gms | German Medical Science

German Congress of Orthopedic and Trauma Surgery (DKOU 2017)

24.10. - 27.10.2017, Berlin

Is dual mobility total hip arthroplasty associated with an increased risk of revision for infection? Matched cohort of 231 dual mobility cups and 231 Fixed cups

Meeting Abstract

  • presenting/speaker Jean Louis Prudhon - Clinique des Cèdres, Grenoble , France
  • Romain Desmarchelier - Centre Hospitalier Lyon-Sud, Pierre-Bénite, France
  • Moussa Hamadouche - Hopital Cochin, Paris, France
  • Christian Delaunay - Clinique de l'Yvette, Lonjumeau, France
  • Regis Verdier - Groupe Lépine, Genay, France

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2017). Berlin, 24.-27.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocIN26-1263

doi: 10.3205/17dkou052, urn:nbn:de:0183-17dkou0529

Published: October 23, 2017

© 2017 Prudhon et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives: The reasons for revision of Standard Total Hip Arthroplasty (THA) with so called fixed cups (FC-THA) are well known.. We have recently reported on the reasons for mechanical failures of Dual Mobility (DMC-THA). Recent reports from European northern countries registries have pointed out an increase in infection rate and mortality with DMC-THA.

Based on a matched cohort of 231 cases of primary DM-THA and 231 cases FC-THAs, the purpose of this study was to assess whether:

1.
Revisions for infection are more frequent when using DMC-THA than FC-THA
2.
Causes for revision are significantly different between DMC-THA and FC-THA.

Methods: From 2010 to 2011 a prospective multi centre study was carried out by two of us (C. D and M. H) and the French Society of Orthopaedic and Traumatology. 2044 first revision cases were prospectively collected; 251 (13.5%) were revision of DMC-THA and 1793 were revision of FC-THA (87.7%). Due to the significant differences between the 2 populations we defined a matching process (matching ratio 1:1) between the 2 cohorts. Four mandatory criteria for this matching process were used to select the most appropriate cases.

Results and Conclusion: Forty-seven (20.3%) FC-THAs were revised for infection and 54 (23.3%) in DM-THAs. There was no statistical difference between the 2 series (p-value 0.65.)

Forty-one (17.7%) FC-THAs were revised for dislocation, compared to 11 (4.7%) DMC-THAs (p value is 0.00014).

Twelve DM-THAs were revised for technical errors, 28 FC-THAs (p value 0,023).

Regarding aseptic loosening, peri-prosthetic fracture, osteolysis and wear, implant breakage and miscellaneous, results were comparable without statistical differences.

Main finding of our study is that DM cup are not associated with an increased risk of revision for infection compared to standard THA.