Cementless dual-mobility cup in total hip arthroplasty revision

Prudhon, Jean Louis; Steffann, François; Ferreira, A.; Verdier, Raymond; Aslanian, Thierry; Caton, Jacques

doi:10.1007/s00264-014-2448-1

Cited by 51 publications

(22 citation statements)

References 22 publications

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“…This rate ranges from 1.1 to 5.5% when using DMC in revision for instability [27][28][29]. No dislocation for THA revision was encountered among the ten patients (age range = 45 to 69 years) in our study.…”

Section: Discussionmentioning

confidence: 65%

Outcomes of dual mobility cups in a young Middle Eastern population and its influence on life style

Assi

El-Najjar

Samaha

et al. 2017

International Orthopaedics (SICOT)

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Dual mobility cups (DMC) in total hip arthroplasty (THA) are becoming popular among orthopaedic surgeons. Substantial benefit of their use has been reported among high risk patients, particularly in reducing post-operative hip instability (dislocation). Many reports stated some concern when implanted in young and active people where complications such as polyethylene wear and mechanical loosening could potentially be higher. This Middle Eastern study analyses a retrospective series of THA for any aetiology other than infection, using DMC for the acetabular component in 75 patients (85 implants) less than 70 years old. No instability, intra-prosthetic dislocation or mechanical failure was reported during a mean follow-up of five years. The only major complication was a post-operative infection. The mean post- operative modified Harris hip score was 97.1 out of 100. All patients resumed their daily activities and all religious practicing patients were able to accomplish their prayer positions without pain. DMC is found to be an interesting option in reducing dislocation events in young patients. Those excellent short-term results would encourage surgeons to use DMC in an active and highly demanding population. Further research is necessary to confirm maintenance of such results at long term follow-up.

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Section: Discussionmentioning

confidence: 65%

Outcomes of dual mobility cups in a young Middle Eastern population and its influence on life style

Assi

El-Najjar

Samaha

et al. 2017

International Orthopaedics (SICOT)

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“…40-43 In the challenging situation of unstable THA, revision is known to carry a high probability of failure. 2 Reports on the use of modern dual mobility systems in such situations have demonstrated the efficacy of dual mobility to restore stability, with short- to mid-term re-dislocation rates ranging from 0% to 5.5% (Table 2).…”

Section: Dual Mobilitymentioning

confidence: 99%

Constrained liners, dual mobility or large diameter heads to avoid dislocation in THA

Guyen

2016

EFORT Open Reviews

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Dislocation remains a common cause of failure after total hip arthroplasty. The limitations of existing approaches to address instability have led to the development of powerfull options: constrained liners, dual mobility and large heads. These implant-related options have proven to be very efficient, but have raised concerns.With constrained liners, restricted range of motion (ROM) is responsible for impingement leading to high likelihood of failure, depending on the design, with various failure modes.Improvements of the bearing materials have addressed some of the concerns about increased volumetric wear of conventional polyethylene and offer an option to reduce instability: large diameter heads have the advantage of increased ROM before impingement, increased head-neck ratio, and jump distance. Highly cross-linked polyethylene helps address the risk for increased wear, and also large heads provide improved stability without the risk of mechanical failures observed with constrained liners. However, the increase of the head size remains limited as reducing the thickness of the liner may lead to fractures. In addition, the jump distance decreases as the cup abduction increases.The dual mobility concept simultaneously attempts to address head-neck ratio, constraint, and jump distance. Despite the need for longer follow-up, concerns raised about potential increased wear and intra-prosthetic dislocation with first generation implants have been addressed with modern designs.With a dramatic increase of the head-neck ratio whilst reducing the risk of mechanical failure or excessive wear, dual mobility THA outperforms large diameter heads and constrained liners at 10 years follow-up. For these reasons, dual mobility continues to gain interest worldwide and is becoming the most popular option to manage instability.Cite this article: Guyen O. Constrained liners, dual mobility or large diameter heads to avoid dislocation in THA. EFORT Open Rev 2016;1:197-204. DOI: 10.1302/2058-5241.1.000054.

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“…It combined a small head to decrease wear (low friction arthroplasty principles stated by Charnley [3]) and a large head to increase stability (MacKee and Farrar [4]). Several studies have looked at the outcome of dual mobility articulation in primary THR [5–18] and in revision THR [5, 19–24]. …”

Section: Introductionmentioning

confidence: 99%

Dual mobility total hip replacement in a high risk population

Luthra

Riyami

Allami

2016

SICOT-J

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Objective: The purpose of the study was to evaluate results of dual mobility total replacement in a high risk population who take hip into hyperflexed position while sitting and praying on the floor. Method: The study included 65 (35 primary total replacement and 30 complex total hip replacement) cases of total hip replacement using avantage privilege dual mobility cup system from biomet. A cemented acetabular component and on femoral side a bimetric stem, either cemented or uncemented used depending on the canal type. Ten cases were examined fluoroscopically in follow up. Result: There was dislocation in one patient undergoing complex hip replacement. Fluoroscopy study showed no impingement between the neck of prosthesis and acetabular shell at extremes of all movements. Conclusion: The prevalence of dislocation is low in our high risk population and we consider it preferred concept for patients undergoing complex total hip replacement.

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Cementless dual-mobility cup in total hip arthroplasty revision

Abstract: Considering outcomes of this series, cementless DMC can be suggested in THA revision surgery.

Cited by 51 publications

References 22 publications

Outcomes of dual mobility cups in a young Middle Eastern population and its influence on life style

Outcomes of dual mobility cups in a young Middle Eastern population and its influence on life style

Constrained liners, dual mobility or large diameter heads to avoid dislocation in THA

Dual mobility total hip replacement in a high risk population

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