Early outcomes of THA using uncemented dual-mobility cups with additional fixation screws

Article Sidebar

PDF Download
Published Jan 28, 2021
DOI: https://doi.org/10.18103/mra.v9i1.2265

Downloads

Download data is not yet available.

Submit your own article

Register as an author to reserve your spot in the next issue of the Medical Research Archives.

Author Registration

Join the Society

The European Society of Medicine is more than a professional association. We are a community. Our members work in countries across the globe, yet are united by a common goal: to promote health and health equity, around the world.

Join Europe’s leading medical society and discover the many advantages of membership, including free article publication.

Membership

Main Article Content

Jean-Charles Rollier, MD
Ramsay Santé, Department of Orthopaedic Surgery, Clinique d'Argonay, Annecy, France; Artro Group Institute, Annecy le Vieux, France
Julien Chouteau, MD, PhD
Ramsay Santé, Department of Orthopaedic Surgery, Clinique d'Argonay, Annecy, France; b) Artro Group Institute, Annecy le Vieux, France
Luca Nover, MSc
ReSurg SA, Nyon, Switzerland
Giuseppe Toro, MD
Ramsay Santé, Department of Orthopaedic Surgery, Clinique d'Argonay, Annecy, France
Mo Saffarini, MEng, MBA, FRSM
ReSurg SA, Nyon, Switzerland
Laurent Jacquot, MD
Ramsay Santé, Department of Orthopaedic Surgery, Clinique d'Argonay, Annecy, France; Artro Group Institute, Annecy le Vieux, France
Tarik Ait-Si-Selmi, MD
Artro Group Institute, Annecy le Vieux, France; Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France

Abstract

Background: The use of fixation screws with uncemented cups is controversial particularly for dual mobility (DM) cups where perforation of the articular surface could compromise implant longevity. We aimed to compare outcomes of total hip arthroplasty (THA) using uncemented DM cups with supplementary screw fixation versus simple press-fit fixation.


Methods: From 235 consecutive THAs performed using uncemented DM cups, 203 were fixed by simple press-fit and 32 fixed with additional screws. The Oxford hip score (OHS) and EuroQol 5 Dimensions (EQ-5D) score were available at 3.3±1.1 years. To enable direct comparison, each screw fixation cup was matched to three simple press-fit cups using propensity scores, based on age, sex and bone quality.


Results: The two groups had equivalent age, body mass index, gender distribution, femoral morphology and bone quality. Compared to the press-fit group (n=96), the screw fixation group had more surgical antecedents (p=0.032), higher femoral neck angles (p=0.028), and received slightly larger cups (p=0.036). Revision was required for two (6%) screw fixation cups (only one implant-related) and one (1%) press-fit cup (none implant-related). There were no differences between OHS (19±8 vs 18±7, p=0.682) nor EQ-5D (0.63±0.37, p=0.257).


Conclusions: Revision rates were greater for DM cups fixed with additional screws than for those fixed by simple press-fit, but clinical scores were equivalent. There was only one implant-related revision (acetabular fracture) in the screw fixation group and it is unclear whether this is related to the additional screws or to patient/surgical factors.


Level of evidence: Level IV, retrospective case series.

Keywords: THA, dislocations dual-mobility cup, uncemented, cementless, press-fit, screw fixation

Article Details

How to Cite
ROLLIER, Jean-Charles et al. Early outcomes of THA using uncemented dual-mobility cups with additional fixation screws. Medical Research Archives, [S.l.], v. 9, n. 1, jan. 2021. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/2265>. Date accessed: 22 nov. 2024. doi: https://doi.org/10.18103/mra.v9i1.2265.
ABNT APA BibTeX CBE EndNote - EndNote format (Macintosh & Windows) MLA ProCite - RIS format (Macintosh & Windows) RefWorks Reference Manager - RIS format (Windows only) Turabian
Issue
Vol 9 No 1 (2021): Vol. 9 Issue 1 January 2021
Section
Research Articles

The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.

