Our Summary

This research paper talks about dual mobility cups (DMCs), which are components used in total hip arthroplasty (THA), a surgical procedure to replace the hip joint. DMCs are increasingly being used to prevent and treat instability in the hip after surgery. However, if a dislocation occurs (the hip joint moves out of place), the main challenge is understanding and correcting the causes of the dislocation, which could include adjusting the position of the artificial joint components and treating the surrounding soft tissues.

The authors discuss other options to DMCs like using a larger head for the artificial joint or using constrained liners, which are special types of implants designed to prevent dislocation. They give an overview on how to assess patients with unstable hip joints after surgery, the pros and cons of each treatment option, and share their own experience in treating such cases without using DMCs over a five-year period.

FAQs

  1. What is the role of dual mobility cups in preventing and treating THA instability?
  2. What are the alternative implants to DMCs in treating THA instability?
  3. How do the authors evaluate patients with THA instability and what is their experience within a five-year period?

Doctor’s Tip

A doctor might advise a patient undergoing a hip replacement to carefully follow their post-operative rehabilitation plan, including physical therapy exercises to strengthen the hip muscles and improve range of motion. It is important to avoid activities that put excessive strain on the hip joint to prevent dislocation. Additionally, maintaining a healthy weight and practicing good posture can help reduce the risk of complications and improve the longevity of the hip replacement.

Suitable For

Patients who are typically recommended for hip replacement surgery include those who have severe hip pain and stiffness that limits their daily activities, have not had success with other non-surgical treatments, and have been diagnosed with conditions such as osteoarthritis, rheumatoid arthritis, or avascular necrosis. Additionally, patients who have experienced hip fractures or trauma may also be candidates for hip replacement surgery.

Timeline

Before hip replacement:

  1. Patient experiences hip pain, stiffness, and limited mobility.
  2. Patient consults with a doctor or orthopedic surgeon to discuss treatment options.
  3. Doctor recommends hip replacement surgery as a solution to alleviate pain and improve mobility.
  4. Patient undergoes pre-operative evaluations and tests to ensure they are a suitable candidate for surgery.
  5. Patient schedules surgery and prepares for the procedure, including making arrangements for post-operative care and rehabilitation.

After hip replacement:

  1. Patient undergoes hip replacement surgery, which typically involves removing the damaged hip joint and replacing it with an artificial joint.
  2. Patient spends time in the hospital recovering from surgery and begins physical therapy to regain strength and mobility.
  3. Patient continues physical therapy and rehabilitation at home or in a rehabilitation facility to improve hip function.
  4. Patient gradually resumes daily activities and experiences reduced hip pain and improved mobility.
  5. Patient follows up with their doctor for post-operative appointments to monitor progress and address any concerns or complications.
  6. Patient enjoys a better quality of life with improved hip function and reduced pain.

What to Ask Your Doctor

  1. What is the success rate of hip replacement surgery in terms of reducing pain and improving mobility?
  2. What are the potential risks and complications associated with hip replacement surgery?
  3. How long is the recovery process and what kind of physical therapy will be required?
  4. Will I need any assistive devices or modifications to my home after surgery?
  5. How long can I expect the hip replacement to last before needing a revision surgery?
  6. Are there any restrictions or limitations on physical activity after hip replacement?
  7. What can I do to reduce the risk of dislocation after surgery?
  8. What are the alternatives to dual mobility cups for preventing or treating hip replacement instability?
  9. How will you determine the best course of action for my specific case of hip replacement instability?
  10. What is your experience and success rate in treating cases of hip replacement instability without using dual mobility cups?

Reference

Authors: Zagra L, Caboni E. Journal: Int Orthop. 2017 Mar;41(3):661-668. doi: 10.1007/s00264-016-3383-0. Epub 2017 Jan 14. PMID: 28091768