Skip to main content

Dislocations after use of dual-mobility cups in cementless primary total hip arthroplasty: prospective multicentre series

Abstract

Background

The purpose of this study was to investigate the incidence of dislocation and specific complications of the dual-mobility cup.

Methods

The arthroplasties involved 167 hips in 165 patients; 51 hips (30.5%) were in men and 116 (69.4%) were in women. The active articulation E1® dual-mobility cup (Biomet, Warsaw, IN, USA) was used, and the surgical approach was posterolateral in 120 hips and anterolateral in 47 hips.

Results

Four (2.3%) dislocations were observed. Mean time of dislocation was 30.5 days post-operatively. Three incomplete reductions occurred during closed reduction. When comparing parameters between dislocation and no-dislocation groups, there were no differences in patient and surgical parameters. However, all dislocations occurred in patients with femoral neck fractures and in the posterolateral approach group.

Conclusion

The incidence of dislocation in total hip arthroplasty (THA) using a dual-mobility cup was acceptable, and cup diameter of the dislocation group was substantially larger than that of no-dislocation group. Based on clinical outcomes of our study, we conclude that the dual-mobility cup is a reliable option in THA, and further studies are necessary.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3

References

  1. Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ (2009) The Epidemiology of Revision Total Hip Arthroplasty in the United States. J Bone Joint Surg Am 91-A:128–133. https://doi.org/10.2106/jbjs.h.00155

    Article  Google Scholar 

  2. Springer BD, Fehring TK, Griffin WL, Odum SM, Masonis JL (2009) Why Revision Total Hip Arthroplasty Fails. Clin Orthop Relat Res 467:166–173. https://doi.org/10.1007/s11999-008-0566-z

    Article  PubMed  Google Scholar 

  3. Burroughs BR, Hallstrom B, Golladay GJ, Hoeffel D, Harris WH (2005) Range of motion and stability in total hip arthroplasty with 28-, 32-, 38-, and 44-mm femoral head sizes. J Arthroplast 20:11–19. https://doi.org/10.1016/j.arth.2004.07.008

    Article  Google Scholar 

  4. Berry DJ, von Knoch M, Schleck CD, Harmsen WS (2005) Effect of Femoral Head Diameter and Operative Approach on Risk of Dislocation After Primary Total Hip Arthroplasty. J Bone Joint Surg Am 87-A:2456–2463. https://doi.org/10.2106/jbjs.d.02860

    Google Scholar 

  5. Robinson M, Bornstein L, Mennear B, Bostrom M, Nestor B, Padgett D, Westrich G (2012) Effect of restoration of combined offset on stability of large head THA. Hip Int 22:248–253. https://doi.org/10.5301/HIP.2012.9283

    Article  PubMed  Google Scholar 

  6. Lachiewicz PF, Kelley SS (2002) The use of constrained components in total hip arthroplasty. J Am Acad Orthop Surg 10:233–238

    Article  PubMed  Google Scholar 

  7. Nich C, Vandenbussche E, Augereau B, Sadaka J (2016) Do Dual-Mobility Cups Reduce the Risk of Dislocation in Total Hip Arthroplasty for Fractured Neck of Femur in Patients Aged Older Than 75 Years? J Arthroplast 31:1256–1260. https://doi.org/10.1016/j.arth.2015.11.041

    Article  Google Scholar 

  8. Boyer B, Philippot R, Geringer J, Farizon F (2012) Primary total hip arthroplasty with dual mobility socket to prevent dislocation: a 22-year follow-up of 240 hips. Int Orthop 36:511–518. https://doi.org/10.1007/s00264-011-1289-4

    Article  PubMed  Google Scholar 

  9. Guyen O, Pibarot V, Vaz G, Chevillotte C, Carret JP, Bejui-Hugues J (2007) Unconstrained tripolar implants for primary total hip arthroplasty in patients at risk for dislocation. J Arthroplast 22:849–858. https://doi.org/10.1016/j.arth.2006.11.014

