Skip to main content
Erschienen in: International Orthopaedics 7/2015

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

Einloggen, um Zugang zu erhalten

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.
Literatur
2.
Zurück zum Zitat Tai S, Imbuldeniya A, Munir S, Walter W, Walter W, Zicat B (2014) The effect of obesity on the clinical, functional and radiological outcome of cementless total hip replacement: A case-matched study with a minimum 10-year follow-up. J Arthroplasty 29(9):1758–1762. doi:10.1016/j.arth.2014.04.033 [Epub ahead of print] Tai S, Imbuldeniya A, Munir S, Walter W, Walter W, Zicat B (2014) The effect of obesity on the clinical, functional and radiological outcome of cementless total hip replacement: A case-matched study with a minimum 10-year follow-up. J Arthroplasty 29(9):1758–1762. doi:10.​1016/​j.​arth.​2014.​04.​033 [Epub ahead of print]
3.
Zurück zum Zitat Andrew J, Palan J, Kurup H, Gibson P, Murray D, Beard D (2008) Obesity in total hip replacement. J Bone Joint Surg (Br) 90:424–429CrossRef Andrew J, Palan J, Kurup H, Gibson P, Murray D, Beard D (2008) Obesity in total hip replacement. J Bone Joint Surg (Br) 90:424–429CrossRef
4.
Zurück zum Zitat Sanchez-Sotelo J, Berry D (2001) Epidemiology of instability after total hip replacement. Orthop Clin North Am 32:543–552PubMedCrossRef Sanchez-Sotelo J, Berry D (2001) Epidemiology of instability after total hip replacement. Orthop Clin North Am 32:543–552PubMedCrossRef
5.
Zurück zum Zitat Kim Y, Choi Y, Kim J (2009) Influence of patient-, design-, and surgery-related factors on rate of dislocation after primary cementless total hip arthroplasty. J Arthroplasty 24:1258–1263PubMedCrossRef Kim Y, Choi Y, Kim J (2009) Influence of patient-, design-, and surgery-related factors on rate of dislocation after primary cementless total hip arthroplasty. J Arthroplasty 24:1258–1263PubMedCrossRef
6.
Zurück zum Zitat Kim Y, Morshed S, Joseph T, Bozic K, Ries M (2006) Clinical impact of obesity on stability following revision total hip arthroplasty. Clin Orthop Relat Res 543:142–146CrossRef Kim Y, Morshed S, Joseph T, Bozic K, Ries M (2006) Clinical impact of obesity on stability following revision total hip arthroplasty. Clin Orthop Relat Res 543:142–146CrossRef
7.
Zurück zum Zitat Chee Y, Teoh K, Sabnis B, Ballantyne J, Brenkel I (2010) Total hip replacement in morbidly obese patients with osteoarthritis: results of a prospectively matched study. J Bone Joint Surg 92:1066–1071CrossRef Chee Y, Teoh K, Sabnis B, Ballantyne J, Brenkel I (2010) Total hip replacement in morbidly obese patients with osteoarthritis: results of a prospectively matched study. J Bone Joint Surg 92:1066–1071CrossRef
8.
Zurück zum Zitat Davis A, Wood A, Keenan A, Brenkel I, Ballantyne J (2011) Does body mass index affect clinical outcome post-operatively and at five years after primary unilateral total hip replacement performed for osteoarthritis? a multivariate analysis of prospective data. J Bone Joint Surg 93:1178–1182CrossRef Davis A, Wood A, Keenan A, Brenkel I, Ballantyne J (2011) Does body mass index affect clinical outcome post-operatively and at five years after primary unilateral total hip replacement performed for osteoarthritis? a multivariate analysis of prospective data. J Bone Joint Surg 93:1178–1182CrossRef
9.
Zurück zum Zitat Lubbeke A, Stern R, Garavaglia G, Zurcher L, Hoffmeyer P (2007) Differences in outcomes of obese women and men undergoing primary total hip arthroplasty. Arthritis Rheum 57:327–334PubMedCrossRef Lubbeke A, Stern R, Garavaglia G, Zurcher L, Hoffmeyer P (2007) Differences in outcomes of obese women and men undergoing primary total hip arthroplasty. Arthritis Rheum 57:327–334PubMedCrossRef
10.
