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Use of a Dual Mobility Socket to Manage Total Hip Arthroplasty Instability

机译:使用双移动插座来管理整体髋关节置换术的不稳定性

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摘要

Unconstrained tripolar hip implants provide an additional bearing using a mobile polyethylene component between the prosthetic head and the outer metal shell. Such a design increases the effective head diameter and therefore is an attractive option in challenging situations of unstable total hip arthroplasties. We report our experience with 54 patients treated using this dual mobility implant in such situations. We ascertained its ability to restore and maintain stability, and examined component loosening and component failure. At a minimum followup of 2.2 years (mean, 4 years; range, 2.2–6.8 years), one hip had redislocated 2 months postoperatively and was managed successfully without reoperation by closed reduction with no additional dislocation. Two patients required revision of the implant because of dislocation at the inner bearing. Technical errors were responsible for these failures. Three patients had reoperations for deep infections. The postoperative radiographs at latest followup showed very satisfactory osseointegration of the acetabular component because no radiolucent line or osteolysis was reported. Use of this unconstrained tripolar design was successful in restoring and maintaining hip stability. We observed encouraging results at short-term followup regarding potential for loosening or mechanical failures.>Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
机译:无约束力的三极髋关节植入物在假体头部和金属外壳之间使用活动的聚乙烯组件提供了额外的支撑。这种设计增加了有效的头部直径,因此在不稳定的全髋关节置换术的挑战性情况下是有吸引力的选择。我们报告了在这种情况下使用这种双重活动性植入物治疗的54例患者的经验。我们确定了其恢复和维持稳定性的能力,并检查了组件松动和组件故障。至少随访2.2年(平均4年;范围2.2-6.8年),一只髋关节在术后2个月内重新移位,并且通过闭合复位成功进行手术而无需再次手术,没有其他脱位。由于内轴承脱位,两名患者需要翻修植入物。技术错误是造成这些故障的原因。三例患者因深部感染而再次手术。最近一次随访的术后X线照片显示髋臼组件的骨整合非常令人满意,因为没有放射线透亮或溶骨的报道。使用这种不受约束的三极设计可以成功地恢复和保持髋关节稳定性。我们在短期随访中观察到了潜在的松动或机械衰竭的令人鼓舞的结果。>证据水平:水平,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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