Cementless augmented versus cemented Dual Mobility cups: medium-term outcome of case series with a control group

BMC Musculoskelet Disord. 2023 Feb 6;24(1):97. doi: 10.1186/s12891-023-06204-4.

Abstract

Background: Post-operative dislocation and reconstruction of acetabular defects are two challenging topics in revision Total Hip Arthroplasty (rTHA). Cemented Dual Mobility (DM) cups on top of Kerboull Cross and bone graft have been successfully employed to overcome these challenges. The cementless augmented DM cups were recently introduced. In this study medium term results of the augmented cementless DM Coptos cups are reported and compared to the established technique of cemented DM cups and Kerboull plate.

Material and methods: This is a retrospective analysis of data collected on patients who received rTHA using DM cups in the period between June 2015 and September 2020. Two groups of patients were identified. The first group received cementless augmented DM-cups (NOVAE® Coptos TH-SERF) (Coptos TH cup group). The second comparable group who had Kerboull ring (KE ring group) and cemented DM cups (NOVAE® STICK). Demographic data, surgical technique, functional and radiological outcome as well as complications during the follow-up visits are reported.

Results: Forty-two patients with a mean age at the time of revision 48.8 ± 13.6 years. 29 patients received Coptos TH DM-cup, while 13 patients had Bone Graft (BG), KE ring and cemented DM cups for acetabular reconstruction. Acetabular defects were Paprosky types IIB and IIC in 31 patients and IIIA and B in 11 patients. The follow-up was 52.8 ± 21 months (mean ± STD); and the mean Harris Hip Score (HHS) at last visit was 91 ± 5. Good stability of all cups was reported. Full integration of the impaction graft was observed in 94% of the Coptos and 92% of the KE groups. One of the Coptos cups was readjusted and one case of single dislocation was recorded in the KE group. None of the DM cups in both groups was revised or awaiting revision.

Conclusion: Coptos TH cups achieve similar results to the cemented DM on KE ring at the medium term but long term outcome remains to be seen.

Keywords: Acetabular defects; Coptos TH; Dislocation; Impaction graft; KE ring; Revision THA.

MeSH terms

  • Acetabulum / diagnostic imaging
  • Acetabulum / surgery
  • Adult
  • Arthroplasty, Replacement, Hip* / methods
  • Control Groups
  • Follow-Up Studies
  • Hip Prosthesis*
  • Humans
  • Joint Dislocations* / surgery
  • Middle Aged
  • Prosthesis Design
  • Prosthesis Failure
  • Reoperation / methods
  • Retrospective Studies