraprosthetic dislocation of dual mobility total hip arthroplasty: Still occurring?. Int Orthop 43: 1097-1105. https://doi.org/10.1007/s00264-018-4054-0
    [22] Massin P, Orain V, Philippot R, et al. (2012) Fixation failures of dual mobility cups: A mid-term study of 2601 hip replacements. Clin Orthop Relat Res 470: 1932-1940. https://doi.org/10.1007/s11999-011-2213-3
    [23] Khoshbin A, Haddad FS, Ward S, et al. (2020) A cost-effectiveness assessment of dual-mobility bearings in revision hip arthroplasty. Bone Joint J 102: 1128-1135. https://doi.org/10.1302/0301-620X.102B9.BJJ-2019-1742.R1
    [24] Montgomery S, Bourget-Murray J, You DZ, et al. (2021) Cost-effectiveness of dual-mobility components in patients with displaced femoral neck fractures. Bone Joint J 103: 1783-1790. https://doi.org/10.1302/0301-620X.103B12.BJJ-2021-0495.R2
  • Reader Comments
  • © 2023 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(1289) PDF downloads(226) Cited by(0)

Article outline

Figures and Tables

Tables(1)

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog