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Functional Outcome of Dual Mobility Cup in Complex Primary Hip Arthroplasty - Our Experience from Developing World
Abstract
Introduction: Instability following total hip arthroplasty (THA) is the most common indication of revision surgery globally. It is peculiarly prevailing among high-risk patients such as those with neuromuscular disorders, failed hip fractures, and previous spinal fusion. Dual mobility cups (DMC) is the ultimate solution to reduce the risk of dislocation following THA among patients with complex deformed hip. Our aim of the study is to determine the functional outcome of DMC in the complex deformed hip.
Material & Methods: This is a single-center prospective study conducted in a renowned tertiary care hospital in Karachi, Pakistan. A total of 38 patients underwent THA with DMC for complex deformed hips. Factors analyzed were age, gender, comorbid, American Society of Anesthesiologist (ASA) score, cause of THA, risk factors of dislocation, Body mass index (BMI), surgical approach, implant characteristics (acetabular & femoral components), radiographs immediate post-operative and at final follow-up, Harris Hip Score (HHS) and complications associated with primary THA. All patients were asked to follow up in the clinic at 6 weeks, 3 months, 6 months, and annually thereafter. The minimum follow-up period was 1 year whereas the maximum follow-up period was 3 years. The primary endpoint of our study was to determine the number of patients who presented with dislocation following THA with DMC. The secondary outcome was to assess functional outcomes in patients who underwent THA for complex hips. The data were statistically analyzed using IBM SPSS version 20.0 statistics.
Results: The mean age of patients was 52.3 ± 9.2. In our study, failed hip fractures were the most common reason for performing THA with DMC. An excellent to the good functional outcome was achieved in 36 (94.7%) patients. 1 patient had atraumatic posterior dislocation at 4 weeks following surgery. A closed reduction was performed and an abduction brace was applied for 3-5 days followed by full-weight bear mobilization with a walker allowed.
Conclusion: We conclude that THA with DMC is a reasonable option to prevent dislocation among patients with complex deformed hips.
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