Zurück zum Zitat Sadr Azodi O, Adami J, Lindstrom D, Eriksson K, Wladis A, Bellocco R (2008) High body mass index is associated with increased risk of implant dislocation following primary total hip replacement: 2,106 patients followed for up to 8 years. Acta Orthop 79:141–147PubMedCrossRef Sadr Azodi O, Adami J, Lindstrom D, Eriksson K, Wladis A, Bellocco R (2008) High body mass index is associated with increased risk of implant dislocation following primary total hip replacement: 2,106 patients followed for up to 8 years. Acta Orthop 79:141–147PubMedCrossRef
11.
Zurück zum Zitat Guyen O, Pibarot V, Vaz G, Chevillotte C, Bejui-Hugues J (2009) Use of a dual mobility socket to manage total hip arthroplasty instability. Clin Orthop Relat Res 467:465–472PubMedCentralPubMedCrossRef Guyen O, Pibarot V, Vaz G, Chevillotte C, Bejui-Hugues J (2009) Use of a dual mobility socket to manage total hip arthroplasty instability. Clin Orthop Relat Res 467:465–472PubMedCentralPubMedCrossRef
12.
Zurück zum Zitat Hamadouche M, Biau DJ, Huten D, Musset T, Gaucher F (2010) The use of a cemented dual mobility socket to treat recurrent dislocation. Clin Orthop Relat Res 468:3248–3254PubMedCentralPubMedCrossRef Hamadouche M, Biau DJ, Huten D, Musset T, Gaucher F (2010) The use of a cemented dual mobility socket to treat recurrent dislocation. Clin Orthop Relat Res 468:3248–3254PubMedCentralPubMedCrossRef
13.
Zurück zum Zitat Adam P, Philippe R, Ehlinger M, Roche O, Bonnomet F, Mole D, Fessy MH (2012) Dual mobility cups hip arthroplasty as a treatment for displaced fracture of the femoral neck in the elderly. A prospective, systematic, multicenter study with specific focus on postoperative dislocation. Orthop Traumatol Surg Res 98:296–300PubMedCrossRef Adam P, Philippe R, Ehlinger M, Roche O, Bonnomet F, Mole D, Fessy MH (2012) Dual mobility cups hip arthroplasty as a treatment for displaced fracture of the femoral neck in the elderly. A prospective, systematic, multicenter study with specific focus on postoperative dislocation. Orthop Traumatol Surg Res 98:296–300PubMedCrossRef
14.
Zurück zum Zitat Elkins J, Daniel M, Pedersen D, Singh B, Yack H, Callaghan J, Brown T (2013) Morbid obesity may increase dislocation in total hip patients: a biomechanical analysis. Clin Orthop Relat Res 471:971–980PubMedCentralPubMedCrossRef Elkins J, Daniel M, Pedersen D, Singh B, Yack H, Callaghan J, Brown T (2013) Morbid obesity may increase dislocation in total hip patients: a biomechanical analysis. Clin Orthop Relat Res 471:971–980PubMedCentralPubMedCrossRef
15.
Zurück zum Zitat Hayashi S, Nishiyama T, Fujishiro T, Hashimoto S, Kanzaki N, Nishida K, Kurosaka M (2012) Obese patients may have more soft tissue impingement following primary total hip arthroplasty. Int Orthop 36:2419–2423PubMedCentralPubMedCrossRef Hayashi S, Nishiyama T, Fujishiro T, Hashimoto S, Kanzaki N, Nishida K, Kurosaka M (2012) Obese patients may have more soft tissue impingement following primary total hip arthroplasty. Int Orthop 36:2419–2423PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Ley C, Lees B, Stevenson J (1992) Sex- and menopause-associated changes in body-fat distribution. Am J Clin Nutr 55:950–954 Ley C, Lees B, Stevenson J (1992) Sex- and menopause-associated changes in body-fat distribution. Am J Clin Nutr 55:950–954
17.
