, Volume 470, Issue 11, pp 3048-3053
Date: 26 May 2012

Is a Cementless Dual Mobility Socket in Primary THA a Reasonable Option?

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Abstract

Background

Dislocation after THA continues to be relatively common. Dual mobility sockets have been associated with low dislocation rates, but it remains unclear whether their use in primary THA would not introduce additional complications.

Questions/Purposes

We therefore asked whether a current cementless dual mobility socket (1) reduced the dislocation rate after primary THA, (2) provided a pain-free and mobile hip, and (3) provided durable radiographic fixation of the acetabular component without any unique modes of failure.

Methods

We retrospectively reviewed 168 patients who underwent primary THA using a dual mobility socket between January 2000 and June 2002. The average age at surgery was 67 years. We assessed the rate of dislocation, hip function, and acetabular fixation on serial radiographs. Of the 168 patients, 119 (71%) had clinical and radiographic evaluation at a minimum of 5 years (mean, 6 years; range, 5–8 years).

Results

A long-neck option left the base of the Morse taper uncovered in 53 hips. Four patients underwent revision for dislocation between the femoral head and the mobile insert (intraprosthetic dislocation) at a mean 6 years; all four revisions occurred among the 53 hips with an incompletely covered Morse taper.

Conclusions

A current cementless dual mobility socket was associated with a pain-free and mobile hip and durable acetabular fixation without dislocations if the long-neck option was not used. However, intraprosthetic dislocation related to contact at the femoral neck to mobile insert articulation required revision in four hips. Surgeons should be aware of this specific complication.

Level of Evidence

Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

One or more of the authors (MH, HA, BB) have received or may receive payments or benefits, in any 1 year, in excess on $10,000, from a commercial entity (Aston® Medical, Saint Étienne, France) related to this work.
All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.
Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use.
Each author certifies that his or her institution has approved or waived approval for the human protocol of this investigation and that all investigations were conducted in conformity with ethical principles of research.
This work was performed at the Clinical Orthopaedic Research Center (Paris, France), Centre Hospitalier Fleyriat (Bourg en Bresse, France), and Institut Calot (Berck sur Mer, France).