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General Orthopaedics

EARLY EXPERIENCE OF A DUAL MOBILITY BEARING IN TOTAL HIP ARTHROPLASTY IN A DISTRICT GENERAL HOSPITAL

British Indian Orthopaedic Society (previously IOSUK) Annual Conference, July 2016



Abstract

The dual mobility (DM) bearing concept was introduced to reduce the risk of dislocation in total hip arthroplasty (THA). Our aim was to evaluate the early outcomes following the utilisation of DM in primary and revision THA in our unit.

Prospectively collected data on all patients undergoing a DM bearing at was reviewed between July 2012and December 2015. The primary outcome assessed was dislocation, with a secondary outcome revision for any reasons. All data was gathered from patient clinical records and the digital picture archiving and communication system (PACS)

30 primary THA were undertaken and 54 revision THAin the time period described. 11 of the procedures involved a proximal femoral endoprosthesis. The mean age in the primary setting was 65 and 73 in the revision population. The main indications for using DM bearing in the primary setting were; trauma (40%), residual dysplasia (40%) and malignancy (17%). There were no dislocations in the primary THA category. Indications in the revision THA cohort included 33% for aseptic loosening, 11% for instability, 18% for ALVAL reactions, 20% for infection, 18% for fracture. 1 out of the 54 revision THA had one large bearing dislocation requiring closed reduction. Subsequent analysis confirmed that implant alignment was satisfactory and this was a patient compliance issue due to mental health concerns. To date no patient in either cohort required revision surgery. Overall dislocation rate was 1.2%.

Our early experience with DM bearings has been positive with no evidence of early failure or loosening. The dislocation rate overall has been low and matches the current large series in the literature.