Article
Causes for revision of primary dual mobility total hip arthroplasty. A prospective multicentric study series of 251 implants compared to 1856 fixed socket total hip arthroplasty.
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Authors
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Jean Louis Prudhon
- Clinique des Cèdres, La Tronche, France
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Romain Desmarchelier
- Centre Hospitalier Lyon Sud, Pierre Benite, France
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Christian Delaunay
- Clinique de l'Yvette, Lonjumeau, France
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Moussa Hamadouche
- Hopital Cochin, Paris, France
| Published: | October 5, 2015 |
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Outline
Text
Introduction: The causes for revision of primary Total Hip Arthroplasty (THA) are various and well known. The use of Dual Mobility Total Hip Arthroplasty (DM THA) seems a relevant option to decrease the risk of instability. In lack of long term follow up, this innovative concept was suspected to have an increased risk of polyethylene (PE) wear. The purpose of this study is to analyze the causes for revision of DM THAs and to assess whether or not they are different from standard THA, particularly in term of wear
Methods: The SoFCOT group conducted a, observational prospective multicentric study from January 1st 2010 to December 31 2011. Inclusion criteria were an exhaustive collection of first revision THA or resurfacing arthroplasty.
Results: Aseptic loosening is the first reason for revision DM THAs (28.7%). Infection is the second cause for revision of DM THAs (20%). The same number of DM THA (20%) have been revised for a peri prosthetic fracture. Technical errors are two times more frequent in the series DM THAs (10%). Some DM THAs have been revised for dislocation (5.5%). Ten patients (4%) were revised for an intra-prosthetic dislocation which has been separated from standard dislocation, because we can assess it is totally different. Nine DM THAs (4%) have been revised for osteolysis and wear.
Discussion: We can identify three different periods of occurrence. In the early period (0 to 5 years) patient factors are of most importance. Infection, dislocation, peri prosthetic fracture, is the most common causes for revision. A closer analysis of the reasons for revision of DM THA suggests that early causes are directly linked to patient factors: age, neck fracture, and comorbidities, over or under weight. In the mi- term period, the rate of revision due to a technical error is two times more frequent (10% vs 5.77%) in DM THAs. In the third period (over 10 years) main reasons for revision are aseptic loosening, osteolysis and wear, intra prosthetic dislocation.
Conclusion: DM THAs are not affected by a higher risk of revision compared to FS THAs. Long term outcomes are similar to a standard THA, wear and osteolysis are not clearly increased in DM THAs
