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Dual Mobility Cemented Cups Have Low Dislocation Rates in THA Revisions

机译:双移动胶合杯在THA修订版中位错率低

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摘要

THA revisions using standard cups are at risk of dislocation (5.1% to 14.4% incidence), especially in patients over 70 years of age. Constrained tripolar cups have reduced this risk (6% incidence) but are associated with substantial loosening rates (9%). The nonconstrained dual mobility cup was designed to improve prosthetic stability (polyethylene head ≥ 40 mm diameter) without increasing loosening rates by reducing wear and limiting impingement (rotation range of 108°). We implanted 88 cemented dual mobility cups for THA revisions in 82 patients at high risk of dislocation. Average patient age was 72 years (range, 65–86 years). Eighty-five of the 88 hips were reviewed at 2 to 5 years followup. One patient (1.1%) had a traumatic dislocation at 2 years postoperatively. Two patients (2.3%) had asymptomatic early loosening and three patients (3.5%) had localized radiographic lucencies. These results confirm those with press-fit dual mobility cups suggesting a low dislocation rate at 5 years and a cup survival of 94.6%. At middle term followup, cemented dual mobility cup achieved better results than constrained cups in cases at risk of dislocation and recurrent loosening.>Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
机译:使用标准杯的THA修订版有脱位的风险(发生率从5.1%到14.4%),尤其是在70岁以上的患者中。受约束的三极杯降低了这种风险(发生率6%),但与明显的松动率(9%)相关。无约束的双重活动杯设计用于提高假体稳定性(聚乙烯头直径≥40 mm),而不会通过减少磨损和限制撞击(旋转范围为108°)来提高松开率。我们为高位错风险的82例患者植入了88个胶合双活动杯,用于THA修订。患者平均年龄为72岁(范围65-86岁)。在2至5年的随访中对88例髋关节中的85例进行了评估。一名患者(1.1%)在术后2年发生了外伤性脱位。 2例(2.3%)有无症状的早期松动,3例(3.5%)有局部X线透片。这些结果证实了具有压入配合双移动杯的患者,表明其5年脱位率低,杯生存率为94.6%。在中期随访中,在存在脱位和反复松动的风险的情况下,固结双活动杯比约束杯获得更好的结果。>证据水平: IV级,治疗研究。有关证据水平的完整说明,请参见《作者指南》。

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