The dual mobility socket concept: experience with 668 cases

Abstract

Long-term results of a retrospective series of primary arthroplasty with the original cementless dual mobility socket (A) and the midterm results with the second generation (B) are reported. In series A (follow-up 16.5 years) 437 total hip arthroplasties (THA) were included and in series B (follow-up five years) 231 hips. The 15-year survival rate was 84.4 ± 4.5% (revision for any reason as endpoint); 30 hips (6.8%) were revised for aseptic loosening. Five THA were revised for dislocation: two early and three after ten years or more. With the second generation socket neither dislocation nor revision for mechanical reasons were observed. The survival rate was 99.6 ± 0.4% (revision for any reason). The prevalence of revision for dislocation was very low in our series. This concept does not avoid wear and aseptic loosening, especially in young active patients, but the long-term stability has been confirmed. Dual mobility can be recommended for patients over 70 years of age and for younger patients with high risk of dislocation.

Is a Cementless Dual Mobility Socket in Primary THA a Reasonable Option?

“…Additionally, no component loosened and no femoral component subsided. These findings were comparable with other studies that evaluated cementless fixation of dual mobility sockets using hydroxyapatite at similar followup [13,18,31].…”

“…Loosening of the socket has been attributed to the alumina coating of the metal shell providing limited bone on-growth to the socket [18,31]. Since this early period, a number of cemented and cementless dual mobility designs have emerged in Europe [13,14,18,21,31], and some have been recently approved by the FDA. Dual mobility sockets have gained popularity in Europe since the early 2000s, currently representing 1 .…”

“…The main cause of failure of the original Bousquet dual mobility socket (Novae-1 1 ; Serf, Décines, France) was loosening of the cementless socket in 3% to 12% of patients at 10 to 22 years [5,9,17,[26][27][28][29]. Loosening of the socket has been attributed to the alumina coating of the metal shell providing limited bone on-growth to the socket [18,31]. Since this early period, a number of cemented and cementless dual mobility designs have emerged in Europe [13,14,18,21,31], and some have been recently approved by the FDA.…”

Primary total hip arthroplasty with dual mobility socket to prevent dislocation: a 22-year follow-up of 240 hips

“…For cemented shells, survival rate considering cup or liner revision as end points was 87% for Berry et al [18] at 25 years.…”

“…Vielpeau et al [18] analysed 435 DM THA hips at a mean 16.5-year follow-up. The main difference between the two series was Caen's team choice of a cemented Charnley stem.…”