Low dislocation rate of Saturne®/Avantage® dual-mobility THA after displaced femoral neck fracture: a cohort study of 966 hips with a minimum 1.6-year follow-up

Low revision rate of dual mobility cups after arthroplasty for acute hip fractures: report of 11,857 hip fractures in the Dutch Arthroplasty Register (2007–2019)

“…head size 32 and 36 mm in contrast to our study in which head sizes 22-28 mm were included as well. Tabori-Jensen et al (2019) found low dislocation rates of DMC THA after acute femoral neck fracture in a cohort study of 966 hips. After mean 5.4 years follow-up, 8 cups were revised, 3 due to repeated dislocations.…”

Absence of instabilities and intra-prosthetic dislocations at 7 to 11 years following THA using a fourth-generation cementless dual mobility acetabular cup

“…Dual mobility (DM) cups became increasingly popular in recent years, as they proved effective at preventing articular instability, by virtue of increased ‘jump distance’ and ratio of head-to-neck diameter [ 25 , 47 ]. Though the initial ‘Bousquet’ cup was prone to intra-prosthetic dislocations (IPD) and aseptic loosening [ 37 , 40 , 42 , 46 ], design improvements over the past decades resolved many shortcomings of DM cups, thanks to enhanced press-fit and bioactive coatings [ 10 , 31 ], as well as more durable liners made of ultra-high molecular weight polyethylene (UHMWPE) [ 37 , 45 ].…”

Study protocol: The DUALITY trial—a register-based, randomized controlled trial to investigate dual mobility cups in hip fracture patients

“…The purpose of the DUALITY trial is to provide evidence to support or refute the use of DMC in patients with a displaced FNF treated with THA. The potentially reduced risk of dislocation after the use of DMC in FNF patients is described in several observational studies (Tarasevicius et al 2013, Bensen et al 2014, Tabori-Jensen et al 2019), but no highlevel evidence study has yet been conducted (Griffin et al 2016), and there may be an increased risk of other adverse events such as loosening or PJI (Kreipke et al 2019). The number of elderly patients with displaced FNF treated with THA is increasing in most developed countries, but prior to the broad introduction of the costlier DMC concept its safety and efficacy, including cost-effectiveness from a health-economic perspective, must be evaluated (Horriat andHaddad 2018, Bernstein et al 2019).…”

“…The obvious weakness of previous observational studies is the presence of residual confounding, and confounding by indication may be introduced by the fact that DMC may have been preferentially used in patients who were at higher risk of dislocation. Other limitations to previous studies include small sample sizes or the lack of comparison groups (Adam et al 2012, Tabori-Jensen et al 2019. Thus, by conducting a large-scale RCT, we investigate a sufficiently powered sample of patients randomized to intervention or control treatment, thereby reducing problems related to residual confounding or insufficient sample size.…”

“…A prospective study on FNF patients operated on with DMC reports a relatively low dislocation rate of 1.4% within 9 months (Adam et al 2012), but without a comparison group. A largescale observational study on 9,040 FNF patients treated with THA estimates a considerably reduced risk of revision due to dislocation in patients operated on with DMC compared with those receiving standard cups (Jobory et al 2019), but the low rate of revisions due to dislocation of 0.8% in that study is contradicted by a considerably higher dislocation rate of 4.7% in a smaller observational study (Tabori-Jensen et al 2019). It must be noted that arthroplasty register-based studies only report revisions due to dislocation, but not the incidence of dislocations per se, such that the true dislocation rate is consistently underestimated in arthroplasty register studies (Devane et al 2012).…”