Dual-mobility bearings in complex revision hip arthroplasty
| Autor: | Christopher P Wakeling, Simon J Bridle, Jonathan R.B. Hutt, Philip A. Mitchell, Rafia Ghani, Nemandra A Sandiford |
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| Rok vydání: | 2021 |
| Předmět: |
Reoperation
medicine.medical_specialty business.industry Arthroplasty Replacement Hip medicine.medical_treatment Joint Dislocations Acetabulum Prosthesis Design Dual mobility Arthroplasty Prosthesis Failure Surgery medicine Hip Dislocation Humans Orthopedics and Sports Medicine Hip Prosthesis business Revision hip arthroplasty Retrospective Studies Total hip arthroplasty |
| Zdroj: | HIP International. 32:460-465 |
| ISSN: | 1724-6067 1120-7000 |
| DOI: | 10.1177/1120700021999795 |
| Popis: | Background: Revision total hip arthroplasty (rTHA) is associated with an increased dislocation risk. Dual-mobility (DM) bearings have been used to address this issue. Such constructs offer increased range of motion and enhanced stability whilst avoiding some issues associated with fully-constrained devices. DM bearings have been used in our unit since 2013. Methods: All rTHA cases since 2013 were reviewed using the following criteria: (1) use of a DM bearing; (2) extensive soft tissue or bone loss resulting from ARMD, infection or multiple revisions, or requiring custom or megaprosthetic reconstruction; (3) minimum 2-month follow-up. Results: 52 cases were identified with a median of 2 previous operations (range 1–6) and mean follow-up of 14 (2–41) months. The Novae-Stick component was used in 50 cases, the Avantage in 2 and the Trident MDM in 1 case. 19 required acetabular reconstruction using trabecular metal and four required custom acetabular components. 19 required femoral reconstruction with a proximal or total femoral replacement. Postoperatively, 8 patients (15.4%) sustained a dislocation at a mean of 1.6 (range 1–3) months. 3 (5.8%) requiring re-revision. 1 required excision arthroplasty and 2 a constrained liner, 1 of which went on to have further instability. There were no intraprosthetic dislocations. Conclusions: Dual-mobility components are a viable option in the complex rTHA setting. Early dislocations can occur but the rate of instability is acceptable in this high-risk group. |
| Databáze: | OpenAIRE |
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