title: Cementless dual-mobility cup in total hip arthroplasty revision.
abstract: OBJECTIVE
  Dislocation is a frequent complication in total hip arthroplasty (THA) revision. Cup fixation is the second concern. In order to know outcomes at two years, we prospectively followed a continuous series of 78 patients to demonstrate that cementless dual-mobility cup (DMC) used in revision THA is safe as regards dislocation risk and bone fixation.
  
  
  METHODS
  We enrolled 78 consecutive patients (79 cases) in a prospective study. Mean interval between index surgery and revision was 12.9 years. Mean age at revision was 75.5 years. Two types of cementless DMC were used: a standard DMC in 68 cases with low-grade bone defect (Paprosky grade 1 and 2), and a specific design reconstruction DMC in 11 cases with severe bone loss (Paprosky grade 3).
  
  
  RESULTS
  At two years of follow-up, 68 patients were reviewed; four were lost to follow-up., and six patients were deceased. We identified three types of situations at risk:standard risk (33 cases), Paprosky grade 1 or 2; medium risk (37 cases), revision for recurrent instability (21), periprosthetic fractures (14) or severe loosening Paprosky grade 3 without femorotomy (2); high risk (nine cases), revision for severe loosening with a femorotomy. One (1.3%) patient dislocated her hip at one month without recurrence. Revision rate for dislocation was 0%; two (2.7%) early mechanical failures occurred.
  
  
  CONCLUSIONS
  Considering outcomes of this series, cementless DMC can be suggested in THA revision surgery.
authors: Clinique des Cèdres, 21 rue Albert Londres, 38432, Echirolles, France, jean-louis.prudhon@wanadoo.fr.
authors: Jean Louis
authors: JL
authors: Prudhon
authors: François
authors: F
authors: Steffann
authors: André
authors: A
authors: Ferreira
authors: Régis
authors: R
authors: Verdier
authors: Thierry
authors: T
authors: Aslanian
authors: Jacques
authors: J
authors: Caton
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D001843:Bone Cements; D002484:Cementation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D057068:Periprosthetic Fractures; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies
chemical_list: D001843:Bone Cements