Implant survival of 662 dual-mobility cups and 727 constrained liners in primary THA: small femoral head size increases the cumulative incidence of revision

Pakarinen, Oskari; Lainiala, Olli; Reito, Aleksi; Neuvonen, Perttu; Mäkelä, Keijo; Eskelinen, Antti

doi:10.1080/17453674.2021.1939597

Cited by 5 publications

(1 citation statement)

References 36 publications

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“…A similar study conducted by Dubin and Westrich 19 followed patients with the same MDM implant for a mean of 6 years and 11 months and demonstrated a survivorship of approximately 98.6%, which is in line with our study. Similarly, our survivorship is further supported by a 2021 study by Pakarinen et al 20 that reported an incidence rate of revision of 6.9% following MDM cup implantation in 399 patients at 6 years follow-up, which is comparable to our observed revision rate of 6.5%. Another study looking at mid-term outcomes following implantation only reported 1 of their 43 patients required revision for aseptic loosening.…”

Section: Discussionsupporting

confidence: 91%

Mid-Term Outcomes of Modular Dual Mobility Bearings in Total Hip Arthroplasty

Arraut,

Ward,

Oakley

et al. 2023

The Journal of Hip Surgery

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Modular dual mobility (MDM) prostheses in which a cobalt–chromium liner is inserted into a titanium acetabular shell have the potential for corrosion. This has raised concern. While these constructs have been shown to effectively reduce the risk of dislocation in revision and high-risk primary total hip arthroplasty (THA), previous studies have been limited by the length of follow-up. The purpose of the study is to review the mid-term clinical outcomes of MDM implants with a minimum of 5-year follow-up. A retrospective, observational study was conducted on all consecutive patients who underwent THA with a MDM implant from June 2011 and March 2017 at an urban, tertiary academic medical center. Descriptive statistics were used to describe baseline patient characteristics. Primary endpoints included revision rates, dislocations rates, and implant component survivorship. Implant survival was analyzed using the Kaplan–Meier method. A total of 92 cases (61 primary, 31 revision) underwent THA with a MDM implant at an average follow-up of 6.90 ± 1.48 years (range: 5.01–10.53 years). The mean patient age at the time of surgery was 58.20 ± 11.85 years. Six patients were revised (6.5%, 6/92), two for periprosthetic joint infection (2.2%, 2/92), one due to aseptic loosening (1.1%, 1/92), one due to periprosthetic fracture (1.1%, 1/92), and the remaining two for metallosis (2.2%, 2/92). Kaplan–Meier survivorship analysis showed a 93.5% survival rate for all-cause revisions and 98.9% survival for acetabular component revision. MDM components reliably decrease the risk of dislocation after THA. However, the occurrence of two revisions due to metallosis demonstrates the necessity for continued surveillance in this cohort. Larger trials with long-term follow-up may be required to further elucidate the long-term outcomes and performance of these bearings.

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Section: Discussionsupporting

confidence: 91%

Mid-Term Outcomes of Modular Dual Mobility Bearings in Total Hip Arthroplasty

Arraut,

Ward,

Oakley

et al. 2023

The Journal of Hip Surgery

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Short-term primary and revision modular dual-mobility cup total hip arthroplasty outcomes in high-risk dislocation patients: a retrospective study

Ruusiala,

Miettinen,

Kettunen

et al. 2024

Eur J Orthop Surg Traumatol

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Purpose Modular dual-mobility cups (MDMCs) have a lower risk for dislocation after total hip arthroplasty (THA). The primary aims of our study were to analyze implant survivorship and to determine complications, especially dislocation, and revision rates of primary THAs used for hip fracture patients and for revision THAs. Secondary aims were to evaluate mortality after MDMC surgery and to find out if introduction of MDMC at our institution (Kuopio University Hospital, Finland) have decreased dislocation rate. Methods This retrospective cohort study consisted of 101 MDMC patients who were consecutively operated at our institution between April 1, 2018 and June 30, 2020. The implant survival rate, complications and mortality were evaluated with minimum of 2-year follow-up. Finnish Hospital Discharge Register was used to find out yearly dislocation rates following THA at our institution. Results The cumulative estimate implant survival after MDMC in the primary THA group was 97% at 2 years, and in the revision THA group, it was 90% at 2 years. Dislocation was a rare complication in the primary THA group (1.4%), while it was common in revision THA group (12.9%). The cumulative estimate for mortality after MDMC in the primary THA group was 13% at 2 years, and in the revision group, it was also 13% at 2 years. The yearly number of patients who had re-hospitalization period due to THA dislocation decreased 46% after implementation of MDMC. Conclusion Short-term survival and complication rates after MDMC were excellent after primary THA and moderate after revision THA. Implementation of MDMC THA for hip fracture patients seems to have effectively decrease dislocation rate during a short follow-up.

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