A Meta-Analysis of the Incidence and Temporal Trends of Postoperative Dislocation in Revision Total Hip Arthroplasty Utilizing Constrained Acetabular Components or Dual Mobility Implants

Donovan, Richard L; Johnson, Harvey; Fernando, S; Foxall-Smith, Michael; Whitehouse, Michael; Blom, Ashley; Kunutsor, Setor K

doi:10.1016/j.arth.2022.11.007

Cited by 5 publications

(5 citation statements)

References 89 publications

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“…In the patient cohort for this retrospective study, a dual mobility system (Avantage, Zimmer-Biomet, USA) was only used in 3 cases. As a result of the cases presented here as well as based on favorable results in the literature for revision THA [ 16 , 17 ], dual mobility articulation has been used increasingly in our center in recent years. A similar tendency can also be observed in the German arthroplasty registry which led to a rise in dual mobility articulations in revision THA from 10% in 2014 to over 30% in 2021 [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Mid-term results of a cementless hip stem in femoral revision: how much diaphyseal press-fit do we need?

Herold,

Kuttner,

Dreyer

et al. 2024

Arch Orthop Trauma Surg

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Introduction The aim of this retrospective study was to analyze the clinical and functional outcome of a modular tapered revision hip stem after mid-term follow-up with a special focus on the length of the distal bicortical fixation of the cementless hip stem. Materials and Methods Follow-up examination was carried out for all patients with implantation of the Prevision hip stem between 2014 and 2019 to collect demographic, functional, and radiographic data. Results 44 patients with stem in situ were examined, and 61 patients could be included in the Kaplan–Meier survival analysis. Oxford’s hip score was 37.3 at the mean follow-up of 4.0 years. Two hip stem revisions were performed due to periprosthetic infection, which resulted in a hip stem survival rate of 96.7% (CI: 87.4–99.1%) at the final follow-up of 7.5 years. No aseptic hip stem revision was required. The length of bicortical distal fixation was in the interquartile range of 6.8 to 9.0 cm, which was associated with good bone healing and a low rate of subsidence (4.5%). Implant-associated complications were observed in 10 cases (21.7%). Conclusions The modular revision hip stem provides promising results at medium-term follow-up, with satisfactory clinical and functional outcomes comparable to other modular revision hip stems. The presented length of bicortical distal fixation shows the practice of the study center and was associated with good implant survival, bone healing and radiological results. Registration Clinicaltrials.gov registration: NCT04833634 registered on April 6, 2021

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Section: Discussionmentioning

confidence: 99%

Mid-term results of a cementless hip stem in femoral revision: how much diaphyseal press-fit do we need?

Herold,

Kuttner,

Dreyer

et al. 2024

Arch Orthop Trauma Surg

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“…However, it remains uncertain whether the direct anterior approach offers the same advantage compared with the anterolateral approach. Finally, dual-mobility implants have been shown to reduce the risk of dislocation because they yield a greater range of motion and a larger jump distance before dislocation 40-42 . Vigdorchik et al recommend the use of these implants in patients with >3 contiguous levels of spinal fusion 43 .…”

Section: Discussionmentioning

confidence: 99%

Hip Osteoarthritis in Patients Undergoing Surgery for Severe Adult Spinal Deformity

Diebo,

Alsoof,

Balmaceno-Criss

et al. 2024

Journal of Bone and Joint Surgery

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Background: Hip osteoarthritis (OA) is common in patients with adult spinal deformity (ASD). Limited data exist on the prevalence of hip OA in patients with ASD, or on its impact on baseline and postoperative alignment and patient-reported outcome measures (PROMs). Therefore, this paper will assess the prevalence and impact of hip OA on alignment and PROMs. Methods: Patients with ASD who underwent L1-pelvis or longer fusions were included. Two independent reviewers graded hip OA with the Kellgren-Lawrence (KL) classification and stratified it by severity into non-severe (KL grade 1 or 2) and severe (KL grade 3 or 4). Radiographic parameters and PROMs were compared among 3 patient groups: Hip-Spine (hip KL grade 3 or 4 bilaterally), Unilateral (UL)-Hip (hip KL grade 3 or 4 unilaterally), or Spine (hip KL grade 1 or 2 bilaterally). Results: Of 520 patients with ASD who met inclusion criteria for an OA prevalence analysis, 34% (177 of 520) had severe bilateral hip OA and unilateral or bilateral hip arthroplasty had been performed in 8.7% (45 of 520). A subset of 165 patients had all data components and were examined: 68 Hip-Spine, 32 UL-Hip, and 65 Spine. Hip-Spine patients were older (67.9 ± 9.5 years, versus 59.6 ± 10.1 years for Spine and 65.8 ± 7.5 years for UL-Hip; p < 0.001) and had a higher frailty index (4.3 ± 2.6, versus 2.7 ± 2.0 for UL-Hip and 2.9 ± 2.0 for Spine; p < 0.001). At 1 year, the groups had similar lumbar lordosis, yet the Hip-Spine patients had a worse sagittal vertebral axis (SVA) measurement (45.9 ± 45.5 mm, versus 25.1 ± 37.1 mm for UL-Hip and 19.0 ± 39.3 mm for Spine; p = 0.001). Hip-Spine patients also had worse Veterans RAND-12 Physical Component Summary scores at baseline (25.7 ± 9.3, versus 28.7 ± 9.8 for UL-Hip and 31.3 ± 10.5 for Spine; p = 0.005) and 1 year postoperatively (34.5 ± 11.4, versus 40.3 ± 10.4 for UL-Hip and 40.1 ± 10.9 for Spine; p = 0.006). Conclusions: This study of operatively treated ASD revealed that 1 in 3 patients had severe hip OA bilaterally. Such patients with severe bilateral hip OA had worse baseline SVA and PROMs that persisted 1 year following ASD surgery, despite correction of lordosis. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

“…Several preoperative factors associated with an increased dislocation risk are described in the literature 26 , 27 , 28 , 29 . Biomechanical factors such as reduced offset or leg shortening may raise dislocation risk due to inappropriate soft tissue tension 28 , 29 . Similarly, an undersized spacer at the acetabular or femoral side could increase the dislocation risk due to spacer instability or mobilization 12 , 26 , 27 .…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, an undersized spacer at the acetabular or femoral side could increase the dislocation risk due to spacer instability or mobilization 12 , 26 , 27 . Adductor muscle deficit or a severe bone defect may also result in a higher dislocation rate because they are associated with greater difficulty in achieving spacer stability intraoperatively and during the interval period 28 , 29 .…”

Section: Discussionmentioning

confidence: 99%

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Two-stage revision in periprosthetic joint infection of the hip using a new intraoperatively molded articulating spacer design

Cacciola

Giustra

Bosco

et al. 2023

Journal of Clinical Orthopaedics and Trauma

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A Meta-Analysis of the Incidence and Temporal Trends of Postoperative Dislocation in Revision Total Hip Arthroplasty Utilizing Constrained Acetabular Components or Dual Mobility Implants

Cited by 5 publications

References 89 publications

Mid-term results of a cementless hip stem in femoral revision: how much diaphyseal press-fit do we need?

Mid-term results of a cementless hip stem in femoral revision: how much diaphyseal press-fit do we need?

Hip Osteoarthritis in Patients Undergoing Surgery for Severe Adult Spinal Deformity

Two-stage revision in periprosthetic joint infection of the hip using a new intraoperatively molded articulating spacer design

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