Faculty of Health Sciences, University of Eastern Finland, Yliopistonranta 1, 70210, Kuopio, Finland.
Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio, Finland.
Eur J Orthop Surg Traumatol. 2024 Dec;34(8):3981-3988. doi: 10.1007/s00590-024-04092-5. Epub 2024 Sep 8.
Modular dual-mobility cups (MDMCs) have a lower risk for dislocation after total hip arthroplasty (THA). The primary aims of our study were to analyze implant survivorship and to determine complications, especially dislocation, and revision rates of primary THAs used for hip fracture patients and for revision THAs. Secondary aims were to evaluate mortality after MDMC surgery and to find out if introduction of MDMC at our institution (Kuopio University Hospital, Finland) have decreased dislocation rate.
This retrospective cohort study consisted of 101 MDMC patients who were consecutively operated at our institution between April 1, 2018 and June 30, 2020. The implant survival rate, complications and mortality were evaluated with minimum of 2-year follow-up. Finnish Hospital Discharge Register was used to find out yearly dislocation rates following THA at our institution.
The cumulative estimate implant survival after MDMC in the primary THA group was 97% at 2 years, and in the revision THA group, it was 90% at 2 years. Dislocation was a rare complication in the primary THA group (1.4%), while it was common in revision THA group (12.9%). The cumulative estimate for mortality after MDMC in the primary THA group was 13% at 2 years, and in the revision group, it was also 13% at 2 years. The yearly number of patients who had re-hospitalization period due to THA dislocation decreased 46% after implementation of MDMC.
Short-term survival and complication rates after MDMC were excellent after primary THA and moderate after revision THA. Implementation of MDMC THA for hip fracture patients seems to have effectively decrease dislocation rate during a short follow-up.
模块化双动杯（MDMC）在全髋关节置换术后（THA）发生脱位的风险较低。我们研究的主要目的是分析假体生存率，并确定并发症，特别是脱位和翻修率，包括用于髋部骨折患者的初次 THA 和翻修 THA。次要目的是评估 MDMC 手术后的死亡率，并确定我们医院（芬兰库奥皮奥大学医院）引入 MDMC 是否降低了脱位率。
本回顾性队列研究纳入了 2018 年 4 月 1 日至 2020 年 6 月 30 日期间在我院连续进行的 101 例 MDMC 患者。通过至少 2 年的随访，评估了假体生存率、并发症和死亡率。芬兰住院患者出院登记系统用于确定我院 THA 后的每年脱位率。
在初次 THA 组中，MDMC 术后 2 年的累积估计假体生存率为 97%，在翻修 THA 组中，2 年的累积估计假体生存率为 90%。初次 THA 组脱位是一种罕见的并发症（1.4%），而在翻修 THA 组中较为常见（12.9%）。在初次 THA 组中，MDMC 术后 2 年的累积死亡率估计为 13%，在翻修组中，2 年的累积死亡率估计也为 13%。MDMC 实施后，因 THA 脱位而再住院的患者人数减少了 46%。
初次 THA 后 MDMC 的短期生存率和并发症发生率良好，翻修 THA 后则为中等。在短期随访中，对髋部骨折患者实施 MDMC THA 似乎有效降低了脱位率。
