Complications in Total Hip Arthroplasties After Acetabulum Fractures: A Comparative Study of Conventional Cups Versus Dual Mobility Cups
Abstract
Introduction: Degenerative hip disease can develop after an acetabulum fracture. Total Hip Arthroplasty (THA) is a common salvage procedure that generally yields good outcomes but is not without technical difficulties and complications. Objective: To analyze the clinical and radiological outcomes and short- and medium-term complications of THA by comparing uncemented, dual-mobility acetabular cups with conventional uncemented cups. Materials and Methods: We retrospectively evaluated 37 patients who underwent THA between 2003 and 2022. Clinical and functional outcomes were assessed using the Merle d’Aubigné and Postel scale, while radiographic outcomes were evaluated according to the modified Stauffer criteria and the stability of cementless components based on Engh parameters. Results: The final sample included 37 patients (11 women and 26 men) with an average age of 43.78 years. The average follow-up time was 6.6 years. Outcomes were excellent in 54% of cases, good in 32.4%, fair in 8.1%, and poor in 5.5%. Fisher’s exact test showed no significant correlation between the type of cup used and the risk of complications. Conclusions: Total hip arthroplasty using dual-mobility cups is a highly effective treatment option for the sequelae of acetabular fractures, offering excellent outcomes and a very low complication rate.Downloads
References
Matta JM, Ferguson T. Total hip replacement after acetabular fracture. Orthopaedics 2005;28:959-62.
https://doi.org/10.3928/0147-7447-20050901-23
Lugones MA, Díaz Gallardo P, Bidolegui F, Vindver G, Allende BL. Artroplastia total de cadera con copa no
cementada en secuela de fractura de acetábulo. Rev Asoc Argent Ortop Traumatol 2012;77(3):185-91.
https://doi.org/10.15417/128
Brooker AF, Bowerman JW, Robinson RA, Riley LH. Ectopic ossification following total hip
replacement. Incidence and method of classification. J Bone Joint Surg 1973;55:1629. PMID: 4217797
Larson C. Fracture dislocation of the hip. Clin Orthop Relat Res 1973;92:147-54. https://doi.org/10.1097/00003086-197305000-00013
Mears DC, Velyvis JH. Acute total hip arthroplasty for selected displaced acetabular fractures. Two to twelve-year results. J Bone Joint Surg Am 2002;84:1-9. https://doi.org/10.2106/00004623-200201000-00001
Anglen JO, Burd TA, Hendricks KJ, Harrison P. The “gull sign”. A harbinger of failure for internal fixation of geriatric acetabular fractures. J Orthop Trauma 2003;17(9):625-34. https://doi.org/10.1097/00005131-200310000-00005
O’Toole RV, Hui E, Chandra A, Nascone JW. How often does open reduction and internal fixation of geriatric
acetabular fractures lead to hip arthroplasty? J Orthop Trauma 2014;28(3):148-53. https://doi.org/10.1097/bot.0b013e31829c739a
Daurka JS, Pastides PS, Lewis A, Rickman M, Bircher MD. Acetabular fractures in patients aged >55 years: a
systematic review of the literature. Bone Joint J 2014;96-B(2):157-63. https://doi.org/10.1302/0301-620x.96b2.32979
Sermon A, Broos P, Vanderschot P. Total hip replacement for acetabular fractures. Results in 121 patients operated between 1983 and 2003. Injury 2008;39(8):91421. https://doi.org/10.1016/j.injury.2007.12.004
Ranawat A, Zelken J, Helfet D, Buly R. Total hip arthroplasty for posttraumatic arthritis after acetabular fracture. J Arthroplasty 2009;24(5):759-67. https://doi.org/10.1016/j.arth.2008.04.004
Romness DW, Lewallen DG. Total hip arthroplasty after fracture of the acetabulum. Long-term results. J Bone Joint Surg Br 1990;72(5):761-4. https://doi.org/10.1302/0301-620x.72b5.2211750
Lachiewicz PF, Watters TS. The use of dual-mobility components in total hip arthroplasty. J Am Acad Orthop Surg 2012;20:481-6. https://doi.org/10.5435/jaaos-20-08-481
Schairer WW, Sing DC, Vail TP, Bozic KJ. Causes and frequency of unplanned hospital readmission after total hip arthroplasty. Clin Orthop Relat Res 2014;472:464-70. https://doi.org/10.1007/s11999-013-3121-5
Combes A, Migaud H, Girard J, Duhamel A, Fessy MH. Low rate of dislocation of dual-mobility cups in primary
total hip arthroplasty. Clin Orthop Relat Res 2013;471:3891-900. https://doi.org/10.1007/s11999-013-2929-3
Philippot R, Farizon F, Camilleri JP, Boyer B, Derhi G, Bonnan J, et al. Survival of cementless dual mobility socket with a mean 17 years follow-up. Rev Chir Orthop Reparatrice Appar Mot 2008;94:e23-e27.
