Arthroplasty Today | |
Dual-Mobility Constructs in Primary Total Hip Arthroplasty in High-Risk Patients With Spinal Fusions: Our Institutional Experience | |
Marie Syku, BS1  Brian P. Chalmers, MD2  David J. Mayman, MD3  Seth A. Jerabek, MD3  Thomas P. Sculco, MD3  Geoffrey H. Westrich, MD3  | |
[1] Department of Orthopedic Surgery, Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USA;Corresponding author. 535 East 70th Street, New York, NY 10021, USA. Tel.: +1-816-808-6348.;Department of Orthopedic Surgery, Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USA; | |
关键词: Total hip arthroplasty; Lumbar arthrodesis; Lumbar fusion; Dislocation; Dual mobility; Complications; | |
DOI : | |
来源: DOAJ |
【 摘 要 】
Background: Prior spinal fusion significantly increases the risk of dislocation in patients after total hip arthroplasty (THA). Owing to these high risks, surgeons may use dual-mobility (DM) constructs in these patients to optimize hip stability. However, there is a paucity of data on the outcomes of DM constructs in patients who underwent prior spinal fusions. Methods: We retrospectively identified 80 patients (86 THAs) who underwent a spinal arthrodesis and a subsequent posterior approach THA with a DM construct. The median number of levels fused was 4, with 59 (74%) patients having 2 or more levels fused; in addition, 50 (63%) patients were fused to the sacrum. Ninety percent and 55% of THAs were within the Lewinnek safe zone for inclination and anteversion, respectively. Patients were evaluated for any episode of hip instability, complications, and patient reported outcome measures. Results: At 3-year mean follow-up, no patients sustained a postoperative dislocation or intraprosthetic dislocation (0%). Overall, there were 6 (7.5%) complications during the study period leading to reoperation in 3 (4%) patients, none related to the acetabular component or instability. Hip Injury and Osteoarthritis Outcome Score, Joint Replacement scores significantly improved from a mean of 50 preoperatively to 87 postoperatively (P < .001), and the Veterans Rand 12 Item Health Survey physical score improved from a mean of 31 preoperatively to 44 postoperatively (P < .001). Conclusion: In a high-risk series of patients who underwent prior spinal fusion, posterolateral primary THA with a DM construct demonstrated no dislocations at mean 3-year follow-up. Although these early data are clearly encouraging, more patients with longer term follow-up are needed.
【 授权许可】
Unknown