Bull Hosp Jt Dis (2013). 2024 Sep;82(3):210-216.
Prosthetic dislocation after total hip arthroplasty (THA) is one of the most common causes of revision THA. Dual-mobility (DM) bearings were introduced to mitigate complications; however, there is minimal data on their performance in younger patients. This study compared results of patients who were under 55 years of age undergoing primary THA with DM or fixed-bearing (FB) implants.
A retrospective review of patients younger than 55 years who underwent primary THA with at least 2 years of follow-up between June 2011 and August 2019 was performed. Patients were stratified into two cohorts based on the implant they received (DM vs. FB). Primary outcomes were 90-day all-cause readmission, dislocation, all-cause revision, 90-day readmission and revision due to dislocation, and implant component survivorship. Demographic differences were assessed using chi-squared and independent samples t-tests. Outcomes were compared using multivariate linear and logistic regressions to control for confounding variables.
A total of 803 patients were included (DM = 73, FB = 730). The DM and FB cohorts had similar rates of 90- day all-cause readmission (6.8% vs. 3.2%; p = 0.243) and 90-day readmission due to dislocation (4.1% vs. 0.8%; p = 0.653). At a mean follow-up of 4.42 ± 1.91 years, dislocation (4.1% vs. 1.1%; p = 0.723) and all-cause revision (5.5% vs. 4.9%; p = 0.497) rates between the DM and FB cohorts were similar. Kaplan Meier analysis yielded no significant differences in survivorship between groups for all-cause revision (95.1% vs. 94.5%; p = 0.923), revision due to dislocation (100% vs. 98.9%; p = 0.370), and acetabular component revision (97.3% vs. 98.6%; p = 0.418).
Dual mobility implants demonstrate similar dislocation rates and implant survivorship compared to FB in patients less than 55 years of age. Larger trials with long-term follow-up may be required to further elucidate the effects of DM bearings compared to FB inserts in younger patients undergoing primary THA.
全髋关节置换术后（THA）假体脱位是翻修 THA 的最常见原因之一。双动（DM）轴承的引入是为了减轻并发症；然而，关于它们在年轻患者中的表现的数据很少。本研究比较了年龄在 55 岁以下接受初次 THA 的患者使用 DM 或固定轴承（FB）植入物的结果。
对 2011 年 6 月至 2019 年 8 月期间接受初次 THA 且随访至少 2 年的年龄小于 55 岁的患者进行回顾性研究。根据植入物的不同（DM 与 FB）将患者分为两组。主要结果为 90 天全因再入院、脱位、全因翻修、90 天因脱位再入院和翻修，以及植入物组件存活率。使用卡方检验和独立样本 t 检验评估人口统计学差异。使用多元线性和逻辑回归比较结果，以控制混杂变量。
共纳入 803 例患者（DM 组 73 例，FB 组 730 例）。DM 组和 FB 组 90 天全因再入院率（6.8% vs. 3.2%；p = 0.243）和 90 天因脱位再入院率（4.1% vs. 0.8%；p = 0.653）相似。在平均随访 4.42±1.91 年后，DM 组和 FB 组的脱位（4.1% vs. 1.1%；p = 0.723）和全因翻修率（5.5% vs. 4.9%；p = 0.497）相似。Kaplan-Meier 分析显示，两组全因翻修（95.1% vs. 94.5%；p = 0.923）、因脱位翻修（100% vs. 98.9%；p = 0.370）和髋臼组件翻修（97.3% vs. 98.6%；p = 0.418）的存活率无显著差异。
在年龄小于 55 岁的患者中，与 FB 相比，DM 植入物的脱位率和植入物存活率相似。可能需要更大规模的长期随访试验来进一步阐明 DM 轴承与 FB 植入物在接受初次 THA 的年轻患者中的效果差异。
