The Use of a Cemented Dual Mobility Socket to Treat Recurrent Dislocation

• Published in: Clinical orthopaedics and related research Vol. 468; no. 12; pp. 3248 - 3254
• Main Authors: Hamadouche, Moussa, Biau, David J., Huten, Denis, Musset, Thierry, Gaucher, François
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01-12-2010; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - adverse effects; Arthroplasty, Replacement, Hip - instrumentation; Bone Cements - therapeutic use; Conservative Orthopedics; Female; France; Hip Joint - diagnostic imaging; Hip Joint - physiopathology; Hip Joint - surgery; Hip Prosthesis; Humans; Joint Dislocations - diagnostic imaging; Joint Dislocations - etiology; Joint Dislocations - physiopathology; Joint Dislocations - surgery; Joint Instability - etiology; Joint Instability - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Prosthesis Design; Radiography; Range of Motion, Articular; Recovery of Function; Recurrence; Reoperation; Retrospective Studies; Sports Medicine; Surgery; Surgical Orthopedics; Symposium: Papers Presented at the 2009 Closed Meeting of the International Hip Society; Time Factors; Treatment Outcome; Radiolucent Line; Cumulative Survival Rate; Femoral Head; Recurrent Dislocation; Acetabular Component
• ISSN: 0009-921X; 1528-1132
• DOI: 10.1007/s11999-010-1404-7

Background
The treatment of recurrent dislocation after total hip arthroplasty remains challenging. Dual mobility sockets have been associated with a low rate of dislocation but it is not known whether they are useful for treating recurrent dislocation.
Questions/purposes
We therefore asked whether a cemented dual mobility socket would (1) restore hip stability following recurrent dislocation; (2) provide a pain-free and mobile hip; and (3) show durable radiographic fixation.
Methods
We retrospectively reviewed 51 patients treated with a cemented dual mobility socket for recurrent dislocation after total hip arthroplasty between August 2002 and June 2005. The mean age at the time of the index procedure of was 71.3 years. Of the 51 patients, 47 have had complete clinical and radiographic evaluation data at a mean followup of 51.4 months (range, 25–76.3 months).
Results
The cemented dual mobility socket restored complete stability of the hip in 45 of the 47 patients (96%). The mean Merle d’Aubigné hip score was 16 ± 2 at the latest followup. Radiographic analysis revealed no or radiolucent lines less than 1 mm thick located in a single acetabular zone in 43 of 47 hips (91.5%). The cumulative survival rate of the acetabular component at 72 months using revision for dislocation and/or mechanical failure as the end point was 96% ± 4% (95% confidence interval, 90%–100%).
Conclusions
A cemented dual mobility socket was able to restore hip stability in 96% of recurrent dislocating hips. However, longer-term followup is needed to ensure that dislocation and loosening rates will not increase.
Level of Evidence
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.