Advertisement

International Orthopaedics

, Volume 43, Issue 5, pp 1097–1105 | Cite as

Intraprosthetic dislocation of dual mobility total hip arthroplasty: still occurring?

  • Thomas NeriEmail author
  • Bertrand Boyer
  • Jean Geringer
  • Alexandre Di Iorio
  • Jacques H. Caton
  • Remi PhiIippot
  • Frederic Farizon
Original Paper

Abstract

Purpose

The objective was to identify predictive factors for intraprosthetic dislocation (IPD) and to understand how improvements in dual mobility cups (DMC) have helped to reduce dramatically the occurrence of this complication.

Methods

DM mobile inserts retrieved from 93 hips were divided into three groups: first-generation DMC with IPD (“firstDMC-IPD”), first-generation DMC with over 15 years of implantation without IPD (“firstDMC-noIPD”), and latest-generation DMC (“newDMC”). The predictive factors for IPD based on clinical, prosthetic, radiological and intraoperative characteristics were analysed by multivariate analysis. The surface of each retrieved mobile insert was analysed using three-dimensional CT scan in order to compare their rim wear.

Results

Three predictive factors for IPD were found: a high BMI, a wide rough stem neck and a large cup size. Wear of the firstDMC-noIPD inserts was significantly less than those of firstDMC-IPD inserts and significantly more than those of newDMC inserts. For the firstDMC-IPD inserts, the rim’s outer surface wear was significantly greater than the rim’s inner surface wear.

Conclusions

IPD is a specific complication related to wear of the DM mobile insert due to failure of the liner’s retaining rim, especially from the rim’s outer surface. This long-term issue is different to the early traumatic complication, which can happen after an attempt at closed reduction of a DM THA dislocation. Recent modifications in the design and the coating of contemporary DMC and femoral stems, as well as improvements in the mobile insert itself, seem to corroborate our assumptions about the IPD mechanism and contribute to the quasi-disappearance of this complication.

Keywords

Intraprosthetic dislocation Dual mobility Total hip arthroplasty 

Notes

Acknowledgements

We thank SERF (Décines, France) for giving us complete data on the implants used in this study (blueprints, 3D models, manufacturing tolerances).

We also thank Clement Neri, for his help to create the IPD predicting model.

Compliance with ethical standards

Conflict of interest

Thomas Neri, Bertrand Boyer and Jean Geringer are consultants for SERF (Décines, France).

Rémi Philippot and Frédéric Farizon receive royalties from SERF (Décines, France).

Jacques Caton is consultant for Group Lepine (Genay France).