    Article  Google Scholar 

  10. Philippot R, Camilleri JP, Boyer B, Adam P, Farizon F (2009) The use of a dual-articulation acetabular cup system to prevent dislocation after primary total hip arthroplasty: analysis of 384 cases at a mean follow-up of 15 years. Int Orthop 33:927–932. https://doi.org/10.1007/s00264-008-0589-9

    Article  PubMed  Google Scholar 

  11. Leclercq S, Benoit JY, de Rosa JP, Tallier E, Leteurtre C, Girardin PH (2013) Evora(R) chromium-cobalt dual mobility socket: results at a minimum 10 years' follow-up. Orthop Traumatol Surg Res 99:923–928. https://doi.org/10.1016/j.otsr.2013.07.017

    CAS  Article  PubMed  Google Scholar 

  12. Puch JM, Derhi G, Descamps L, Verdier R, Caton JH (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

    Article  PubMed  Google Scholar 

  13. Prudhon JL, Verdier R, Caton JH (2017) Low friction arthroplasty and dual mobility cup: a new gold standard. Int Orthop 41:563–571. https://doi.org/10.1007/s00264-016-3375-0

    Article  PubMed  Google Scholar 

  14. Caton JH, Prudhon JL, Ferreira A, Aslanian T, Verdier R (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

    Article  PubMed  PubMed Central  Google Scholar 

  15. Prudhon JL, 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

    Article  PubMed  PubMed Central  Google Scholar 

  16. Langlais FL, Ropars M, Gaucher F, Musset T, Chaix O (2008) Dual mobility cemented cups have low dislocation rates in THA revisions. Clin Orthop Relat Res 466:389–395. https://doi.org/10.1007/s11999-007-0047-9

    Article  PubMed  PubMed Central  Google Scholar 

  17. Philippot R, Adam P, Reckhaus M, Delangle F, Verdot F, Curvale G, Farizon F (2009) Prevention of dislocation in total hip revision surgery using a dual mobility design. Orthop Traumatol Surg Res 95:407–413. https://doi.org/10.1016/j.otsr.2009.04.016

    CAS  Article  PubMed  Google Scholar 

  18. Berry DJ, von Knoch M, Schleck CD, Harmsen WS (2004) The cumulative long-term risk of dislocation after primary Charnley total hip arthroplasty. J Bone Joint Surg Am 86-A:9–14

    Article  PubMed  Google Scholar 

  19. Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ (2009) The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am 91:128–133. https://doi.org/10.2106/JBJS.H.00155

    Article  PubMed  Google Scholar 

  20. Clohisy JC, Harris WH (1999) Primary hybrid total hip replacement, performed with insertion of the acetabular component without cement and a precoat femoral component with cement. An average ten-year follow-up study. J Bone Joint Surg Am 81-A:247–255

    Article  Google Scholar 

  21. Harris WH (1969) Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. An end-result study using a new method of result evaluation. J Bone Joint Surg Am 51-A:737–755

    Article  Google Scholar 

  22. Woo RYG, Morrey BF (1982) Dislocations after total hip arthroplasty. J Bone Joint Surg Am 64-A:1295–1306

    Article  Google Scholar 

  23. D'Apuzzo MR, Koch CN, Esposito CI, Elpers ME, Wright TM, Westrich GH (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

    Article  Google Scholar 

  24. Boyer B, Neri T, Geringer J, Di Iorio A, Philippot R, Farizon F (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

    Article  PubMed  Google Scholar 

  25. Gaudin G, Ferreira A, Gaillard R, Prudhon JL, Caton JH, Lustig S (2017) Equivalent wear performance of dual mobility bearing compared with standard bearing in total hip arthroplasty: in vitro study. Int Orthop 41:521–527. https://doi.org/10.1007/s00264-016-3346-5

    Article  PubMed  Google Scholar 

  26. Plummer DR, Haughom BD, Della Valle CJ (2014) Dual mobility in total hip arthroplasty. Orthop Clin North Am 45:1–8. https://doi.org/10.1016/j.ocl.2013.08.004

