Femoral Head Dislodgement Complicating Use of a Dual Mobility Prosthesis for Recurrent Instability

Banzhof, Jennifer A.; Robbins, Claire E.; Ven, Alexander van der; Talmo, Carl T.; Bono, James V.

doi:10.1016/j.arth.2012.08.020

Cited by 23 publications

(32 citation statements)

References 14 publications

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“…Mohammed et al [19] have reported severe metallosis after IPD in their case of a primary THA performed with a dual-mobility cup. Several other case reports have also demonstrated the potential complications of these designs [1,2,14,16,18,19,21,23]. Further studies detail this important complication of dualmobility articulations.…”

Section: Discussionmentioning

confidence: 80%

“…During revision procedures, Langlois et al [18] have described a case of a dual-mobility articulation with a dislodged femoral head with loss of sphericity secondary to IPD. Similarly, Banzhof et al [2] also experienced a dislodged femoral head in a revised THA after attempting to reduce a dislocation with this device. Mohammed et al [19] have reported severe metallosis after IPD in their case of a primary THA performed with a dual-mobility cup.…”

Section: Discussionmentioning

confidence: 95%

“…In the present study, we similarly evaluated a dualmobility articulation; however, it is different in design from most of the aforementioned studies. Although there are advantages to dual-mobility implants, they are not without disadvantages such as polyethylene wear, loosening, and the unique complication of IPD [1,2,14,16,18,19,21,23]. We therefore asked: (1) What is the cup survivorship when the dual-mobility articulation is used in the setting of primary THA?…”

Section: Discussionmentioning

confidence: 99%

“…We therefore asked: (1) What is the cup survivorship when the dual-mobility articulation is used in the setting of primary THA? (2) What are the clinical outcomes with this approach? (3) What are the radiographic outcomes?…”

Section: Discussionmentioning

confidence: 99%

“…Although there are advantages to this design, it is not without its disadvantages such as polyethylene wear and intraprosthetic dislocation (IPD) (unique to these articulations). Intraprosthetic dislocation may lead to others such as femoral head wear, metallosis, and impingement, which may cause implant failure and necessitate revision surgery [1,2,14,16,18,19,21,23].…”

Section: Introductionmentioning

confidence: 99%

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Low Frequency of Early Complications With Dual-mobility Acetabular Cups in Cementless Primary THA

Chughtai

Diedrich

Jauregui

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Dislocation complicates 1% to 5% of primary total hip arthroplasties (THAs). As a result, some surgeons consider dual-mobility articulations, which are usually used in the revision setting to decrease the likelihood of dislocation, as an option for primary THA. However, few studies have evaluated their use in this setting. Questions/purposes (1) What is the cup survivorship when the dual-mobility articulation is used in the setting of primary THA? (2) What are the clinical outcomes with this approach? (3) What are the radiographic outcomes? (4) What are the complications of dual-mobility articulations in primary THA? Methods Between 2011 and 2013, the five participating surgeons performed 495 cementless primary THAs. During that time, one of the five surgeons used dual-mobility articulations for all THAs, and the other four used it whenever the acetabular cup size was 52 mm or greater to enable a 28-mm head. Of the 495 patients, 453 (92%) were performed using this device. Smaller patients were treated with a standard THA. Of the 453 patients, a total of 43 One of the authors certifies that he (PMB) has received or may receive payments, during the study period, an amount of USD 100,000 to USD 1,000,000 from Stryker Orthopaedics (Mahwah, NJ, USA) and an amount of USD 10,000 to USD 100,000 from Joint Active Systems (Effingham, IL, USA). One of the authors certifies that he (SFH) has received or may receive payments, during the study period, an amount of USD 100,000 to USD 1,000,000 from Stryker Orthopaedics, less than USD 10,000 from Slack Inc (Thorofare, NJ, USA), an amount of USD 10,000 to USD 100,000 from Convatec, and less than USD 10,000 from Thieme Inc (New York, NY, USA). One of the authors certifies that he (ALM) has received or may receive payments, during the study period, an amount of USD 100,000 to USD 1,000,000 from Stryker Orthopaedics. One of the authors certifies that he (FRK) has received or may receive payments, during the study period, an amount of USD 100,000 to USD 1,000,000 from Stryker Orthopaedics and an amount of USD 10,000 to USD 100,000 from DJ Orthopedics (Vista, CA, USA). One of the authors certifies that he (MAM) has received or may receive payments, during the study period, an amount of USD 100,000 to USD 1,000,000 from Stryker Orthopaedics, an amount of USD 10,000 to USD 100,000 from DJ Orthopedics, an amount of USD 10,000 to USD 100,000 from Microport (Arlington, TN, USA), an amount of USD 10,000 to USD 100,000 from J&J (New Brunswick NJ, USA), an amount of USD 10,000 to USD 100,000 from Medical Compression Systems (Tel Aviv, Israel), an amount of USD 10,000 to USD 100,000 from OnGoing Care Solutions (Pinellas Park, FL, USA), an amount of USD 10,000 to USD 100,000 from Sage Products LLC (Cary, IL, USA), an amount of USD 10,000 to USD 100,000 from TissueGene (Rockville, MD, USA) an amount of USD 10,000 to USD 100,000 from Pacira Pharmaceuticals (Parsippany, NJ, USA), an amount of USD 10,000 to USD 100,000 from Merz (Frankfurt, Germany), and an amount of USD 10,000 ...

