The double-mobility acetabular component in revision total hip replacement

Vasukutty, N; Middleton, Rory G; Matthews, E. C.; Young, P.S.; Uzoigwe, Chika Edward; Minhas, Tahawwar Hasnat A.

doi:10.1302/0301-620x.94b5.27876

Cited by 54 publications

(23 citation statements)

References 56 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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“…In these studies, involving between 29 and 163 revision THAs with a dual-mobility cup, the reported short-term risk of dislocation (within 6 weeks to 6 months after revision THA) varied between 2% and 4% (Vasukutty et al. 2012, Saragaglia et al. 2013, Philippot et al.…”

Section: Discussionmentioning

confidence: 99%

“…Considering only revision for failure of the dual-mobility cup as endpoint, reported survival rates ranged from 95% to 100% at 5 years in case series involving 50–155 revision THAs (Vasukutty et al. 2012, Langlais et al. 2008, van Heumen et al.…”

Section: Discussionmentioning

confidence: 99%

Comparison of dual-mobility cup and unipolar cup for prevention of dislocation after revision total hip arthroplasty

et al. 2016

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Background and purpose — Revision total hip arthroplasty (THA) is associated with higher dislocation rates than primary THA. We compared the risk of dislocation within 6 months and all-cause re-revision during the whole study period using either the dual-mobility cup or the unipolar cup.Methods — We used a prospective hospital registry-based cohort including all total and cup-only revision THAs performed between 2003 and 2013. The cups used were either dual-mobility or unipolar; the choice was made according to the preference of the surgeon. 316 revision THAs were included. The mean age of the cohort was 69 (25–98) years and 160 THAs (51%) were performed in women. The dual-mobility group (group 1) included 150 THAs (48%) and the mean length of follow-up was 31 (0–128) months. The unipolar group (group 2) included 166 THAs (53%) and the mean length of follow-up was 52 (0–136) months.Results — The incidence of dislocation within 6 months was significantly lower with the dual-mobility cup than with the unipolar cup (2.7% vs. 7.8%). The unadjusted risk ratio (RR) was 0.34 (95% CI: 0.11–1.02) and the adjusted RR was 0.28 (95% CI: 0.09–0.87). The number of patients needed to treat with a dual-mobility cup in order to prevent 1 case of dislocation was 19. The unadjusted incidence rate ratio for all-cause re-revision in the dual-mobility group compared to the unipolar group was 0.6 (95% CI: 0.3–1.4).Interpretation — Use of a dual-mobility rather than a unipolar cup in revision THA reduced the risk of dislocation within 6 months.

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“…Short-and medium-term results of this type of implant used in primary and revision THA have been published mainly by European centers [25,26]. Vasukutty et al [34] reported the outcome for 155 double-mobility components used in revision THA cases; 29 of these were for instability. Three subsequently dislocated (2%).…”

Section: Discussionmentioning

confidence: 99%

Acetabular Liner With Focal Constraint to Prevent Dislocation After THA

Munro

Vioreanu

Masri

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Dislocation continues to commonly cause failure after primary and revision total hip arthroplasty (THA). Fully constrained liners intended to prevent dislocation are nonetheless associated with a substantial incidence of failure by redislocation, mechanical failure, aseptic loosening, or a combination. Constrained liners with cutouts of the elevated rims can theoretically increase range of movement and therefore decrease the risk dislocation, but it is unclear if they do so in practice and whether they are associated with early wear or loosening. Questions/purposes We therefore determined (1) occurrence or recurrence of dislocation and (2) rate of complications associated with constrained implants with cutouts; and (3) assessed for early cup loosening. Methods We retrospectively reviewed the records of 81 patients at high risk for dislocation who had 82 constrained liners inserted for primary (n = 10) or revision (n = 72) THA between 2008 and 2010. From the records we extracted demographic and implant data and instances of recurrent dislocation, implant failure, osteolysis, loosening, or construct failure. The minimum followup was 24 months (mean, 34 months; range, 24-49 months).

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The double-mobility acetabular component in revision total hip replacement

Cited by 54 publications

References 56 publications

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

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

Comparison of dual-mobility cup and unipolar cup for prevention of dislocation after revision total hip arthroplasty

Acetabular Liner With Focal Constraint to Prevent Dislocation After THA

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