Abstract
Purpose
Revision of failed modular metal-on-metal total hip replacement (MoM-THA) can be technically difficult. A dual mobility liner can help to salvage a well-fixed acetabular component. The present paper reports the clinical and radiographic outcome of revision of failed Birmingham modular MoM-THA using a dual mobility liner.
Methods
The present study reports on ten patients (3 female and 7 male) with 11 revision THAs. Patients underwent revision an average of 51 months (range 40–73 months) after index procedure. Mean follow-up after the revision was 31 months (range 24–37 months) and all patients underwent an MRI with metal artifact reduction software (MARS) at least two years after revision to assess for local polyethylene wear and osteolysis.
Results
The Harris Hip score improved from 92.2 (range 63.0–100.0) to 100.0 (p = 0.072). One patient had a one-time dislocation within seven days of surgery. No patient required additional surgeries. Radiographs showed no signs of component loosening and osteolysis and MRI imaging revealed no evidence of polyethylene wear or osteolysis.
Conclusion
A dual mobility liner in an existing Birmingham cup can provide excellent clinical and radiological short-term results without MRI evidence of increased polyethylene wear. Post-operative hip precautions should be enforced.
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We certify that we have not signed any agreement with commercial interest related to this study, which would in any way limit publication of any and all data generated for the study or to delay publication for any reason.
Dr. Boettner reports personal fees from Smith & Nephew, Ortho Development Corporation and from DePuy, outside the submitted work.
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Kasparek, M.F., Renner, L., Faschingbauer, M. et al. Salvage of a monoblock metal-on-metal cup using a dual mobility liner: a two-year MRI follow-up study. International Orthopaedics (SICOT) 42, 1035–1041 (2018). https://doi.org/10.1007/s00264-017-3641-9
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DOI: https://doi.org/10.1007/s00264-017-3641-9