No Difference in Force Required for Intraprosthetic Dislocation of Mixed Manufacturer vs Same Manufacturer Dual Mobility Articulations

Buller, Leonard T.; Torres, Lisa; Baral, Elexis; Wright, Timothy M.; Ast, Michael P.

doi:10.1016/j.arth.2019.09.039

Cited by 9 publications

(9 citation statements)

References 27 publications

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“…However, there is no standard treatment procedure, and no surgery method has shown superior results. Leonard T et.al found that mixing manufacturers when placing dual mobility articulations on well-xed femoral stems should not increase the risk of bipolar cup instability [23]. The isolated mobile component exchange could be used to manage early bipolar cup dissociation with well-xed, and nondamaged implants occurring after external maneuvers [10,16].…”

Section: Discussionmentioning

confidence: 99%

Early Recurrent Dislocation and Dissociation of Bipolar Cup: Two Intricate Cases and Review of Literature.

Fan¹,

Wang²,

Zhang³

et al. 2020

Preprint

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Background: Bipolar hemiarthroplasty (BHA) is one of the best options to treat femoral neck fracture in elderly patients. However, the early dislocation problem also happens in the bipolar cup. Furthermore, BHA has a specific implant-related complication, namely bipolar cup dissociation, in which the femoral head dissociates from the polyethylene (PE) liner. Early dislocation and dissociation are relatively uncommon but devastating complications and almost always lead to reoperation with revision of the prosthesis. Dislocation and dissociation of the bipolar cup can be challenging to manage and easily turn to recurrent episodes in case of improper handling. We hope to find out the best strategy for treatment early recurrent dislocation and dissociation of the bipolar cup.Methods: We retrospectively reviewed 2 patients who had a history of early recurrent posterior dislocations following primary BHA from 2016 to 2019. What’s more, they had early recurrent bipolar cup dissociation during the attempt of closed reduction maneuvers within 3 months of the original surgery.Results: All the patients were treated with open reduction and revision of Bipolar hemiarthroplasty (BHA). One patient has a good outcome, and no recurrence of dislocation was recorded.Conclusion: Recognition of the risk of dislocation and dissociation of bipolar cup is essential to its prevention and treatment. Complete revision of bipolar parts and the femoral head may be the minimum solution necessary to avoid the early recurrence of bipolar cup dissociation. Further investigations are recommended to strengthen these results.

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Section: Discussionmentioning

confidence: 99%

Early Recurrent Dislocation and Dissociation of Bipolar Cup: Two Intricate Cases and Review of Literature.

Fan¹,

Wang²,

Zhang³

et al. 2020

Preprint

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“…Complications of THA related to dislocation in particular were associated with substantial destruction of the surrounding tissue of the hip as well as an increased risk of revision, especially in patients with osteoporosis, potentially escalating the difficulty of additional interventions and posing a challenge for surgeons. 2 , 27 DM cups can include bearings involving a polyethylene liner between the prosthetic head and the outer metal shell, which has been increasingly used in primary or secondary THA for the management of FNFs, with a significantly reduced risk of dislocation and instability, which are regarded as causes of failure. 1 , 28 Thus, this technique can eventually yield favorable outcomes in the treatment of FNFs.…”

Section: Discussionmentioning

confidence: 99%

“…Dislocation or instability following total hip arthroplasty (THA) is well-known, is attributable to diverse reasons, and frequently requires revision. [1][2][3][4][5][6] Among mostly active patients, dislocation that occurs secondary to THA has increasingly become a concern. 2,7,8 The use of small cups can lead to prosthesis loosening or instability instigated by large forces, 9 which are associated with poor outcomes of THA and the markedly high incidence of revision THA, as well as the short time between failures.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6] Among mostly active patients, dislocation that occurs secondary to THA has increasingly become a concern. 2,7,8 The use of small cups can lead to prosthesis loosening or instability instigated by large forces, 9 which are associated with poor outcomes of THA and the markedly high incidence of revision THA, as well as the short time between failures. [10][11][12] Although THA has become less preferred, surgeons have attempted to overcome this issue of dislocation using diverse strategies to decrease the risk of post-surgical dislocation, including using large cups, modular components that can be exchanged, or components made of cross-linked polyethylene.…”

Section: Introductionmentioning

confidence: 99%

“… 10 Through the unique DM design, with the femoral head captured within polyethylene, DM cups can maximize the impingement-free arc of motion, have a superior head-to-neck ratio, and increase the safety area required for dislocation. 2 , 13 Theoretically, it is a safe, effective and durable solution for preventing dislocation. 17 , 18 Several studies 10 , 17 , 18 have demonstrated that DM-THA significantly reduces the rate of dislocation in the management of FNFs.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Dual-Mobility Cup Total Hip Arthroplasty for Displaced Femoral Neck Fractures: A Retrospective Study With a Median Follow-Up of 5 Years

Zhang

Cao

et al. 2021

Geriatr Orthop Surg Rehabil

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Introduction: Patient outcomes following modern dual-mobility cup total hip arthroplasty (DM-THA) remains a concern. Few reports have focused on the use of modern DM-THA in the setting of Asian populations for displaced osteoporotic femoral neck fractures (FNFs). This study aimed to investigate the outcomes of Chinese population with displaced osteoporotic FNFs initially treated with modern DM-THA. Materials and Methods: Data from 112 consecutive patients (112 hips) with displaced osteoporotic FNFs initially treated with modern DM-THA during 2011-2018 were retrospectively analyzed. Follow-ups were performed at 3 months, 6 months, 12 months, and then every 1 year after surgery. The primary endpoint was the Harris Hip Score (HHS); the secondary endpoint was the main orthopedic complication rate. Results: The mean HHS improved from 58.62 (±15.79) prior to surgery to 86.13 (±9.92) at the final follow-up. The main complication rate was 14.2% (16/112). Sixteen complications in 10 patients were recorded. Of the 16 complications, there were 2 (1.7%) cases requiring revision DM-THA, 3 (2.6%) cases of loosening, 2 (1.7%) cases of migration, 3 (2.6%) intra-prosthetic dislocation (IPD), 4 (3.5%) cases of tilting, and 2 (1.7%) cases of severe wear. The need for revision was attributed to prosthesis loosening associated with poor bony quality. Conclusion: In patients with displaced osteoporotic FNFs, DM-THA may yield favorable functional outcomes and a low rate of main orthopedic complications, in particular, a low dislocation rate.

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Clinical Concerns With Dual Mobility- Should I Avoid it When Possible?

Lee

Kamath

Courtney

2021

The Journal of Arthroplasty

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No Difference in Force Required for Intraprosthetic Dislocation of Mixed Manufacturer vs Same Manufacturer Dual Mobility Articulations

Cited by 9 publications

References 27 publications

Early Recurrent Dislocation and Dissociation of Bipolar Cup: Two Intricate Cases and Review of Literature.

Early Recurrent Dislocation and Dissociation of Bipolar Cup: Two Intricate Cases and Review of Literature.

Dual-Mobility Cup Total Hip Arthroplasty for Displaced Femoral Neck Fractures: A Retrospective Study With a Median Follow-Up of 5 Years

Clinical Concerns With Dual Mobility- Should I Avoid it When Possible?

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