Use of dual mobility components in total hip arthroplasty: Indications and outcomes

Abstract

Instability after total hip arthroplasty (THA) can be a problematic complication and remains one of the leading causes of revision surgery in the early post-operative period. Dual mobility (DM) implants decrease dislocation risk after THA but they come with their own set of complications. Selective use of DM implants for THA in high risk groups can confer the advantages of this construct while mitigating the risks. In this paper, we review the current literature to examine the evidence for or against use of DM implants in various clinical scenarios and provide an algorithm for when to consider using DM design construct in THA.

Obturator Anterior Dislocation After Direct Anterior Total Hip Arthroplasty in a Patient with Ehlers-Danlos Syndrome

“…Dual-mobility cups decrease the dislocation risk by increasing the range of motion that is possible before impingement, made possible by 2 articulating interfaces-head-polyethylene liner and polyethylene head-acetabular shell 23 . Reasonable indications for a dual-mobility implant are in spinopelvic disease, recent spinal fusion, neurological disorder (cognitive or motor), acute THA for fracture, and/or older age 24,25 . Unfortunately for cases in patients with soft-tissue laxity, cup placement calculation is less predictable.…”

Risk Factors for Revision After Early and Delayed Total Hip Arthroplasty Dislocation. An Analysis of Lithuanian Arthroplasty Register

“…We chose a three-month period as the distinguishing point between early and delayed dislocations, because dislocations usually occur within a period of three months after THA. Up to 70% of dislocations occur during the first month after surgery or up to 66% occur during first five weeks [ 16 - 17 ]. Dislocations that happen within 0-3 months from surgery, usually occur due to patient factors, deficiency of mature scar tissue or tension in soft tissue, while delayed dislocations are most often caused by component malposition or polyethylene wear [ 10 ].…”

Custom three‐dimensional printed implants for reconstruction of oncologic pelvic defects

“…Dual mobility bearing/implants have been naturally adapted in oncologic pelvic reconstruction due to their properties allowing for increased hip stability. 48 A dual implant bearing consists of two articulating surfaces: one between the femoral head and the polyethylene liner, and the other between the liner and the acetabular shell. One major advantage of this system is that it allows for improved range of motion.…”