Clinical and radiological outcomes with the Durom™ acetabular cup for large-diameter total hip arthroplasty: 177 implants after a mean of 80 months - 21/05/15
, B. Belvisi, B. Rubens-Duval, R. Pailhé, R.C. Rouchy, R. Mader
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Abstract |
Background |
Large-diameter metal-on-metal hip prostheses are no longer used, but their outcomes after more than 5years are unknown. We conducted a retrospective study with a 6.8-year mean follow-up to assess clinical outcomes after Durom™ cup implantation, including the dislocation rate, comparatively to the reference metal-on-polyethylene bearing. We determined the rate of failure ascribable to Durom™ cup use. We also looked for a sharp drop in the implant survival curve during the follow-up period and for factors associated with adverse reactions to metal debris (ARMDs).
Hypothesis |
We hypothesised that clinical outcomes after Durom™ cup implantation were similar to those seen with a metal-on-polyethylene bearing, except for a lower rate of dislocation.
Patients and methods |
We included 177 consecutive THA procedures that were performed between 2005 and 2008 in 165 patients with a mean age of 57.6±9.4years (range, 31–76years) and involved the implantation of a Durom™ cup, a femoral head greater than 36mm in diameter, and a PF® femoral stem (Zimmer, Etupes, France). The mini-posterior approach was used, with 2mm of acetabular overreaming in 82% of cases, a short femoral neck in 75% of cases, and a mean cup inclination of 34±5° (range, 21–50°).
Results |
Outcomes were assessed for 156 THA procedures in 146 patients after a mean follow-up of 6years 8months. The mean Postel-Merle d’Aubigné score improved from 9.7±2.7 (range, 4–14) to 17.4±1.7 (range, 15–18) and the mean Harris hip score from 45.2±15.3 (range, 9–83) to 96.3±7 (75–100). No episodes of dislocation were recorded. We identified 7 failures ascribable to the Durom™ cup including 6 due to ARMD and 1 to aseptic loosening. Implant survival after a mean of 80months was 95.5% (95% CI, 93.1–99.2), with no sharp drop in the survival curve.
Conclusion |
The Durom™ cup eliminates the risk of hip dislocation and produces similar functional outcomes to those seen with metal-on-polyethylene bearings after a mean follow-up of 80months. Nevertheless, given the difficulty in predicting ARMD and hypersensitivity reactions, the Durom™ cup has been discarded and patients carrying it are monitored closely.
Level of evidence |
IV, retrospective study.
Le texte complet de cet article est disponible en PDF.Keywords : Metal-on-metal, Large-diameter head, Total hip arthroplasty, Durom™
Plan
Vol 101 - N° 4
P. 437-441 - juin 2015 Retour au numéro
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