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      No dislocation and low complication rate for a modern dual mobility cup with pre-impacted femoral head in primary hip replacement: A consecutive series of 175 hips at minimum 5-year follow-up

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          Abstract

          Introduction: Despite its excellent results in preventing dislocation, the dual mobility cup (DMC) is still struggling to be adopted by some teams due to premature wear and loosening reported on first-generation implants. Therefore, this study aimed to assess the mid-term survivorship of a modern DMC with a pre-impacted head and the radio-clinical results at a minimum follow-up of 5 years. Methods: This was a retrospective single-centre study performed on patients who had a primary total hip replacement for osteoarthritis in 2016. The cup was a third-generation DMC with a pre-impacted femoral head. Clinical (harris hip score (HHS)) and radiological (cup abduction, anteversion, overhang, and radiolucent lines) results were recorded, as well as complications, particularly dislocations and survivorship. A minimum of five years of follow-ups was required. Results: One hundred and seventy-five hips (167 patients) met the inclusion criteria. Five hips (2.9%, 5/175) were lost to follow-up and excluded from the postoperative analysis. The mean follow-up period was 70 ± 2.9 months [63.6–76.5]. Three cups needed revision surgery (1.8%, 3/170): one for septic loosening, and two for chronic infection. At 77 months, the global survival probability was 98.2% ± 1, and the survival probability excluding septic aetiology was 100%. There was a significant improvement in the HHS from pre-operatively (48.3 ± 6.0 [14.0–70.0]) to post-operatively (96 ± 4.5 [50–100]) ( p < 0.0001). There were no postoperative dislocations recorded, nor any iliopsoas-impingement or symptomatic cam-effect. Discussion: This study showed excellent survival and good radiological and clinical results of this dual mobility cup at a mid-term follow-up. None of the patients had dislocation or any specific complication feared with dual mobility cups.

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          Most cited references64

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          Radiological Demarcation of Cemented Sockets in Total Hip Replacement

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            Outcomes of dual mobility components in total hip arthroplasty

            Instability remains a challenging problem in both primary and revision total hip arthroplasty (THA). Dual mobility components confer increased stability, but there are concerns about the unique complications associated with these designs, as well as the long-term survivorship.
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              Intraprosthetic dislocation: a specific complication of the dual-mobility system.

              The dual-mobility concept was proposed as an alternative to prevent postoperative dislocation events. However, intraprosthetic dislocation (IPD) is a troublesome and specific complication induced by the loss of the polyethylene retentive rim and escape of the femoral head from the polyethylene liner. The factors associated with IPD are unknown as only isolated cases have been reported and do not provide a clear understanding of the mechanisms of failure.
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                Author and article information

                Journal
                SICOT J
                SICOT J
                sicotj
                SICOT-J
                EDP Sciences
                2426-8887
                2023
                17 January 2023
                : 9
                : 1
                Affiliations
                [1 ] Department of Orthopedic Surgery and Sport Medicine, Croix-Rousse Hospital, FIFA Medical Center of Excellence 69004 Lyon France
                [2 ] Université de Lyon, Université Claude Bernard Lyon 1 69100 Lyon France
                [3 ] The Midyorkshire Hospitals NHS Trust WF14DG Wakefield United Kingdom
                [4 ] Fortis Hospital 560076 Bangalore India
                [5 ] EA 7424, Interuniversity Laboratory of Human Movement Science, Université Lyon 1 69100 Lyon France
                [6 ] Université de Lyon, Université Claude Bernard Lyon 1, IFSTTAR, LBMC UMR_T9406 69622 Lyon France
                Author notes
                [* ]Corresponding author: constant.foissey@ 123456chu-lyon.fr
                Author information
                http://orcid.org/0000-0001-7724-3703
                Article
                sicotj220096 10.1051/sicotj/2022050
                10.1051/sicotj/2022050
                9878999
                36648274
                74d496f0-4877-4149-9721-1c92ec5fa570
                © The Authors, published by EDP Sciences, 2023

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 October 2022
                : 26 November 2022
                Page count
                Figures: 5, Tables: 2, Equations: 0, References: 52, Pages: 8
                Categories
                Original Article
                Hip

                total hip arthroplasty,dual mobility cup,survival,dislocation,complication,loosening

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