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Neri T, Boyer B, Batailler C, Klasan A, Lustig S, Philippot R, Farizon F. Dual mobility cups for total hip arthroplasty: tips and tricks. SICOT J 2020; 6:17. [PMID: 32553100 PMCID: PMC7301635 DOI: 10.1051/sicotj/2020018] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 05/27/2020] [Indexed: 12/12/2022] Open
Abstract
Since its creation in 1974, the Dual Mobility Cup (DMC) has been gaining in popularity, especially in the past decade. This intensive use could lead to inappropriate use and consequently to an increased complication rate. Compliance with conceptual requirements and surgical techniques will prevent the occurrence of complications that can be wrongly attributed to implants. In this context, we feel that it is essential to share our tips and tricks as well as an overview and an explanation of common errors, based on more than 45 years of clinical and research experience. From basic principles, including indications, implant choice and implant compatibility, to surgical tips, in this article orthopedic surgeons will find a practical overview of DMC in order to use it safely and with confidence.
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Affiliation(s)
- Thomas Neri
- Department of Orthopaedic Surgery, University Hospital Centre of Saint-Étienne, avenue Albert Raimond, 42000 Saint-Étienne, France - EA 7424 - Inter-University Laboratory of Human Movement Science, University Lyon - University Jean Monnet Saint-Étienne, avenue Albert Raimond, 42000 Saint-Étienne, France
| | - Bertrand Boyer
- Department of Orthopaedic Surgery, University Hospital Centre of Saint-Étienne, avenue Albert Raimond, 42000 Saint-Étienne, France - INSERM U1059 SAINBIOSE, avenue Albert Raimond, 42000 Saint-Étienne, France
| | - Cécile Batailler
- Orthopedic Surgery Department, Croix-Rousse Hospital, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France
| | - Antonio Klasan
- North Shore Hospital, 124 Shakespeare Road, Takapuna, 0620 Auckland, New Zealand
| | - Sebastien Lustig
- Orthopedic Surgery Department, Croix-Rousse Hospital, 103 Grande Rue de la Croix-Rousse, 69004 Lyon, France
| | - Remi Philippot
- Department of Orthopaedic Surgery, University Hospital Centre of Saint-Étienne, avenue Albert Raimond, 42000 Saint-Étienne, France - EA 7424 - Inter-University Laboratory of Human Movement Science, University Lyon - University Jean Monnet Saint-Étienne, avenue Albert Raimond, 42000 Saint-Étienne, France
| | - Frederic Farizon
- Department of Orthopaedic Surgery, University Hospital Centre of Saint-Étienne, avenue Albert Raimond, 42000 Saint-Étienne, France - INSERM U1059 SAINBIOSE, avenue Albert Raimond, 42000 Saint-Étienne, France
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Neri T, Philippot R, Klasan A, Putnis S, Leie M, Boyer B, Farizon F. Dual mobility acetabular cups for total hip arthroplasty: advantages and drawbacks. Expert Rev Med Devices 2018; 15:835-845. [PMID: 30345834 DOI: 10.1080/17434440.2018.1538781] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The dual mobility cup (DMC) concept was proposed by Professor Gilles Bousquet in 1974. Its' aims were to prevent postoperative dislocation, restore the physiological range of motion of the hip, and reduce the stresses at the interface. Since it was created, this design has been modified multiple times to reduce the complication rate, improve implant survival, and expand the indications. AREAS COVERED The objective of this review is to discuss the advantages and disadvantages of this implant based on its 40-year history and also to propose a range of indications based on published results. This will provide surgeons with a complete overview of DMC. EXPERT COMMENTARY Published studies on DMC confirm the low dislocation rate. Improvements made to DMC overtime have greatly reduced the complications related to wear, such as aseptic loosening and intraprosthetic dislocation (IPD). According to the literature, the indications have expanded and are no longer limited to revision surgery only. Long-term studies are needed before we can draw formal conclusions and consolidate these promising results.
