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Total hip arthroplasty using a cementless dual-mobility cup provides increased stability and favorable gait parameters at five years follow-up - 08/02/17

Doi : 10.1016/j.otsr.2016.09.020 
A. Acker a, J.-F. Fischer b, K. Aminian c, E. Lécureux a, B.M. Jolles d,
a Department of Orthopaedic Surgery and Traumatology, centre hospitalier universitaire vaudois (CHUV) and University of Lausanne, bureau HO/03/321, avenue Pierre-Decker 4, 1011 Lausanne, Switzerland 
b Department of Orthopaedic Surgery and Traumatology, établissements hospitaliers du nord vaudois (EHNV), rue d’Entremonts 11, 1400 Yverdon-les-Bains, Switzerland 
c Laboratory of Movement Analysis and Measurement, Interinstitutional Centre of Translational Biomechanics (STI CBT), École polytechnique fédérale de Lausanne, ELH 132, Station 11, 1015 Lausanne, Switzerland 
d Swiss BioMotion Lab, Department of Musculoskeletal Medicine (DAL), centre hospitalier universitaire vaudois (CHUV) and University of Lausanne, Bureau HO/03/321, avenue Pierre-Decker 4, 1011 Lausanne, Switzerland 

Corresponding author. Centre hospitalier universitaire vaudois (CHUV) and University of Lausanne, Department of Musculoskeletal Medicine, hôpital orthopédique, bureau HO/03/321, avenue Pierre-Decker 4, 1011 Lausanne, Switzerland. Tel.: +41 0 21 314 97 91; fax: +41 0 21 314 97 92.

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Abstract

Background

Rates of dislocation following primary total hip arthroplasty (THA) vary from 0.5 to 10%. Dual-mobility cups in THA demonstrate increased stability. Clinical outcomes following THA with dual-mobility cups have been reported, but gait has not been assessed. Therefore we performed a retrospective case control study to answer: (1) is gait better in patients following THA with a dual-mobility cup than in frail, elderly patients of the same age? (2) Are clinical outcomes better in patients following THA with a dual-mobility cup than in frail, elderly patients? (3) What is the dislocation rate following THA with a dual-mobility cup?

Hypothesis

We hypothesized that patients who underwent THA with a dual-mobility cup have a better gait compared to frail, elderly patients of the same age.

Patients and methods

Twenty patients (22 hips), mean age 79.9±7.7 (range, 62.3–88.3) years were assessed in this retrospective case-control series 5.6±1.4 (range: 4.1–8.8) years following dual-mobility cup THA. A reference group consisted of 72 “frail elderly” patients in a rehabilitation hospital for health problems unrelated to the lower limb, with no lower limb surgery or neurological conditions. Temporal and spatial gait performance were measured with four miniature gyroscopes, mounted on each thigh and calf, while patients walked freely along a 30m corridor. Harris Hip Score, WOMAC, radiological outcomes, and dislocation rate were determined.

Results

All gait parameters were better in the dual-mobility group compared to the frail elderly group. The dual-mobility group had a higher cadence (100.3 steps/minute versus 75.6 steps/minute), shorter (relative to gait cycle time) stance (61.6% versus 67.8%), shorter (relative to gait cycle time) double stance (23.3% versus 36.0%), longer stride (1.13m versus 0.80m), and faster walking speed (0.96m/s versus 0.52m/s). Range of motion of the shank, thigh and knee were better in the dual-mobility group. Harris Hip Score was 87.6±13.9 (range 51–100) and WOMAC score was 11.3±12.1 (range 0–34) in the THA group. We observed no dislocations.

Discussion

Gait patterns five years following THA with the dual-mobility cup were better or comparable to published study populations.

Level of evidence

III, retrospective case-control series.

El texto completo de este artículo está disponible en PDF.

Keywords : Dual-mobility cup, Total hip arthroplasty, Outcomes, Gait analysis


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Vol 103 - N° 1

P. 21-25 - février 2017 Regresar al número
Artículo precedente Artículo precedente
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