Erschienen in:
01.07.2015 | Original Paper
Obesity is no longer a risk factor for dislocation after total hip arthroplasty with a double-mobility cup
verfasst von:
Paul Maisongrosse, Benoit Lepage, Etienne Cavaignac, Régis Pailhe, Nicolas Reina, Philippe Chiron, Jean-Michel Laffosse
Erschienen in:
International Orthopaedics
|
Ausgabe 7/2015
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Abstract
Purpose
Dislocation is one of the most feared complications after total hip arthroplasty (THA). This risk is greater in obese patients compared with the general population.
Methods
We performed a retrospective cohort study in which the main objective was to compare the dislocation rate between obese patients (BMI > 30 kg/m²) (exposed group) and non-obese patients (BMI ≤ 30 kg/m²) (unexposed group) after primary THA with a double-mobility acetabular cup. The patients had a minimum follow-up of 24 months.
Results
The ‘obese’ group consisted of 77 THA cases and the ‘non-obese’ group of 425 cases; the two groups were similar in terms of age, gender and ASA score. After a mean follow-up of 58.3 ± 27 months (range 27–159), 43 patients had been lost to follow-up and 56 had died; the two groups had similar mean values. One patient in the ‘obese’ group had suffered a dislocation due to a fall 16 months after the THA. One patient in the ‘non-obese’ group had suffered a dislocation after a periprosthetic femur fracture with stem subsidence two months after the THA procedure. Both patients underwent surgical revision where the double-mobility cup was preserved; there were no further dislocation events as of the last follow-up. The dislocation rate in the two groups was similar (1.3 % versus 0.23 %, p > 0.05). No cases of loosening were found. Revisions were secondary to deep or superficial infection (n = 22), periprosthetic femur fracture (n = 10) or haematoma (n = 3).
Conclusion
These findings imply that double-mobility cups are a reliable way of reducing the risk of dislocation in obese patients after primary THA.