References

  1. 1.
    Farizon F, de Lavison R, Azoulai JJ, Bousquet G (1998) Results with a cementless alumina-coated cup with dual mobility. A twelve-year follow-up study. Int Orthop 22:219–224CrossRefGoogle Scholar
  2. 2.
    Noyer D, Caton JH (2017) Once upon a time.... Dual mobility: history. Int Orthop 41:611–618.  https://doi.org/10.1007/s00264-016-3361-6 CrossRefGoogle Scholar
  3. 3.
    Charnley J, Kamangar A, Longfield MD (1969) The optimum size of prosthetic heads in relation to the wear of plastic sockets in total replacement of the hip. Med Biol Eng 7:31–39CrossRefGoogle Scholar
  4. 4.
    Caton JH, Prudhon JL, Ferreira A et al (2014) A comparative and retrospective study of three hundred and twenty primary Charnley type hip replacements with a minimum follow up of ten years to assess whether a dual mobility cup has a decreased dislocation risk. Int Orthop 38:1125–1129.  https://doi.org/10.1007/s00264-014-2313-2 CrossRefGoogle Scholar
  5. 5.
    Philippot R, Boyer B, Farizon F (2013) Intraprosthetic dislocation: a specific complication of the dual-mobility system. Clin Orthop 471:965–970.  https://doi.org/10.1007/s11999-012-2639-2 CrossRefGoogle Scholar
  6. 6.
    Lecuire F, Benareau I, Rubini J, Basso M (2004) Intra-prosthetic dislocation of the Bousquet dual mobility socket. Rev Chir Orthopédique Réparatrice Appar Mot 90:249–255CrossRefGoogle Scholar
  7. 7.
    Mohammed R, Cnudde P (2012) Severe metallosis owing to intraprosthetic dislocation in a failed dual-mobility cup primary total hip arthroplasty. J Arthroplast 27:493.e1–493.e3.  https://doi.org/10.1016/j.arth.2010.11.019 CrossRefGoogle Scholar
  8. 8.
    Neri T, Philippot R, Farizon F, Boyer B (2017) Results of primary total hip replacement with first generation Bousquet dual mobility socket with more than twenty five years follow up. About a series of two hundred and twelve hips. Int Orthop 41:557–561.  https://doi.org/10.1007/s00264-016-3373-2 CrossRefGoogle Scholar
  9. 9.
    Philippot R, Farizon F, Camilleri J-P et al (2008) Survival of cementless dual mobility socket with a mean 17 years follow-up. Rev Chir Orthopédique Réparatrice Appar Mot 94:e23–e27.  https://doi.org/10.1016/j.rco.2007.10.013 CrossRefGoogle Scholar
  10. 10.
    Massin P, Orain V, Philippot R et al (2012) Fixation failures of dual mobility cups: a mid-term study of 2601 hip replacements. Clin Orthop 470:1932–1940.  https://doi.org/10.1007/s11999-011-2213-3 CrossRefGoogle Scholar
  11. 11.
    Vermersch T, Viste A, Desmarchelier R, Fessy M-H (2015) Prospective longitudinal study of one hundred patients with total hip arthroplasty using a second-generation cementless dual-mobility cup. Int Orthop 39:2097–2101.  https://doi.org/10.1007/s00264-015-2985-2 CrossRefGoogle Scholar
  12. 12.
    Ferreira A, Prudhon J-L, Verdier R et al (2017) Contemporary dual-mobility cup regional and private register: methodology and results. Int Orthop 41:439–445.  https://doi.org/10.1007/s00264-017-3405-6 CrossRefGoogle Scholar
  13. 13.
    Leclercq S, Benoit JY, de Rosa JP et al (2013) Evora® chromium-cobalt dual mobility socket: results at a minimum 10 years’ follow-up. Orthop Traumatol Surg Res OTSR 99:923–928.  https://doi.org/10.1016/j.otsr.2013.07.017 CrossRefGoogle Scholar
  14. 14.
    Prudhon J-L, Ferreira A, Verdier R (2013) Dual mobility cup: dislocation rate and survivorship at ten years of follow-up. Int Orthop 37:2345–2350.  https://doi.org/10.1007/s00264-013-2067-2 CrossRefGoogle Scholar
  15. 15.
    Puch J-M, Derhi G, Descamps L et al (2017) Dual-mobility cup in total hip arthroplasty in patients less than fifty five years and over ten years of follow-up: a prospective and comparative series. Int Orthop 41:475–480.  https://doi.org/10.1007/s00264-016-3325-x CrossRefGoogle Scholar
  16. 16.
    Fabry C, Langlois J, Hamadouche M, Bader R (2016) Intra-prosthetic dislocation of dual-mobility cups after total hip arthroplasty: potential causes from a clinical and biomechanical perspective. Int Orthop 40:901–906.  https://doi.org/10.1007/s00264-015-3000-7 CrossRefGoogle Scholar
