Total hip arthroplasty using a cementless dual-mobility cup provides increased stability and favorable gait parameters at five years follow-up - 08/02/17
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
Articolo gratuito.
Si connetta per beneficiarne
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.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Dual-mobility cup, Total hip arthroplasty, Outcomes, Gait analysis
Mappa
Vol 103 - N° 1
P. 21-25 - febbraio 2017 Ritorno al numero
Articolo precedente
- Cementless lateralized stems in primary THA: Mid-term survival and risk factors for failure in 172 stems
- C. Courtin, A. Viste, F. Subtil, O. Cantin, R. Desmarchelier, M.H. Fessy
- Subperitoneal approach in revision arthroplasty for acetabular component protrusion: Analysis of practices within the French Hip and Knee Society (SFHG)
- F. Gouin, V. Crenn, J. Tabutin, Société française de chirurgie de la hanche et du genou (SFHG) c
Benvenuto su EM|consulte, il riferimento dei professionisti della salute.