The use of a dual mobility cup in the management of recurrent dislocations of hip hemiarthroplasty

Carulli, Christian; Macera, Armando; Matassi, Fabrizio; Civinini, Roberto; Innocenti, Massimo

doi:10.1007/s10195-015-0365-8

Cited by 41 publications

(30 citation statements)

References 55 publications

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“…This is shown in several studies in which dual mobility components were used specifically to treat recurrent dislocation [35–38]. Furthermore, dual mobility implants have also shown good reliability in unstable hemiarthroplasty revision converted to THA [40]. …”

Section: Resultsmentioning

confidence: 93%

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How to prevent dislocation after revision total hip arthroplasty: a systematic review of the risk factors and a focus on treatment options

et al. 2018

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BackgroundDislocation represents the most common complication after revision total hip arthroplasty (rTHA). Understanding risk factors for dislocation has a great clinical relevance for every hip surgeon in order to consider all surgical options for effective planning. The aim of this systematic review was to answer two main questions—(1) what are the risk factors for instability after rTHA? and (2) what are the best preoperative assessments and surgical options to avoid dislocation after rTHA?Materials and methodsScientific databases were accessed to identify papers dealing with prevention and treatment of dislocation after rTHA. We performed a search using the keywords ‘revision hip arthroplasty’ and ‘dislocation’, ‘instability’, ‘outcome’, ‘failure’, ‘treatment’. After removal of duplicates and exclusion of works published in different languages, 33 articles were reviewed completely.ResultsRisk factors were analysed in order to establish the most relevant and evidence-based treatments available in the current literature.ConclusionsThe risk of dislocation after rTHA can be reduced using some precautions inferred from the literature. The use of a larger femoral and acetabular component, elevated rim liner and dual mobility implants can significantly reduce the risk of dislocation after rTHA. However, care must be taken regarding patient-related risk factors since these cannot be addressed and modified. Hence, a complete evaluation of risk factors should be performed for each patient and procedure before starting rTHA.

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Section: Resultsmentioning

confidence: 93%

“…Dual mobility cups are widely reported to reduce the risk of dislocation after rTHA [33–40]. Dual mobility cups are designed with a 22- or 28-mm diameter femoral head component moving inside a larger polyethylene liner.…”

Section: Resultsmentioning

confidence: 99%

How to prevent dislocation after revision total hip arthroplasty: a systematic review of the risk factors and a focus on treatment options

et al. 2018

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“…Reports on the prognosis of these treatments are lacking. Some scholars reported that convert to a THA with dual mobility cups in the treatment of a hemiarthroplasty recurrent dislocation had a very good outcome [19]. Early recurrent dislocation of BHA is a frequent indication for revision surgery.…”

Section: Discussionmentioning

confidence: 99%

Early Recurrent Dislocation and Dissociation of Bipolar Cup: Two Intricate Cases and Review of Literature.

Fan¹,

Wang²,

Zhang³

et al. 2020

Preprint

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Background: Bipolar hemiarthroplasty (BHA) is one of the best options to treat femoral neck fracture in elderly patients. However, the early dislocation problem also happens in the bipolar cup. Furthermore, BHA has a specific implant-related complication, namely bipolar cup dissociation, in which the femoral head dissociates from the polyethylene (PE) liner. Early dislocation and dissociation are relatively uncommon but devastating complications and almost always lead to reoperation with revision of the prosthesis. Dislocation and dissociation of the bipolar cup can be challenging to manage and easily turn to recurrent episodes in case of improper handling. We hope to find out the best strategy for treatment early recurrent dislocation and dissociation of the bipolar cup.Methods: We retrospectively reviewed 2 patients who had a history of early recurrent posterior dislocations following primary BHA from 2016 to 2019. What’s more, they had early recurrent bipolar cup dissociation during the attempt of closed reduction maneuvers within 3 months of the original surgery.Results: All the patients were treated with open reduction and revision of Bipolar hemiarthroplasty (BHA). One patient has a good outcome, and no recurrence of dislocation was recorded.Conclusion: Recognition of the risk of dislocation and dissociation of bipolar cup is essential to its prevention and treatment. Complete revision of bipolar parts and the femoral head may be the minimum solution necessary to avoid the early recurrence of bipolar cup dissociation. Further investigations are recommended to strengthen these results.

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“…Previously, less than − 10°of APP angle was considered to increase the anterior dislocation in standing position [3], therefore, our current patient was considered having the severe posterior pelvic tilt that resulted in anterior dislocation. In the previous reports, late postoperative dislocation of THA due to severe posterior tilt were treated by revision THA with elevated liner or optimization of cup anteversion [10] or use of dual mobility cup [11]. In our case, she underwent revision THA using a CT-based navigation system for the appropriate cup positioning in combination with a dual mobility cup.…”

Section: Discussionmentioning

confidence: 81%

Utility of CT-based navigation in revision total hip arthroplasty for a patient with severe posterior pelvic tilt-case report-

Watanabe

Choe

Kobayashi

et al. 2020

BMC Musculoskelet Disord

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Background: Hip dislocation after total hip arthroplasty (THA) or hemi-arthroplasty is a rare but serious complication. Dislocation may be prevented by appropriate positioning of the cup angle of inclination and anteversion. Case presentation: This report describes a 66-year-old woman who underwent revision THA using a computer tomography (CT)-based navigation system to treat an anterior dislocation after hemi-arthroplasty due to a severe posterior pelvic tilt. At initial presentation, her sagittal pelvic tilt angle, measured as anterior pelvic plane (APP) in the supine position, was 38 degrees posterior to the coronal plane. Owing to the posterior pelvic tilt, revision THA was performed using CT-based navigation, while dual mobility was utilized to reduce the risk of re-dislocation. Postoperatively, her sagittal pelvic tilt angle showed further progression over time, with an APP of 66 degrees posterior to the coronal plane in the standing position 3 years after revision THA. Simulation with the Zed Hip system showed that the risk of implant-to-implant impingement was much higher posteriorly than anteriorly. Gait analysis demonstrated hyperextension of the hip joint while walking, although hip joint function required for daily activity was maintained. Conclusions: Preoperative planning of implant orientation, based on posterior progression of pelvic tilt and accurate placement of components, is important to prevent dislocation in patients with severe posterior pelvic tilt. A dual mobility cup may also improve hip function in these patients.

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The use of a dual mobility cup in the management of recurrent dislocations of hip hemiarthroplasty

Cited by 41 publications

References 55 publications

How to prevent dislocation after revision total hip arthroplasty: a systematic review of the risk factors and a focus on treatment options

How to prevent dislocation after revision total hip arthroplasty: a systematic review of the risk factors and a focus on treatment options

Early Recurrent Dislocation and Dissociation of Bipolar Cup: Two Intricate Cases and Review of Literature.

Utility of CT-based navigation in revision total hip arthroplasty for a patient with severe posterior pelvic tilt-case report-

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