Is Cemented Dual-Mobility Cup a Reliable Option in Primary and Revision Total Hip Arthroplasty: A Systematic Review

Abstract

Background: Instability is a common complication following total hip arthroplasty (THA). The dual mobility cup (DMC) allows a reduction in the dislocation rate. The goal of this systematic review was to clarify the different uses and outcomes according to the indications of the cemented DMC (C-DMC). Methods: A systematic review was performed using the keywords “Cemented Dual Mobility Cup” or “Cemented Tripolar Cup” without a publication year limit. Of the 465 studies identified, only 56 were eligible for the study. Results: The overall number of C-DMC was 3452 in 3426 patients. The mean follow-up was 45.9 months (range 12–98.4). In most of the cases (74.5%) C-DMC was used in a revision setting. In 57.5% DMC was cemented directly into the bone, in 39.6% into an acetabular reinforcement and in 3.2% into a pre-existing cup. The overall dislocation rate was 2.9%. The most frequent postoperative complications were periprosthetic infections (2%); aseptic loosening (1.1%) and mechanical failure (0.5%). The overall revision rate was 4.4%. The average survival rate of C-DMC at the last follow-up was 93.5%. Conclusions: C-DMC represents an effective treatment option to limit the risk of dislocations and complications for both primary and revision surgery. C-DMC has good clinical outcomes and a low complication rate.

Dual mobility in primary total hip arthroplasty: A temptation from the devil or a blessing from above

“…This modular design allows for flexibility in addressing various patient anatomies and optimizing stability. Monoblock (non-modular) DM designs integrate the articulating surface with the acetabular shell, providing an alternative approach[ 6 , 8 ].…”

“…Cemented DM implants, for instance, are utilized in both primary and revision surgeries. A systematic review by Ciolli et al [ 8 ] concluded that cemented DM cups represent an effective treatment option with favorable clinical outcomes[ 8 ].…”

“…Patients with specific comorbidities or anatomical issues may not be suitable candidates. Factors such as acetabular deficiency, abductor deficiency, prior acetabular fracture fixation, or high-demand physical activity may increase the risk of dislocation and loosening, influencing the decision to use DM implants[ 8 ].…”

“…The utilization of these implants, however, varies among institutions and surgeons, reflecting diverse preferences and patient demographics. The incidence of their use in primary THA raises questions about the criteria governing their application in this context, calling for standardized guidelines[ 7 , 8 ].…”