Dual-mobility versus Fixed-bearing in Primary Total Hip Arthroplasty: Outcome Comparison

Singh, Vivek; Loloi, Jeremy; Macaulay, William; Hepinstall, Matthew S.; Schwarzkopf, Ran; Aggarwal, Vinay K.

doi:10.5371/hp.2022.34.2.96

Cited by 5 publications

(5 citation statements)

References 35 publications

(44 reference statements)

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“…The dislocation rate in modDM has been likely influenced by confounding factors such as cup malpositioning or femoral neck fracture, even though the multivariate regression analysis did not show any significant covariate predictive for dislocation. Similar results are reported by Singh et al [ 25 ] who conducted a retrospective propensity score-matched analysis between SB vs monobloc DM vs modular DM. The authors found no statistical difference in the 90-day all-cause revision rate (3.4% vs. 2.7% vs. 0.7%; p = 0.265) and the 90-day revision rate due to dislocation (1.3% vs. 0.7% vs. 0.0%; p = 0.365) between the SB, modular DM, and monobloc DM cohorts, respectively.…”

Section: Discussionsupporting

confidence: 88%

Is Modular Dual Mobility Superior to Standard Bearings for Reducing Dislocation Risk after Primary Total Hip Arthroplasty? A Retrospective Comparative Multicenter Study

Ciriello,

La China,

Chirillo

et al. 2023

JCM

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Background: Dual mobility (DM) has been proven to reduce dislocation risk after total hip arthroplasty (THA). In the last decade modular DM (modDM) constructs have been introduced to allow the use of DM articulation with standard cementless acetabular shells. However, clinical evidence of modDM effectiveness is still low in primary THA and concerns about implant-related complications are increasing. This retrospective comparative multicenter study is aimed to investigate if the dislocation rate after primary THA could be reduced with modDM in comparison to standard bearing (SB). Methods: 262 THAs were performed between 2017 and 2019, using SB (129 hips) or modDM (133) with the same cementless highly porous modular acetabular cup. Dislocations, complications and revisions were recorded and implant survival was analyzed. Results: At 2.5-year mean follow-up, dislocation occurred in 4 hips (3.1%) within the SB group while intraprosthetic dislocation in 2 hips (1.5%) within the modDM group (p = 0.44). Implant survivals with revision due to dislocation were 95.2% and 95.9% at 4-year follow-up for SB and modDM, respectively (p = 0.50). Conclusions: modDM used in primary THA might reduce dislocation rate in comparison to SB, even in high-risk patients, however, caution is advocated due to specific intraprosthetic dislocation.

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Section: Discussionsupporting

confidence: 88%

Is Modular Dual Mobility Superior to Standard Bearings for Reducing Dislocation Risk after Primary Total Hip Arthroplasty? A Retrospective Comparative Multicenter Study

Ciriello,

La China,

Chirillo

et al. 2023

JCM

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“…Of the 63 articles included, 11 reported outcomes for two different approaches in the same study [ 10 , 33 , 40 , 43 , 49 , 50 , 52 , 69 , 79 , 84 ], and one study reported three approaches [ 74 ], resulting in 75 total study arms. Eight studies reported the DAA, five reported the ALA, six reported the DLA, and 56 studies reported the PLA (Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Zero dislocations were reported in 4 of 5 ALA studies (80%), 7 of 8 DAA studies (87.5%), 6 of 6 DLA studies (100%), and 46 of 56 PLA studies (82.1%) (Table 3 ). The two studies with dislocations following DAA and ALA reported rates of 1.8% and 0.9%, respectively [ 84 , 87 ]. The highest dislocation rate for PLA was 4.7% [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

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Comparing dislocation rates by approach following elective primary dual mobility total hip arthroplasty: a systematic review

