Implant survival of 662 dual-mobility cups and 727 constrained liners in primary THA: small femoral head size increases the cumulative incidence of revision

Background and purpose — In total hip arthroplasty (THA), the risk for dislocation can be reduced using either dual-mobility cups (DMCs) or constrained liners (CLs). There are few studies comparing these concepts in primary THA. Therefore, we compared the cumulative incidence of revision in primary...

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Autores principales:	Oskari Pakarinen, Olli Lainiala, Aleksi Reito, Perttu Neuvonen, Keijo Mäkelä, Antti Eskelinen
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/88b495a9f19548f585dd5b8deecc6fae
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spelling	oai:doaj.org-article:88b495a9f19548f585dd5b8deecc6fae2021-11-26T11:19:47ZImplant survival of 662 dual-mobility cups and 727 constrained liners in primary THA: small femoral head size increases the cumulative incidence of revision1745-36741745-368210.1080/17453674.2021.1939597https://doaj.org/article/88b495a9f19548f585dd5b8deecc6fae2021-10-01T00:00:00Zhttp://dx.doi.org/10.1080/17453674.2021.1939597https://doaj.org/toc/1745-3674https://doaj.org/toc/1745-3682Background and purpose — In total hip arthroplasty (THA), the risk for dislocation can be reduced using either dual-mobility cups (DMCs) or constrained liners (CLs). There are few studies comparing these concepts in primary THA. Therefore, we compared the cumulative incidence of revision in primary THA patients treated with DMC or CL with varying head sizes with conventional THA patients as reference group. Patients and methods — We performed a cohort study based on the Finnish arthroplasty register, comparing DMCs and CLs operated over the period 2000–2017. DMCs were divided into 2 groups based on the implant design: “DMC Trident” group (n = 399) and “DMC Others” group (n = 263). CLs were divided based on the femoral head size: “CL 36 mm” group (n = 425) and “CL < 36 mm” group (n = 302). All conventional primary THAs operated on in 2000–2017 with 28–36 mm femoral head were included as control group (“Conventional THA” group, n = 102,276). Implant survival was calculated by the corresponding cumulative incidence function with revision as the endpoint and death as competing event. Also, the prevalence of different reasons for revision was compared. Results — The 6-year cumulative incidence function estimates for the first revision were 6.9% (95% CI 4.0–9.7) for DMC Trident, 5.0% (CI 1.5–8.5) for DMC Others, 13% (CI 9.3–17) for CL < 36 mm, 6.3% (3.7–8.9) for CL 36 mm, and 4.7% (CI 4.5–4.8) for control group (conventional THA). The prevalence of dislocation revision was high (5.0%, CI 2.9–8.2) in the CL < 36 mm group compared with other groups. Interpretation — The DMC and CL 36 mm groups had promising mid-term survival rates, comparable to those of primary conventional THA group. The revision rate of CLs with < 36 mm head was high, mostly due to high prevalence of dislocation revisions. Therefore, CLs with 36 mm femoral head should be preferred over smaller ones.Oskari PakarinenOlli LainialaAleksi ReitoPerttu NeuvonenKeijo MäkeläAntti EskelinenTaylor & Francis GrouparticleOrthopedic surgeryRD701-811ENActa Orthopaedica, Vol 92, Iss 6, Pp 658-664 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Orthopedic surgery RD701-811
spellingShingle	Orthopedic surgery RD701-811 Oskari Pakarinen Olli Lainiala Aleksi Reito Perttu Neuvonen Keijo Mäkelä Antti Eskelinen Implant survival of 662 dual-mobility cups and 727 constrained liners in primary THA: small femoral head size increases the cumulative incidence of revision
description	Background and purpose — In total hip arthroplasty (THA), the risk for dislocation can be reduced using either dual-mobility cups (DMCs) or constrained liners (CLs). There are few studies comparing these concepts in primary THA. Therefore, we compared the cumulative incidence of revision in primary THA patients treated with DMC or CL with varying head sizes with conventional THA patients as reference group. Patients and methods — We performed a cohort study based on the Finnish arthroplasty register, comparing DMCs and CLs operated over the period 2000–2017. DMCs were divided into 2 groups based on the implant design: “DMC Trident” group (n = 399) and “DMC Others” group (n = 263). CLs were divided based on the femoral head size: “CL 36 mm” group (n = 425) and “CL < 36 mm” group (n = 302). All conventional primary THAs operated on in 2000–2017 with 28–36 mm femoral head were included as control group (“Conventional THA” group, n = 102,276). Implant survival was calculated by the corresponding cumulative incidence function with revision as the endpoint and death as competing event. Also, the prevalence of different reasons for revision was compared. Results — The 6-year cumulative incidence function estimates for the first revision were 6.9% (95% CI 4.0–9.7) for DMC Trident, 5.0% (CI 1.5–8.5) for DMC Others, 13% (CI 9.3–17) for CL < 36 mm, 6.3% (3.7–8.9) for CL 36 mm, and 4.7% (CI 4.5–4.8) for control group (conventional THA). The prevalence of dislocation revision was high (5.0%, CI 2.9–8.2) in the CL < 36 mm group compared with other groups. Interpretation — The DMC and CL 36 mm groups had promising mid-term survival rates, comparable to those of primary conventional THA group. The revision rate of CLs with < 36 mm head was high, mostly due to high prevalence of dislocation revisions. Therefore, CLs with 36 mm femoral head should be preferred over smaller ones.
format	article
author	Oskari Pakarinen Olli Lainiala Aleksi Reito Perttu Neuvonen Keijo Mäkelä Antti Eskelinen
author_facet	Oskari Pakarinen Olli Lainiala Aleksi Reito Perttu Neuvonen Keijo Mäkelä Antti Eskelinen
author_sort	Oskari Pakarinen
title	Implant survival of 662 dual-mobility cups and 727 constrained liners in primary THA: small femoral head size increases the cumulative incidence of revision
title_short	Implant survival of 662 dual-mobility cups and 727 constrained liners in primary THA: small femoral head size increases the cumulative incidence of revision
title_full	Implant survival of 662 dual-mobility cups and 727 constrained liners in primary THA: small femoral head size increases the cumulative incidence of revision
title_fullStr	Implant survival of 662 dual-mobility cups and 727 constrained liners in primary THA: small femoral head size increases the cumulative incidence of revision
title_full_unstemmed	Implant survival of 662 dual-mobility cups and 727 constrained liners in primary THA: small femoral head size increases the cumulative incidence of revision
title_sort	implant survival of 662 dual-mobility cups and 727 constrained liners in primary tha: small femoral head size increases the cumulative incidence of revision
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/88b495a9f19548f585dd5b8deecc6fae
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Implant survival of 662 dual-mobility cups and 727 constrained liners in primary THA: small femoral head size increases the cumulative incidence of revision

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