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Low Frequency of Early Complications With Dual-mobility Acetabular Cups in Cementless Primary THA

Chughtai

Diedrich

Jauregui

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Intraprosthetic dislocation: a potentially serious complication of dual mobility acetabular cups

2014

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Though dual mobility cups have gained growing popularity as a solution for instability in total hip replacements, these promising devices are subject to a specific implant failure mode, named intraprosthetic dislocation. We present the case of a patient sustaining such an adverse event. The planned revision surgery was postponed 12 months due to a severe heart condition, allowing a rare opportunity to document the natural history of this unusual complication. The small femoral head was found dislodged in the superior part of the metallic shell and had remarkably lost its sphericity. Severe metallic debris and granuloma were found in the proximal femoral region, associated with major periprosthetic bony and soft tissue damage. Surgeons, radiologists, and general practitioners should be aware of this specific complication, its incidence (almost 5%) and mechanisms (femoral neck to mobile polyethylene insert impingement, leading to rim fatigue and wear of the insert at the capturing area). Diagnosis is mainly based on anteroposterior and modified Lowenstein lateral radiographs of the hip, as an eccentric position of the small femoral head, lying against the concave inner surface of the shell. Prompt component revision should be planned, since delayed management could lead to severe irretrievable damages.

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Wear of dual-mobility cups: a review article

Laura

Hothi

Battisti

et al. 2016

International Orthopaedics (SICOT)

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Dual-mobility (DM) cups have been clinically used in hip surgery in Europe for more than 35 years and continue to gain popularity worldwide due to promising results at reducing instability. Concerns related to polyethylene wear apply as in conventional standard bearings but are accentuated by the larger-diameter articulations with multiple surfaces. We critically reviewed the reported literature regarding the in vivo and in vitro wear occurring on all surfaces involved. We looked for patterns to create a rational classification of sites of wear and to identify areas for future research. Wear was a significant problem for first-generation designs and appeared to be design related. Improved polyethylene, thinner and smoother trunnions, chamfered rims and eccentric configuration of insert and shell seem to enhance outcome performance; however, long-term clinical evidence and retrieval studies are needed to better understand the balance of benefit and risk when opting for DM bearings.

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Femoral Head Dislodgement Complicating Use of a Dual Mobility Prosthesis for Recurrent Instability

Cited by 23 publications

References 14 publications

Low Frequency of Early Complications With Dual-mobility Acetabular Cups in Cementless Primary THA

Low Frequency of Early Complications With Dual-mobility Acetabular Cups in Cementless Primary THA

Intraprosthetic dislocation: a potentially serious complication of dual mobility acetabular cups

Wear of dual-mobility cups: a review article

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