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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Dislocation of the hip is a well-described event that occurs in conjunction with high-energy trauma or postoperatively after total hip arthroplasty. Bigelow first described closed treatment of a dislocated hip in 1870, and in the last decade many reduction techniques have been proposed. In this article, we review all described techniques for the reduction of hip dislocation while focusing on physician safety. Furthermore, we introduce a modified technique for the reduction of posterior hip dislocation that allows the physician to adhere to the back safety principles set for by the Occupational Safety and Health Administration.

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