Zurück zum Zitat Tomlinson D, Erskine R, Winwood K, Morse C, Onambélé G (2014) Obesity decreases both whole muscle and fascicle strength in young females but only exacerbates the aging-related whole muscle level asthenia. Physiol Rep 2–6 Tomlinson D, Erskine R, Winwood K, Morse C, Onambélé G (2014) Obesity decreases both whole muscle and fascicle strength in young females but only exacerbates the aging-related whole muscle level asthenia. Physiol Rep 2–6
18.
Zurück zum Zitat Lerner Z, Board W, Browning R (2014) Effects of obesity on lower extremity muscle function during walking at two speeds. Gait Posture 39:97–84CrossRef Lerner Z, Board W, Browning R (2014) Effects of obesity on lower extremity muscle function during walking at two speeds. Gait Posture 39:97–84CrossRef
19.
Zurück zum Zitat Philippot R, Boyer B, Farizon F (2013) Intraprosthetic dislocation: a specific complication of the dual-mobility system. Clin Orthop Relat Res 471:965–970PubMedCentralPubMedCrossRef Philippot R, Boyer B, Farizon F (2013) Intraprosthetic dislocation: a specific complication of the dual-mobility system. Clin Orthop Relat Res 471:965–970PubMedCentralPubMedCrossRef
20.
Zurück zum Zitat Fresard PL, Alvherne C, Cartier JL, Cuinet P, Lantuejoul JP (2013) Seven-year results of a press-fit, hydroxyapatite-coated double mobility acetabular component in patients aged 65 years or older. Eur J Orthop Surg Traumatol 23:425–429PubMedCrossRef Fresard PL, Alvherne C, Cartier JL, Cuinet P, Lantuejoul JP (2013) Seven-year results of a press-fit, hydroxyapatite-coated double mobility acetabular component in patients aged 65 years or older. Eur J Orthop Surg Traumatol 23:425–429PubMedCrossRef
21.
Zurück zum Zitat Leclercq S, Benoit JY, de Rosa JP, Euvrard P, Leteurtre C, Girardin P (2008) Results of the Evora dual-mobility socket after a minimum follow-up of five years. Rev Chir Orthop Reparatrice Appar Mot 94:e17–e22PubMedCrossRef Leclercq S, Benoit JY, de Rosa JP, Euvrard P, Leteurtre C, Girardin P (2008) Results of the Evora dual-mobility socket after a minimum follow-up of five years. Rev Chir Orthop Reparatrice Appar Mot 94:e17–e22PubMedCrossRef
22.
Zurück zum Zitat Epinette JA, Beracassat R, Tracol P, Pagazani G, Vandenbussche E (2014) Are modern dual mobility cups a valuable option in reducing instability after primary hip arthroplasty, even in younger patients? J Arthroplasty 29:1323–1328PubMedCrossRef Epinette JA, Beracassat R, Tracol P, Pagazani G, Vandenbussche E (2014) Are modern dual mobility cups a valuable option in reducing instability after primary hip arthroplasty, even in younger patients? J Arthroplasty 29:1323–1328PubMedCrossRef
23.
Zurück zum Zitat Philippot R, Meucci JF, Boyer B, Farizon F (2013) Modern dual-mobility cup implanted with an uncemented stem: about 100 cases with 12-year follow-up. Surg Technol Int 23:208–212PubMed Philippot R, Meucci JF, Boyer B, Farizon F (2013) Modern dual-mobility cup implanted with an uncemented stem: about 100 cases with 12-year follow-up. Surg Technol Int 23:208–212PubMed
24.
Zurück zum Zitat Combes A, Migaud H, Girard J, Duhamel A, Fessy MH (2013) Low rate of dislocation of dual-mobility cups in primary total hip arthroplasty. Clin Orthop Relat Res 471:3891–3900PubMedCentralPubMedCrossRef Combes A, Migaud H, Girard J, Duhamel A, Fessy MH (2013) Low rate of dislocation of dual-mobility cups in primary total hip arthroplasty. Clin Orthop Relat Res 471:3891–3900PubMedCentralPubMedCrossRef
25.
Zurück zum Zitat Farizon F, de Lavison R, Azoulai JJ, Bousquet G (1998) Results with a cementless alumina-coated cup with dual mobility. A twelve-year follow-up study. Int Orthop 22:219–224PubMedCentralPubMedCrossRef Farizon F, de Lavison R, Azoulai JJ, Bousquet G (1998) Results with a cementless alumina-coated cup with dual mobility. A twelve-year follow-up study. Int Orthop 22:219–224PubMedCentralPubMedCrossRef
26.
