gms | German Medical Science

Objectives: Low friction arthroplasty (LFA) introduced by Sir John Charnley was the gold standard for many years. Dislocation and infection are the first causes for early revision. Late failures are Polyethylene (PE) wear and loosening. Due to dislocation risk we slowly switched to use Dual Mobility Cups (DMC).

Purposes are 1) to assess whether our changes have improved outcomes, 2) what is the new gold standard?

Methods: We selected on an observational registry 1091 cases of hybrid Charnley Total Hip Arthroplasty (THA). Acetabular component was either DMC in 455 cases or Fixed Cup (FC) in 636 cases.

Results and Conclusion: Three dislocations (0.6%) occurred in DMC group (none revised). In FC group 54 dislocated (8.49%) and 20 were recurrent and underwent revision (revision rate 3.14%).

In DMC group 5 acetabular and 3 femoral revisions were performed (revision rate for loosening 1.7%).

In FC group 19 cases underwent acetabular revision, 5 cases had femoral component revised (revision rate for loosening 3.7%).

Charnley' s LFA has proven over 50 years excellent survivorship. To decrease dislocation risk, one suggested to increase femoral head diameter. Gilles Bousquet proposed another way: DMC concept. Dislocation is no longer a critical issue with DMC as demonstrated in our series and main series. DMC in primary THA is still a subject of debate. Mid-term results do not demonstrate a higher rate of wear than LFA. What is the current gold standard? LFA was and is our current gold standard in association with a DMC.