https://doi.org/10.1016/j.rco.2007.10.013
Stauffer RN. Ten-year follow-up study of total hip replacement. With particular reference to roentgenographic
loosening of the components. J Bone Joint Surg Am 1982;64:983-90. PMID: 7118986
Engh CA, Bobyn JD, Glassman AH. Porous-coated hip replacement. The factors governing bone ingrowth, stress shielding, and clinical results. J Bone Joint Surg Br 1987;69(1):45-55. https://doi.org/10.1302/0301-620x.69b1.3818732
Gruen TA, McNeice GM, Amstutz HC. “Modes of failure” of cemented stem-type femoral components: a
radiographic analysis of loosening. Clin Orthop Relat Res 1979;141:17. PMID: 477100
Giannoudis PV, Grotz MRW, Papakostidis C, Dinopoulos H. Operative treatment of displaced fractures of the
acetabulum. A meta-analysis. J Bone Joint Surg Br 2005;87(1):2-9. PMID: 15686228
Judet R, Judet J, Letournel E. Fractures of the acetabulum: classification and surgical approaches for open reduction. Preliminary report. J Bone Joint Surg Am 1964;46:1615-46. PMID: 14239854
Pritchett JW, Bortel DT. Total hip replacement after central fracture dislocation of the acetabulum. Orthop Rev
;20:607-10. PMID: 1945506
Waddell JP, Morton J. Total hip arthroplasty following acetabular fracture. Annual Meeting of the Orthopaedic
Trauma Association, Los Angeles, California, Sept. 23, 1994.
Weber M, Berry DJ, Harmsen SH. Total hip arthroplasty after operative treatment of an acetabular fracture. J Bone Joint Surg 1998;80(9):1295-305. https://doi.org/10.2106/00004623-199809000-00008
Kreder HJ, Rozen N, Borkhoff CM, Laflamme YG, McKee MD, Schemitsch EH, et al. Determinants of functional
outcome after simple and complex acetabular fractures involving the posterior wall. J Bone Joint Surg Br 2006;88(6):776-82. https://doi.org/10.1302/0301-620x.88b6.17342
Guyen O, Chen QS, Bejui-Hugues J, Berry DJ, An KN. Unconstrained tripolar hip implants: effect on hip stability. Clin Orthop Relat Res 2007;455:202-8. https://doi.org/10.1097/01.blo.0000238796.59596.1f
Leclercq S, Benoit JY, de Rosa JP, Euvrard P, Leteurtre C, Girardin P. Results of the Evora dual-mobility socket
after a minimum follow-up of five years. Rev Chir Orthop Reparatrice Appar Mot 2008;94(8):e17-e22.
https://doi.org/10.1016/j.rco.2007.10.015
Vielpeau C, Lebel B, Ardouin L, Burdin G, Lautridou C. The dual mobility socket concept: experience with 668
cases. Int Orthop 2011;35(2):225-30. https://doi.org/10.1007/s00264-010-1156-8
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
