Dual mobility cup in revision total hip arthroplasty: Dislocation rate and survival after 5 years

Simian, E.; Chatellard, R.; Druon, J.; Berhouet, Julien; Rosset, Philippe

doi:10.1016/j.otsr.2015.05.002

Cited by 73 publications

(31 citation statements)

References 24 publications

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“…After reviewing the abstracts of these, 75 were screened for eligibility and 16 were identified for inclusion. Fifty-nine articles were excluded because reporting no IPD episodes (30 articles) [7] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , IPD episodes were not mentioned (13) [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , reporting delayed IPD episodes (13) [8] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , reporting early IPD episodes with old DM designs with small femoral heads (2) [9] , [69] , and reporting a suspicious IPD episode (1) [70] ( Fig. 1 ).…”

Section: Resultsmentioning

confidence: 99%

Early intraprosthetic dislocation in dual-mobility implants: a systematic review

et al. 2017

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BackgroundDual mobility implants are subject to a specific implant-related complication, intraprosthetic dislocation (IPD), in which the polyethylene liner dissociates from the femoral head. For older generation designs, IPD was attributable to late polyethylene wear and subsequent failure of the head capture mechanism. However, early IPDs have been reportedly affecting contemporary designs.MethodsA systematic review of the literature according to the preferred reporting items for systematic reviews and meta-analyses guidelines was performed. A comprehensive search of PubMed, MEDLINE, Embase, and Google Scholar was conducted for English articles between January 1974 and August 2016 using various combinations of the keywords “intraprosthetic dislocation,” “dual mobility,” “dual-mobility,” “tripolar,” “double mobility,” “double-mobility,” “hip,” “cup,” “socket,” and “dislocation.”ResultsIn all, 16 articles met our inclusion criteria. Fourteen were case reports and 2 were retrospective case series. These included a total of 19 total hip arthroplasties, which were divided into 2 groups: studies dealing with early IPD after attempted closed reduction and those dealing with early IPD with no history of previous attempted closed reduction. Early IPD was reported in 15 patients after a mean follow-up of 3.2 months (2.9 SD) in the first group and in 4 patients after a mean follow-up of 15.1 months (9.9 SD) in the second group.ConclusionsBased on the current data, most cases have been preceded by an attempted closed reduction in the setting of outer, large articulation dislocation, perhaps indicating an iatrogenic etiology for early IPD. Recognition of this possible failure mode is essential to its prevention and treatment.

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Section: Resultsmentioning

confidence: 99%

Early intraprosthetic dislocation in dual-mobility implants: a systematic review

et al. 2017

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“…24 5- and 10-year survivorship data on dual-mobility cups have shown that a reduced risk of postoperative complications with similar 5 year outcomes when compared to other treatment methods makes DMC-THA the overall most cost-effective treatment long-term despite the initial high cost of the implant. 23,24,74–76…”

Section: Discussionmentioning

confidence: 99%

Outcomes of total hip arthroplasty using dual-mobility cups for femoral neck fractures: a systematic review and meta-analysis

et al. 2020

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Objectives: Femoral neck fractures (FNFs), with up to 15% mortality, are prominent orthopaedic emergencies. After treating FNFs, dislocation is another challenge increasing morbidity, mortality and treatment costs substantially. The emerging dual-mobility cup (DMC) may decrease dislocation rates following total hip arthroplasty (THA) for FNFs. We performed a systematic review of literature reporting dislocation and mortality rates with DMC-THA for the treatment of FNFs. Methods: 2 authors independently searched PubMed (MEDLINE), Google Scholar and Cochrane library for studies reporting dislocation and mortality rates for FNFs treated with DMC-THA since inception up to January 2019. Data on outcomes of interest was extracted from all studies and assessed for eligibility for a meta-analysis. Results: Out of 522 search results, 18 studies were included in the systematic review and 4 in the meta-analysis. The mean rate of dislocation following DMC-THA for FNFs was found to be 1.87% ± 2.11, with a 1-year mortality rate of 14.0% ± 10.55. Results of meta-analysis showed that dislocation and 1-year postoperative mortality rates were significantly lower for DMC-THA with a risk ratio 0.31 (95% CI, 0.16–0.59; I2 = 0%, p = 0.0003) and 0.55 (0.40, 0.77; I2 = 0%, p = 0.003) respectively when compared to biploar hemiathroplasty (BHA). Conclusions: The mean dislocation and mortality rates in DMC-THA are lower than previously reported rates for THA with single cup and comparable to unipolar and bipolar hemiarthroplasty. Further research involving randomised control trials to assess differences in outcomes, longevity and cost-effectiveness needs to be conducted to make recommendations for the use of DMC in treating FNFs.

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“…Mean HHS improved preoperatively from 60 to 85 at latest followup. Several studies have reported reliable results and outcomes with the use of DM constructs in primary and revision THA [8,20,25]. In a series of 36 patients undergoing revision THA considered at high risk for recurrent dislocation, Plummer et al [16] reported improved HHS by a mean of 45 points with a final mean of 90.…”

Section: Discussionmentioning

confidence: 99%

“…A recent report indicated that cumulative risk of redislocation after revision THA for recurrent instability was 35% at 15 years [10]. There are multiple surgical options to address an unstable prosthesis including abductor repairs or reconstructions, conversion to hemiarthroplasty [15], large-diameter femoral heads [1,19,26], acetabular revision [18], increased hip offset [18], constrained liners [4-7, 9, 13, 19, 24], and dual-mobility (DM) constructs [3,8,12,16,17,20,21,24,25]. One of the more commonly utilized techniques to treat or prevent recurrent dislocation, especially in multiply operated on patients with deficient abductor mechanisms, is constrained liners [4-7, 9, 13, 19, 23].…”

mentioning

confidence: 99%

Can Dislocation of a Constrained Liner Be Salvaged With Dual-mobility Constructs in Revision THA?

Chalmers

Pallante

Taunton

et al. 2018

Clin Orthop Relat Res

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Dual mobility cup in revision total hip arthroplasty: Dislocation rate and survival after 5 years

Abstract: IV, retrospective study.

Cited by 73 publications

References 24 publications

Early intraprosthetic dislocation in dual-mobility implants: a systematic review

Early intraprosthetic dislocation in dual-mobility implants: a systematic review

Outcomes of total hip arthroplasty using dual-mobility cups for femoral neck fractures: a systematic review and meta-analysis

Can Dislocation of a Constrained Liner Be Salvaged With Dual-mobility Constructs in Revision THA?

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