et al. 2023

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Background Dual mobility components can be implanted during total hip arthroplasty (THA) for primary osteoarthritis via a direct anterior approach (DAA), anterolateral approach (ALA), direct lateral approach (DLA), or posterior/posterolateral approach (PLA). This review compares dual mobility hip dislocation rates using these approaches for elective primary THA. Methods PubMed, Embase, and Cochrane databases were systematically searched for articles published after January 1, 2006 that reported dislocation rates for adult patients after primary THA with dual mobility implants. Articles were excluded if they reported revision procedures, nonelective THA for femoral neck fractures, acetabular defects requiring supplemental implants, prior surgery, or ≤ 5 patients. The primary outcome was hip dislocation rate. Secondary outcomes included infection, Harris Hip Score (HHS), and Postel-Merle d’Aubigné (PMA) score. Results After screening 542 articles, 63 met inclusion criteria. Due to study heterogeneity, we did not perform a meta-analysis. Eight studies reported DAA, 5 reported ALA, 6 reported the DLA, and 56 reported PLA. Study size ranged from 41 to 2,601 patients. Mean follow-up time ranged from 6 months to 25 years. Rates of infection and dislocation were low; 80% of ALA, 87.5% of DAA, 100% of DLA, and 82.1% of PLA studies reported zero postoperative dislocations. Studies reporting postoperative HHS and PMA scores showed considerable improvement for all approaches. Conclusions Patients undergoing primary THA with dual mobility implants rarely experience postoperative dislocation, regardless of surgical approach. Additional studies directly comparing DAA, ALA, DLA, and PLA are needed to confirm these findings.

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“…These findings are corroborated by those of other studies, where DM implants in the setting of primary THA yield high PROMS. Singh et al compared primary THA patients who received a fixed-bearing, monoblock or modular DM implant and found no difference in PROMs at two years in the DM groups [ 28 ]. Tarazi et al also noted excellent Harris hip scores (HHS) at long-term follow-up (seven years) in patients who received a primary THA with DM liner [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Two-Year Outcomes of Novel Dual-Mobility Implant in Primary Total Hip Arthroplasty

Schaffler,

Raymond,

Black

et al. 2024

Advances in Orthopedics

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Introduction. Dual-mobility (DM) implants for total hip arthroplasty (THA) have gained popularity due to their potential to reduce hip instability and dislocation events that may lead to revision surgery. These implants consist of a femoral head articulated within a polyethylene liner, which articulates within an outer acetabular shell, creating a dual-bearing surface. Our study aimed to report our observations on the survivorship of a novel DM implant for primary total hip arthroplasty at two years. Methods. We conducted a retrospective, multicenter study to assess the clinical outcomes of patients undergoing a THA with a novel DM implant (OR3O acetabular system™, Smith & Nephew, Inc., Memphis, TN) from January 2020 to September 2021. Patient demographics, surgical information, and survivorship data were collected from medical records for patients with a minimum of two years of follow-up. Primary outcomes included overall implant survivorship at two years as well as aseptic survivorship, revision rates of the DM acetabular shell, and average time to revision. Patient-reported outcomes were collected in the form of HOOS JR. Results. A total of 250 hips in 245 patients had a minimum two-year follow-up. Primary osteoarthritis (80%) was the most common indication for index THA. The average aseptic survivorship of the DM acetabular components at two years for the cohort was 98.4% and survivorship of the acetabular implants overall was 97.6%. There were a total of four (1.6%) aseptic revisions of the DM acetabular component. Reasons for aseptic acetabular revision included one case of instability, one intraprosthetic dislocation, one periprosthetic acetabular fracture, and one malpositioned acetabular cup resulting in impingement. The mean time of follow-up was 893.9 days. Eighty-seven patients had preoperative and two-year HOOS JR available. HOOS JR improved by an average of 38.5 points. Conclusion. This novel DM acetabular implant demonstrates excellent survivorship at two years follow-up with low rates of instability and intraprosthetic dislocation and no episodes of metal-on-metal corrosion. Use of the DM implant demonstrated clinically relevant improvements in patient-reported outcomes at two years.

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Dual-mobility versus Fixed-bearing in Primary Total Hip Arthroplasty: Outcome Comparison

Cited by 5 publications

References 35 publications

Is Modular Dual Mobility Superior to Standard Bearings for Reducing Dislocation Risk after Primary Total Hip Arthroplasty? A Retrospective Comparative Multicenter Study

Is Modular Dual Mobility Superior to Standard Bearings for Reducing Dislocation Risk after Primary Total Hip Arthroplasty? A Retrospective Comparative Multicenter Study

Comparing dislocation rates by approach following elective primary dual mobility total hip arthroplasty: a systematic review

Two-Year Outcomes of Novel Dual-Mobility Implant in Primary Total Hip Arthroplasty

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