Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, UK.
Bone Joint J. 2020 Apr;102-B(4):423-425. doi: 10.1302/0301-620X.102B4.BJJ-2019-1492.R1.
Dislocation remains a significant complication after total hip arthroplasty (THA), being the third leading indication for revision. We present a series of acetabular revision using a dual mobility cup (DMC) and compare this with our previous series using the posterior lip augmentation device (PLAD).
A retrospective review of patients treated with either a DMC or PLAD for dislocation in patients with a Charnley THA was performed. They were identified using electronic patient records (EPR). EPR data and radiographs were evaluated to determine operating time, length of stay, and the incidence of complications and recurrent dislocation postoperatively.
A total of 28 patients underwent revision using a DMC for dislocation following Charnley THA between 2013 and 2017. The rate of recurrent dislocation and overall complications were compared with those of a previous series of 54 patients who underwent revision for dislocation using a PLAD, between 2007 and 2013. There was no statistically significant difference in the mean distribution of sex or age between the groups. The mean operating time was 71 mins (45 to 113) for DMCs and 43 mins (21 to 84) for PLADs (p = 0.001). There were no redislocations or revisions in the DMC group at a mean follow-up of 55 months (21 to 76), compared with our previous series of PLAD which had a redislocation rate of 16% (n = 9) and an overall revision rate of 25% (n = 14, p = 0.001) at a mean follow-up of 86 months (45 to 128).
These results indicate that DMC outperforms PLAD as a treatment for dislocation in patients with a Charnley THA. This should therefore be the preferred form of treatment for these patients despite a slightly longer operating time. Work is currently ongoing to review outcomes of DMC over a longer follow-up period. PLAD should be used with caution in this patient group with preference given to acetabular revision to DMC. Cite this article: 2020;102-B(4):423-425.
髋关节置换术后脱位仍然是一个严重的并发症，是翻修的第三大指征。我们报告了一系列使用双动杯（DMC）进行髋臼翻修的病例，并将其与我们之前使用后唇增强装置（PLAD）的系列病例进行了比较。
通过电子病历（EPR）对接受 DMC 或 PLAD 治疗 Charnley 髋关节置换术后脱位的患者进行回顾性分析。评估 EPR 数据和 X 线片以确定手术时间、住院时间以及术后并发症和复发性脱位的发生率。
2013 年至 2017 年间，共有 28 例 Charnley 髋关节置换术后脱位患者接受了 DMC 翻修。将 DMC 组的复发性脱位和总体并发症发生率与 2007 年至 2013 年间接受 PLAD 翻修治疗脱位的 54 例患者的先前系列进行比较。两组的性别和年龄的平均分布无统计学差异。DMC 的平均手术时间为 71 分钟（45 至 113 分钟），PLAD 为 43 分钟（21 至 84 分钟）（p = 0.001）。DMC 组在平均 55 个月（21 至 76）的随访中无再脱位或翻修，而我们之前的 PLAD 系列中，再脱位率为 16%（n = 9），总体翻修率为 25%（n = 14，p = 0.001），平均随访时间为 86 个月（45 至 128）。
这些结果表明，DMC 在治疗 Charnley 髋关节置换术后脱位方面优于 PLAD。因此，尽管手术时间略长，但对于这些患者，它应该是首选的治疗方法。目前正在进行一项研究，以在更长的随访时间内审查 DMC 的结果。在这组患者中应谨慎使用 PLAD，并优先考虑髋臼翻修为 DMC。
2020;102-B(4):423-425.