Zurück zum Zitat Caton JH, Prudhon JL, Ferreira A, Aslanian T, Verdier R (2014) A comparative and retrospective study of three hundred and twenty primary Charnley type hip replacements with a minimum follow up of ten years to assess wether a dual mobility cup has a decreased dislocation risk. Int Orthop 38:1125–1129PubMedCentralPubMedCrossRef Caton JH, Prudhon JL, Ferreira A, Aslanian T, Verdier R (2014) A comparative and retrospective study of three hundred and twenty primary Charnley type hip replacements with a minimum follow up of ten years to assess wether a dual mobility cup has a decreased dislocation risk. Int Orthop 38:1125–1129PubMedCentralPubMedCrossRef
27.
Zurück zum Zitat Hamadouche M, Arnould H, Bouxin B (2012) Is a cementless dual mobility socket in primary THA a reasonable option? Clin Orthop Relat Res 470:3048–3053PubMedCentralPubMedCrossRef Hamadouche M, Arnould H, Bouxin B (2012) Is a cementless dual mobility socket in primary THA a reasonable option? Clin Orthop Relat Res 470:3048–3053PubMedCentralPubMedCrossRef
28.
Zurück zum Zitat Prudhon JL (2012) Dual-mobility cup and cemented femoral component: 6 year follow-up results. Hip Int 21:713–717CrossRef Prudhon JL (2012) Dual-mobility cup and cemented femoral component: 6 year follow-up results. Hip Int 21:713–717CrossRef
29.
Zurück zum Zitat Boyer B, Philippot R, Geringer J, Farizon F (2012) Primary total hip arthroplasty with dual mobility socket to prevent dislocation: a 22-year follow-up of 240 hips. Int Orthop 36:511–518PubMedCentralPubMedCrossRef Boyer B, Philippot R, Geringer J, Farizon F (2012) Primary total hip arthroplasty with dual mobility socket to prevent dislocation: a 22-year follow-up of 240 hips. Int Orthop 36:511–518PubMedCentralPubMedCrossRef
30.
Zurück zum Zitat Lautridou C, Lebel B, Burdin G, Vielpeau C (2008) Survival of the cementless Bousquet dual mobility cup: minimum 15-year follow-up of 437 total hip arthroplasties. Rev Chir Orthop Reparatrice Appar Mot 94:731–739PubMedCrossRef Lautridou C, Lebel B, Burdin G, Vielpeau C (2008) Survival of the cementless Bousquet dual mobility cup: minimum 15-year follow-up of 437 total hip arthroplasties. Rev Chir Orthop Reparatrice Appar Mot 94:731–739PubMedCrossRef
31.
Zurück zum Zitat Philippot R, Farizon F, Camilleri JP, Boyer B, Derhi G, Bonnan J, Fessy MH, Lecuire F (2008) Survival of dual mobility socket with a mean 17 years follow-up. Rev Chir Orthop Reparatrice Appar Mot 94:e23–e27PubMedCrossRef Philippot R, Farizon F, Camilleri JP, Boyer B, Derhi G, Bonnan J, Fessy MH, Lecuire F (2008) Survival of dual mobility socket with a mean 17 years follow-up. Rev Chir Orthop Reparatrice Appar Mot 94:e23–e27PubMedCrossRef
32.
Zurück zum Zitat Philippot R, Camilleri JP, Boyer B, Adam P, Farizon F (2009) The use of a dual-articulation acetabular cup system to prevent dislocation after primary total hip arthroplasty: analysis of 384 cases at a mean follow-up of 15 years. Int Orthop 33:927–932PubMedCentralPubMedCrossRef Philippot R, Camilleri JP, Boyer B, Adam P, Farizon F (2009) The use of a dual-articulation acetabular cup system to prevent dislocation after primary total hip arthroplasty: analysis of 384 cases at a mean follow-up of 15 years. Int Orthop 33:927–932PubMedCentralPubMedCrossRef
33.