  17. 17.
    Geringer J, Boyer B, Farizon F (2011) Understanding the dual mobility concept for total hip arthroplasty. Investigations on a multiscale analysis-highlighting the role of arthrofibrosis. Wear 271:2379–2385.  https://doi.org/10.1016/j.wear.2011.02.027 CrossRefGoogle Scholar
  18. 18.
    Fabry C, Kaehler M, Herrmann S et al (2014) Dynamic behavior of tripolar hip endoprostheses under physiological conditions and their effect on stability. Med Eng Phys 36:65–71.  https://doi.org/10.1016/j.medengphy.2013.09.007 CrossRefGoogle Scholar
  19. 19.
    Boyer B, Neri T, Geringer J et al (2017) Long-term wear of dual mobility total hip replacement cups: explant study. Int Orthop.  https://doi.org/10.1007/s00264-017-3525-z
  20. 20.
    McArthur B, Cross M, Geatrakas C et al (2012) Measuring acetabular component version after THA: CT or plain radiograph? Clin Orthop 470:2810–2818.  https://doi.org/10.1007/s11999-012-2292-9 CrossRefGoogle Scholar
  21. 21.
    Brooker AF, Bowerman JW, Robinson RA, Riley LH (1973) Ectopic ossification following total hip replacement. Incidence and a method of classification. J Bone Joint Surg Am 55:1629–1632CrossRefGoogle Scholar
  22. 22.
    Boyer B, Neri T, Geringer J et al (2017) Understanding wear in dual mobility total hip replacement: first generation explant wear patterns. Int Orthop 41:529–533.  https://doi.org/10.1007/s00264-016-3362-5 CrossRefGoogle Scholar
  23. 23.
    Blunt L, Jiang XQ (2000) Three dimensional measurement of the surface topography of ceramic and metallic orthopaedic joint prostheses. J Mater Sci Mater Med 11:235–246.  https://doi.org/10.1023/A:1008924511967 CrossRefGoogle Scholar
  24. 24.
    Nowakowski AM, Müller-Gerbl M, Valderrabano V (2012) Assessment of knee implant alignment using coordinate measurement on three-dimensional computed tomography reconstructions. Surg Innov 19:375–384.  https://doi.org/10.1177/1553350611429689 CrossRefGoogle Scholar
  25. 25.
    Cvetanovich GL, Fillingham YA, Della Valle CJ, Sporer SM (2015) Intraprosthetic dislocation of dual-mobility bearings associated with closed reduction: a report of two cases. JBJS Case Connect 5:e26.  https://doi.org/10.2106/JBJS.CC.N.00137 CrossRefGoogle Scholar
  26. 26.
    De Martino I, D’Apolito R, Waddell BS et al (2017) Early intraprosthetic dislocation in dual-mobility implants: a systematic review. Arthroplasty Today 3:197–202.  https://doi.org/10.1016/j.artd.2016.12.002 CrossRefGoogle Scholar
  27. 27.
    D’Apuzzo MR, Koch CN, Esposito CI et al (2016) Assessment of damage on a dual mobility acetabular system. J Arthroplast 31:1828–1835.  https://doi.org/10.1016/j.arth.2016.01.039 CrossRefGoogle Scholar
  28. 28.
    Dumbleton JH, Manley MT, Edidin AA (2002) A literature review of the association between wear rate and osteolysis in total hip arthroplasty. J Arthroplast 17:649–661CrossRefGoogle Scholar
  29. 29.
    Hernigou P, Trousselier M, Roubineau F et al (2016) Dual-mobility or constrained liners are more effective than preoperative bariatric surgery in prevention of THA dislocation. Clin Orthop 474:2202–2210.  https://doi.org/10.1007/s11999-016-4859-3 CrossRefGoogle Scholar
  30. 30.
    Loving L, Lee RK, Herrera L et al (2013) Wear performance evaluation of a contemporary dual mobility hip bearing using multiple hip simulator testing conditions. J Arthroplast 28:1041–1046.  https://doi.org/10.1016/j.arth.2012.09.011 CrossRefGoogle Scholar

Copyright information

© SICOT aisbl 2018
corrected publication August/2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryUniversity Hospital Centre of Saint-EtienneSaint-EtienneFrance
  2. 2.EA 7424 - Inter-university Laboratory of Human Movement ScienceUniversity Lyon - University Jean MonnetSaint EtienneFrance
  3. 3.Ecole des mines de Saint-EtienneSaint-EtienneFrance
  4. 4.Institut orthopédiqueCaluireFrance

Personalised recommendations