The use of a cemented dual mobility socket to treat recurrent dislocation.
BACKGROUND
The treatment of recurrent dislocation after total hip arthroplasty remains challenging. Dual mobility sockets have been associated with a low rate of dislocation but it is not known whether they are useful for treating recurrent dislocation.


OBJECTIVE
We therefore asked whether a cemented dual mobility socket would (1) restore hip stability following recurrent dislocation; (2) provide a pain-free and mobile hip; and (3) show durable radiographic fixation.


METHODS
We retrospectively reviewed 51 patients treated with a cemented dual mobility socket for recurrent dislocation after total hip arthroplasty between August 2002 and June 2005. The mean age at the time of the index procedure of was 71.3 years. Of the 51 patients, 47 have had complete clinical and radiographic evaluation data at a mean followup of 51.4 months (range, 25-76.3 months).


RESULTS
The cemented dual mobility socket restored complete stability of the hip in 45 of the 47 patients (96%). The mean Merle d'Aubigné hip score was 16 ± 2 at the latest followup. Radiographic analysis revealed no or radiolucent lines less than 1 mm thick located in a single acetabular zone in 43 of 47 hips (91.5%). The cumulative survival rate of the acetabular component at 72 months using revision for dislocation and/or mechanical failure as the end point was 96% ± 4% (95% confidence interval, 90%-100%).


CONCLUSIONS
A cemented dual mobility socket was able to restore hip stability in 96% of recurrent dislocating hips. However, longer-term followup is needed to ensure that dislocation and loosening rates will not increase.
The Clinical Orthopaedic Research Centre, Department of Reconstructive and Orthopaedic Surgery, Service A, Centre Hospitalo-Universitaire Cochin-Port Royal, Université René Descartes, Hôpital Cochin (AP-HP), 75014, Paris, France. moussah@club-internet.fr
Moussa
M
Hamadouche
David J
DJ
Biau
Denis
D
Huten
Thierry
T
Musset
François
F
Gaucher
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000295:instrumentation*; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D005602:France; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D007593:Joint Instability / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D001843:Bone Cements