 

References

1. Boukebous B, Boutroux P, Zahi R, Azmy C, Guillon P. Comparison of dual mobility total hip arthroplasty and bipolar arthroplasty for femoral neck fractures: A retrospective case-control study of 199 hips. Orthop Traumatol Surg Res 2018; 104 (3):369-375.
2. Terrier A, Latypova A, Guillemin M, Parvex V, Guyen O. Dual mobility cups provide biomechanical advantages in situations at risk for dislocation: a finite element analysis. Int Orthop 2017; 41 (3):551-556.
3. Ozden VE, Dikmen G, Beksac B, Tozun R. Dual-mobility bearings for patients with abductor-trochanteric complex insufficiency. Hip Int 2018; 28 (5):491-497.
4. De Martino I, D'Apolito R, Soranoglou VG, Poultsides LA, Sculco PK, Sculco TP. Dislocation following total hip arthroplasty using dual mobility acetabular components: a systematic review. Bone Joint J 2017; 99-b (ASuppl1):18-24.
5. Horriat S, Haddad FS. Dual mobility in hip arthroplasty: What evidence do we need? Bone Joint Res 2018; 7 (8):508-510.
6. Klingenstein GG, Yeager AM, Lipman JD, Westrich GH. Computerized range of motion analysis following dual mobility total hip arthroplasty, traditional total hip arthroplasty, and hip resurfacing. J Arthroplasty 2013; 28 (7):1173-1176.
7. Reina N, Pareek A, Krych AJ, Pagnano MW, Berry DJ, Abdel MP. Dual-Mobility Constructs in Primary and Revision Total Hip Arthroplasty: A Systematic Review of Comparative Studies. J Arthroplasty 2018.
8. Chughtai M, Mistry JB, Diedrich AM, Jauregui JJ, Elmallah RK, Bonutti PM, et al. Low Frequency of Early Complications With Dual-mobility Acetabular Cups in Cementless Primary THA. Clin Orthop Relat Res 2016; 474 (10):2181-2187.
9. Ferreira A, Prudhon JL, Verdier R, Puch JM, Descamps L, Dehri G, et al. Contemporary dual-mobility cup regional and private register: methodology and results. Int Orthop 2017; 41 (3):439-445.
10. Fessy MH, Jacquot L, Rollier JC, Chouteau J, Ait-Si-Selmi T, Bothorel H, et al. Midterm Clinical and Radiographic Outcomes of a Contemporary Monoblock Dual-Mobility Cup in Uncemented Total Hip Arthroplasty. J Arthroplasty 2019; 34 (12):2983-2991.
11. Dangin A, Boulat S, Farizon F, Philippot R. Prevention of Dislocation Risk During Hip Revision Surgery with the Dual Mobility Concept; Study of a New Generation of Dual Mobility Cups. Surg Technol Int 2016; 29:314-319.
12. Ko LM, Hozack WJ. The dual mobility cup: what problems does it solve? Bone Joint J 2016; 98-b (1 Suppl A):60-63.
13. Noyer D, Caton JH. Once upon a time.... Dual mobility: history. Int Orthop 2017; 41 (3):611-618.
14. Haen TX, Lonjon G, Vandenbussche E. Can cemented dual-mobility cups be used without a reinforcement device in cases of mild acetabular bone stock alteration in total hip arthroplasty? Orthop Traumatol Surg Res 2015; 101 (8):923-927.
15. Spaans EA, Koenraadt KLM, Wagenmakers R, van den Hout J, Te Stroet MAJ, Bolder SBT. Midterm survival analysis of a cemented dual-mobility cup combined with bone impaction grafting in 102 revision hip arthroplasties. Hip Int 2018; 28 (2):161-167.
16. Engh CA, Hopper RH, Jr., Engh CA, Jr. Long-term porous-coated cup survivorship using spikes, screws, and press-fitting for initial fixation. J Arthroplasty 2004; 19 (7 Suppl 2):54-60.
17. Toro G, Bothorel H, Saffarini M, Jacquot L, Chouteau J, Rollier JC. Uncemented total hip arthroplasty in octogenarian and nonagenarian patients. Eur J Orthop Surg Traumatol 2019; 29 (1):103-110.
18. Delaunay C, Epinette JA, Dawson J, Murray D, Jolles BM. Cross-cultural adaptations of the Oxford-12 HIP score to the French speaking population. Orthop Traumatol Surg Res 2009; 95 (2):89-99.
19. EuroQol G. EuroQol--a new facility for the measurement of health-related quality of life. Health Policy 1990; 16 (3):199-208.
20. Garcia-Rey E, Garcia-Cimbrelo E, Cruz-Pardos A. Cup press fit in uncemented THA depends on sex, acetabular shape, and surgical technique. Clin Orthop Relat Res 2012; 470 (11):3014-3023.
21. Barrack RL. Neurovascular injury: avoiding catastrophe. J Arthroplasty 2004; 19 (4 Suppl 1):104-107.
22. Rohrl SM, Nivbrant B, Snorrason F, Karrholm J, Nilsson KG. Porous-coated cups fixed with screws: a 12-year clinical and radiostereometric follow-up study of 50 hips. Acta Orthop 2006; 77 (3):393-401.