The use of a dual-mobility concept in total hip arthroplasty patients with spastic disorders
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HIP ARTHROPLASTY
The use of a dual‑mobility concept in total hip arthroplasty patients with spastic disorders No dislocations in a series of ten cases at midterm follow-up Rick J. M. Sanders · Bart A. Swierstra · Jon H. M. Goosen
Received: 8 January 2013 / Published online: 30 April 2013 © Springer-Verlag Berlin Heidelberg 2013
Abstract Introduction Total hip arthroplasty (THA) is one of the treatment options in patients with cerebral palsy (CP) with painful osteoarthritis of the hip. However, the risk of dislocation of the prosthesis is higher in patients with CP when compared with physically normal patients. In this retrospective study of ten consecutive cases, we hypothesized that the use of a dual-mobility cup could reduce this risk of dislocation combined with good functional results. Materials and methods From January 2008 until October 2010, eight patients (ten hips) with CP who consecutively received a THA using a dual-mobility cup were identified. At the time of surgery, the average age of the patient group was 54 years (range 43–61). Latest follow-up took place after on average 39 months (range 22–56 months). All patients or their caregivers were interviewed by telephone. They were asked if dislocation of the prosthesis had occurred. To evaluate quality of life and health in general, patients completed the SF-36 questionnaire. Results None of the prostheses had dislocated at the latest follow-up. Reoperation was needed in one patient after a periprosthetic fracture. Radiologic evaluation showed a mean cup inclination of 46 (range 27–58). On average, the quality of life of patients in this study was found to be limited in particular on the domains of physical health and functioning, while a fair to good score was measured at the six other different domains.
R. J. M. Sanders · B. A. Swierstra · J. H. M. Goosen (*) Department of Orthopaedic Surgery, Sint Maartenskliniek, Hengstdal 3, P.O. Box 9011, 6500, GM, Nijmegen, The Netherlands e-mail: [email protected]
Conclusion The use of a dual-mobility cup in THA in patients with CP can lead to favourable results with respect to dislocation and clinical outcome. Keywords Hip arthroplasty · Cerebral palsy · Dislocation · Dual-mobility cup
Introduction Patients with cerebral palsy (CP) have an enlarged chance to develop hip problems. Subluxation of the femoral head due to muscular imbalance is commonly diagnosed with incidence rates varying between 23 and 79 % [18]. This is mainly a consequence of the imbalanced forces produced by the adductor, internal rotator and hip-flexor muscle groups that migrate the femoral head in the superolateral direction. This can progress into a painful osteoarthritis (OA) of the hip [4, 7]. The combination of stiffness of the hip joint and pain may indicate surgery. Surgical alternatives include arthrodesis [10], valgus osteotomy [12, 23], resection arthroplasty [8, 16] and total hip arthroplasty (THA) [17, 20]. Studies on THA reported good results for pain relief and hip function. However, dislocation of the pros
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