Early Failure of Metal-on-Metal Large-Diameter Head Total Hip Arthroplasty Revised with a Dual-Mobility Bearing

Rivière, Charles; Lavigne, Martin; Alghamdi, Ahmad M.; Vendittoli, Pascal-André

doi:10.2106/jbjs.cc.l.00222

Cited by 9 publications

(10 citation statements)

References 15 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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“…The dual-mobility bearing incorporates a relatively small (22-28mm) metal or ceramic femoral head press fit into a larger polyethylene liner which articulates with the acetabular component. Dissociation of the femoral head from the polyethylene liner (intraprosthetic dislocation) is a known late complication thought to be related to polyethylene liner wear and has been previously reported [2][3][4][5][6][7]. In a consecutive series of 384 primary THAs employing Bousquet's original design, there were 14 intraprosthetic dislocations over 15 years (3.6%).…”

Section: Introductionmentioning

confidence: 99%

“…Three recent case reports describe early (within 14 months) intraprosthetic dislocation of the dual mobility implants following attempted closed reduction of an ipsilateral hip dislocation [4,[6][7]. The reports, however, concern patients in which the dual-mobility head was used in an off-label, mix-and-match fashion to revise an existing THA with retention of either the femoral stem [7] or acetabular cup [4,6].…”

Section: Introductionmentioning

confidence: 99%

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Early Intraprosthetic Dislocation of Dual-Mobility Total Hip Arthroplasty Implant Following Attempted Closed Reduction: A Case Report

Schirmers¹,

Horazdovsky²,

Marston³

2014

JISRF

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Introduced in 1974 by Bousquet, the dual-mobility bearing for use in total hip arthroplasty (THA) confers increased jump distance and improved overall stability relative to conventional THA designs [1-3]. The dual-mobility bearing incorporates a relatively small (22-28mm) metal or ceramic femoral head press fit into a larger polyethylene liner which articulates with the acetabular component. Dissociation of the femoral head from the polyethylene liner (intraprosthetic dislocation) is a known late complication thought to be related to polyethylene liner wear and has been previously reported [2-7]. In a consecutive series of 384 primary THAs employing Bousquet’s original design, there were 14 intraprosthetic dislocations over 15 years (3.6%). The authors cited polyethylene wear as causative and mean time to intraprosthetic dislocation was 8.9 years [2].

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“…1 Multiple case reports have shown IPDs to be occurring much too early for a wear process to contribute to this complication, including the case reported here. [2][3][4][5][6][7][8][9][10][11][12] The conversion mechanism of a dual mobility dislocation to an IPD during closed reduction has been described as a cam effect with impingement of the polyethylene on the acetabulum. 2 Off-label component usage has also been suggested to be a risk for early IPDs as demonstrated by both Ward et al 3 with an off-label head and Riviere et al 4 with an off-label cup.…”

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confidence: 99%

Closed Reduction Conversion of a Dual Mobility Dislocation to an Intraprosthetic Dislocation

Mesko

Bloomfield

2017

J Hip Surg

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Building on a paucity of prior reported cases, we report on a patient with an off-label dual mobility liner, who sustained a dislocation. Following closed reduction in the emergency room, catching/grinding was felt, and imaging confirmed an intraprosthetic dislocation (IPD). This required revision hip arthroplasty. Dual mobility dislocations have the unique risk of conversion to IPDs during closed reduction attempts. There should be a low threshold to perform closed reductions in the operating room (OR) setting by an orthopaedic surgeon under full relaxation/sedation to optimize success and reduce the risk of creating an IPD.

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Early Failure of Metal-on-Metal Large-Diameter Head Total Hip Arthroplasty Revised with a Dual-Mobility Bearing

Cited by 9 publications

References 15 publications

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

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

Early Intraprosthetic Dislocation of Dual-Mobility Total Hip Arthroplasty Implant Following Attempted Closed Reduction: A Case Report

Closed Reduction Conversion of a Dual Mobility Dislocation to an Intraprosthetic Dislocation

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