Dual-mobility versus Fixed-bearing in Primary Total Hip Arthroplasty: Outcome Comparison.
Dual-mobility versus Fixed-bearing in Primary Total Hip Arthroplasty: Outcome Comparison.
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DOI：
10.5371/hp.2022.34.2.96
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发表时间：
2022-06
期刊：
影响因子：
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通讯作者：
Aggarwal, Vinay K
中科院分区：
文献类型：
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作者：
Singh, Vivek;Loloi, Jeremy;Macaulay, William;Hepinstall, Matthew S;Schwarzkopf, Ran;Aggarwal, Vinay K
使用双动（DM）关节可以降低初次和翻修全髋关节置换术（THA）中的不稳定风险。关于这种设计对患者报告结局指标（PROM）的影响的知识有限。本研究旨在比较初次THA后DM和固定平台（FB）假体的临床结局。对2011-2021年期间接受初次THA的所有患者进行了回顾性分析。患者被分为三个队列：FB vs单块-D vs模块化-DM。对包括HOOS、JR和FJS-12在内的PROM以及出院处置、90天再入院率和翻修率进行了评价。进行倾向评分匹配以限制显著的人口统计学差异，而方差分析和卡方检验用于结果的比较。在确定的15，184例患者中，14，652例患者（96.5%）植入FB，185例患者（1.2%）植入单块DM，347例患者（2.3%）植入组配式DM假体。经过倾向性评分匹配后，共对447例患者进行匹配比较。两个队列之间的90天再入院率（P=0.584）、翻修率（P=0.265）以及90天再入院率（P=0.365）和脱位翻修率（P= 0.365）无统计学差异。出院处置也不显著（P=0.124）。两组在3个月（P=0.820）、1年（P=0.982）和2年（P=0.608）时的FJS-12评分无统计学差异。在接受初次THA的患者中，DM关节面产生的PROM与FB植入物相似。虽然DM植入物更常用于不稳定风险较高的患者，但我们认为，在实现相似脱位率的同时，可以获得相似的患者满意度。
Use of dual mobility (DM) articulations can reduce the risk of instability in both primary and revision total hip arthroplasty (THA). Knowledge regarding the impact of this design on patient-reported outcome measures (PROMs) is limited. This study aims to compare clinical outcomes between DM and fixed bearing (FB) prostheses following primary THA. All patients who underwent primary THA between 2011-2021 were reviewed retrospectively. Patients were separated into three cohorts: FB vs monoblock-D vs modular-DM. An evaluation of PROMs including HOOS, JR, and FJS-12, as well as discharge-disposition, 90-day readmissions, and revisions rates was performed. Propensity-score matching was performed to limit significant demographic differences, while ANOVA and chi-squared test were used for comparison of outcomes. Of the 15,184 patients identified, 14,652 patients (96.5%) had a FB, 185 patients (1.2%) had a monoblock-DM, and 347 patients (2.3%) had a modular-DM prosthesis. After propensity-score matching, a total of 447 patients were matched comparison. There was no statistical difference in the 90-day readmission (P=0.584), revision rate (P=0.265), and 90-day readmission (P=0.365) and revision rate due to dislocation (P=0.365) between the cohorts. Discharge disposition was also non-significant (P=0.124). There was no statistical difference in FJS-12 scores at 3-months (P=0.820), 1-year (P=0.982), and 2-years (P=0.608) between the groups. DM bearings yield PROMs similar to those of FB implants in patients undergoing primary THA. Although DM implants are utilized more often in patients at higher-risk for instability, we suggest that similar patient satisfaction may be attained while achieving similar dislocation rates.