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Affiliation(s)
- Thomas Neri
- a Department of Orthopaedic Surgery , University Hospital Centre of Saint-Etienne , Saint Etienne , France.,b EA 7424, Inter-university Laboratory of Human Movement Science , University Lyon, University Jean Monnet , Saint Etienne , France.,c Sydney Orthopaedic Research Institute , Sydney , Australia
| | - Remi Philippot
- a Department of Orthopaedic Surgery , University Hospital Centre of Saint-Etienne , Saint Etienne , France.,b EA 7424, Inter-university Laboratory of Human Movement Science , University Lyon, University Jean Monnet , Saint Etienne , France
| | - Antonio Klasan
- c Sydney Orthopaedic Research Institute , Sydney , Australia
| | - Sven Putnis
- c Sydney Orthopaedic Research Institute , Sydney , Australia
| | - Murilo Leie
- c Sydney Orthopaedic Research Institute , Sydney , Australia
| | - Bertrand Boyer
- a Department of Orthopaedic Surgery , University Hospital Centre of Saint-Etienne , Saint Etienne , France.,b EA 7424, Inter-university Laboratory of Human Movement Science , University Lyon, University Jean Monnet , Saint Etienne , France
| | - Frederic Farizon
- a Department of Orthopaedic Surgery , University Hospital Centre of Saint-Etienne , Saint Etienne , France.,b EA 7424, Inter-university Laboratory of Human Movement Science , University Lyon, University Jean Monnet , Saint Etienne , France
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De Martino I, D'Apolito R, Waddell BS, McLawhorn AS, Sculco PK, Sculco TP. Early intraprosthetic dislocation in dual-mobility implants: a systematic review. Arthroplast Today 2017; 3:197-202. [PMID: 28913407 PMCID: PMC5585769 DOI: 10.1016/j.artd.2016.12.002] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/07/2016] [Accepted: 12/09/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Dual mobility implants are subject to a specific implant-related complication, intraprosthetic dislocation (IPD), in which the polyethylene liner dissociates from the femoral head. For older generation designs, IPD was attributable to late polyethylene wear and subsequent failure of the head capture mechanism. However, early IPDs have been reportedly affecting contemporary designs. METHODS A systematic review of the literature according to the preferred reporting items for systematic reviews and meta-analyses guidelines was performed. A comprehensive search of PubMed, MEDLINE, Embase, and Google Scholar was conducted for English articles between January 1974 and August 2016 using various combinations of the keywords "intraprosthetic dislocation," "dual mobility," "dual-mobility," "tripolar," "double mobility," "double-mobility," "hip," "cup," "socket," and "dislocation." RESULTS In all, 16 articles met our inclusion criteria. Fourteen were case reports and 2 were retrospective case series. These included a total of 19 total hip arthroplasties, which were divided into 2 groups: studies dealing with early IPD after attempted closed reduction and those dealing with early IPD with no history of previous attempted closed reduction. Early IPD was reported in 15 patients after a mean follow-up of 3.2 months (2.9 SD) in the first group and in 4 patients after a mean follow-up of 15.1 months (9.9 SD) in the second group. CONCLUSIONS Based on the current data, most cases have been preceded by an attempted closed reduction in the setting of outer, large articulation dislocation, perhaps indicating an iatrogenic etiology for early IPD. Recognition of this possible failure mode is essential to its prevention and treatment.
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Affiliation(s)
- Ivan De Martino
- Department of Orthopaedic Surgery, Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA
- Department of Orthopaedic Surgery, Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, New York, NY, USA
| | - Rocco D'Apolito
- Department of Orthopaedic Surgery, Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, New York, NY, USA
| | - Bradford S. Waddell
- Department of Orthopaedic Surgery, Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, New York, NY, USA
| | - Alexander S. McLawhorn
- Department of Orthopaedic Surgery, Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, New York, NY, USA
| | - Peter K. Sculco
- Department of Orthopaedic Surgery, Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, New York, NY, USA
| | - Thomas P. Sculco
- Department of Orthopaedic Surgery, Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA
- Department of Orthopaedic Surgery, Adult Reconstruction and Joint Replacement Division, Hospital for Special Surgery, New York, NY, USA
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Batailler C, Fary C, Verdier R, Aslanian T, Caton J, Lustig S. The evolution of outcomes and indications for the dual-mobility cup: a systematic review. INTERNATIONAL ORTHOPAEDICS 2016; 41:645-659. [PMID: 28004142 DOI: 10.1007/s00264-016-3377-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 12/11/2016] [Indexed: 01/12/2023]
Abstract
PURPOSE Instability following total hip arthroplasty remains a common and disabling complication. The dual mobility cup (DMC) allows a reduction in the dislocation rate. An increasing number of studies have been undertaken to better understand DMC long term outcomes and complications. The goal of this systematic review was to clarify its different uses and outcomes according to the indications. METHODS A comprehensive literature review was performed using the keywords 'dual mobility' and 'tripolar cup' with no limit regarding the year of publication. One hundred seventy six publications were identified. RESULTS Current literature shows that "contemporary" dual mobility cup are a significant indication to manage instability following primary and revision hip arthroplasty. Survivorship at midterm is comparable to other articulations for primary THA, but is more difficult to evaluate in revision. Intra-prosthetic dislocation, wear, and loosening are now uncommon with new generations of DMC. CONCLUSIONS Compared to previous generations of DMC, the current "contemporary" DMC presents a significant improvement. Current literature reveals a tendency to increase the indications but further studies with long term follow up remain important to consolidate these findings.
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Waddell BS, De Martino I, Sculco T, Sculco P. Total Hip Arthroplasty Dislocations Are More Complex Than They Appear: A Case Report of Intraprosthetic Dislocation of an Anatomic Dual-Mobility Implant After Closed Reduction. Ochsner J 2016; 16:185-190. [PMID: 27303232 PMCID: PMC4896666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Total hip arthroplasty is a successful operation for the treatment of hip pain. One of the common complications of hip arthroplasty is dislocation. While reduction of standard prosthetic dislocations is highly successful, new prostheses add the potential for new complications. CASE REPORT We present the case of a patient who experienced intraprosthetic dislocation of an anatomic dual-mobility total hip prosthesis after a closed hip reduction and include the prereduction and postreduction radiographic findings. CONCLUSION Emergency department physicians should be aware of intraprosthetic dislocation. This complication can be easily missed because the metal/ceramic femoral head appears to be reduced in the acetabulum.
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Affiliation(s)
- Bradford S. Waddell
- Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY
| | - Ivan De Martino
- Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY
| | - Thomas Sculco
- Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY
| | - Peter Sculco
- Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY
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Langlois J, El Hage S, Hamadouche M. Intraprosthetic dislocation: a potentially serious complication of dual mobility acetabular cups. Skeletal Radiol 2014; 43:1013-6. [PMID: 24522771 DOI: 10.1007/s00256-014-1824-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 01/06/2014] [Accepted: 01/09/2014] [Indexed: 02/02/2023]
Abstract
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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Affiliation(s)
- Jean Langlois
- Department of Orthopaedic and Reconstructive Surgery, Hopital Cochin, 27 Rue du Faubourg St. Jacques, 75014, Paris, France,
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