Zurück zum Zitat Vielpeau C, Lebel B, Ardouin L, Burdin G, Lautridou C (2011) The dual mobility socket concept: experience with 668 cases. Int Orthop 35:225–230PubMedCentralPubMedCrossRef Vielpeau C, Lebel B, Ardouin L, Burdin G, Lautridou C (2011) The dual mobility socket concept: experience with 668 cases. Int Orthop 35:225–230PubMedCentralPubMedCrossRef
34.
Zurück zum Zitat Adam P, Farizon F, Fessy MH (2005) Dual articulation retentive acetabular liners and wear: surface analysis of 40 retrieved polyethylene implants. Rev Chir Orthop Reparatrice Appar Mot 91:627–636PubMedCrossRef Adam P, Farizon F, Fessy MH (2005) Dual articulation retentive acetabular liners and wear: surface analysis of 40 retrieved polyethylene implants. Rev Chir Orthop Reparatrice Appar Mot 91:627–636PubMedCrossRef
35.
Zurück zum Zitat Philippot R, Adam P, Farizon F, Fessy MH, Bousquet G (2006) Survival of cementless dual mobility sockets: ten-year follow-up. Rev Chir Orthop Reparatrice Appar Mot 92:326–331PubMedCrossRef Philippot R, Adam P, Farizon F, Fessy MH, Bousquet G (2006) Survival of cementless dual mobility sockets: ten-year follow-up. Rev Chir Orthop Reparatrice Appar Mot 92:326–331PubMedCrossRef
36.
Zurück zum Zitat Bunn A, Colwell C Jr, D’Lima D (2014) Effect of head diameter on passive and active dynamic hip dislocation. J Orthop Res 32(11):1525–1531. doi:10.1002/jor.22659 [Epub ahead of print] Bunn A, Colwell C Jr, D’Lima D (2014) Effect of head diameter on passive and active dynamic hip dislocation. J Orthop Res 32(11):1525–1531. doi:10.​1002/​jor.​22659 [Epub ahead of print]
37.
Zurück zum Zitat Berend K, Lombardi A Jr, Mallory T, Adams J, Russell J, Groseth K (2005) The long-term outcome of 755 consecutive constrained acetabular components in total hip arthroplasty examining the successes and the failures. J Arthroplasty 20(3):93–102PubMedCrossRef Berend K, Lombardi A Jr, Mallory T, Adams J, Russell J, Groseth K (2005) The long-term outcome of 755 consecutive constrained acetabular components in total hip arthroplasty examining the successes and the failures. J Arthroplasty 20(3):93–102PubMedCrossRef
38.
Zurück zum Zitat Leclercq S, Benoit JY, de Rosa JP, Tallier E, Leteurtre C, Girardin PH (2013) Evora® chromium-cobalt dual mobility socket: results at a minimum 10 years’ follow-up. Orthop Traumatol Surg Res 99:923–928PubMedCrossRef Leclercq S, Benoit JY, de Rosa JP, Tallier E, Leteurtre C, Girardin PH (2013) Evora® chromium-cobalt dual mobility socket: results at a minimum 10 years’ follow-up. Orthop Traumatol Surg Res 99:923–928PubMedCrossRef
40.
Zurück zum Zitat Paans N, Stevens M, Wagenmakers R, van Beveren J, van der Meer K, Bulstra S, van den Akker-Scheek I (2012) Changes in body weight after total hip arthroplasty: short-term and long-term effects. Phys Ther 92:680–687PubMedCrossRef Paans N, Stevens M, Wagenmakers R, van Beveren J, van der Meer K, Bulstra S, van den Akker-Scheek I (2012) Changes in body weight after total hip arthroplasty: short-term and long-term effects. Phys Ther 92:680–687PubMedCrossRef
41.
Zurück zum Zitat Donovan J, Dingwall I, McChesney S (2006) Weight change 1 year following total knee or hip arthroplasty. ANZ J Surg 76:222–225PubMedCrossRef Donovan J, Dingwall I, McChesney S (2006) Weight change 1 year following total knee or hip arthroplasty. ANZ J Surg 76:222–225PubMedCrossRef
Metadaten
Titel
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
Publikationsdatum
01.07.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 7/2015
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-014-2612-7

Weitere Artikel der Ausgabe 7/2015

International Orthopaedics 7/2015 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.