    Article  PubMed  Google Scholar 

  27. Bousquet G, Gazielly DF, Debiesse JL (1985) The ceramic coated cementless total hip arthroplasty: Basic concepts and surgical technique. J Orthopaedic Surg Tech 1:15–28

    Google Scholar 

  28. Combes A, Migaud H, Girard J, Duhamel A, Fessy MH (2013) Low rate of dislocation of dual-mobility cups in primary total hip arthroplasty. Clin Orthop Relat Res 471:3891–3900. https://doi.org/10.1007/s11999-013-2929-3

    Article  PubMed  PubMed Central  Google Scholar 

  29. Hamadouche M, Arnould H, Bouxin B (2012) Is a cementless dual mobility socket in primary THA a reasonable option? Clin Orthop Relat Res 470:3048–3053. https://doi.org/10.1007/s11999-012-2395-3

    Article  PubMed  PubMed Central  Google Scholar 

  30. Vielpeau C, Lebel B, Ardouin L, Burdin G, Lautridou C (2011) The dual mobility socket concept: experience with 668 cases. Int Orthop 35:225–230. https://doi.org/10.1007/s00264-010-1156-8

    Article  PubMed  Google Scholar 

  31. Ferreira A, Prudhon JL, Verdier R, Puch JM, Descamps L, Dehri G, Remi M, Caton JH (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

    Article  PubMed  Google Scholar 

  32. Liao L, Zhao Jm SW, Xf D, Lj C, Luo S (2012) A meta-analysis of total hip arthroplasty and hemiarthroplasty outcomes for displaced femoral neck fractures. Arch Orthop Trauma Surg 132:1021–1029. https://doi.org/10.1007/s00402-012-1485-8

    Article  PubMed  Google Scholar 

  33. Yu L, Wang Y, Chen J (2012) Total Hip Arthroplasty Versus Hemiarthroplasty for Displaced Femoral Neck Fractures: Meta-analysis of Randomized Trials. Clin Orthop Relat Res 470:2235–2243. https://doi.org/10.1007/s11999-012-2293-8

    Article  PubMed  PubMed Central  Google Scholar 

  34. Burgers PTPW, Van Geene AR, Van den Bekerom MPJ, Van Lieshout EMM, Blom B, Aleem IS, Bhandari M, Poolman RW (2012) Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis and systematic review of randomized trials. Int Orthop 36:1549–1560. https://doi.org/10.1007/s00264-012-1569-7

    Article  PubMed  PubMed Central  Google Scholar 

  35. Brooks PJ (2013) Dislocation following total hip replacement: causes and cures. Bone Joint J 95-B:67–69. https://doi.org/10.1302/0301-620x.95b11.32645

    CAS  Article  PubMed  Google Scholar 

  36. Masonis JL, Bourne RB (2002) Surgical approach, abductor function, and total hip arthroplasty dislocation. Clin Orthop Relat Res 405:46–53

    Article  Google Scholar 

  37. Soong M, Rubash HE, Macaulay W (2004) Dislocation after total hip arthroplasty. J Am Acad Orthop Surg 12:314–321

    Article  PubMed  Google Scholar 

  38. Roberts JM, Fu FH, McClain EJ, Ferguson AB Jr (1984) A comparison of the posterolateral and anterolateral approaches to total hip arthroplasty. Clin Orthop Relat Res 187:205–210

    Google Scholar 

  39. Enocson A, Hedbeck CJ, Tidermark J, Pettersson H, Ponzer S, Lapidus LJ (2009) Dislocation of total hip replacement in patients with fractures of the femoral neck. Acta Orthop 80:184–189. https://doi.org/10.3109/17453670902930024

    Article  PubMed  PubMed Central  Google Scholar 

  40. Philippot R, Boyer B, Farizon F (2013) Intraprosthetic dislocation: a specific complication of the dual-mobility system. Clin Orthop Relat Res 471:965–970. https://doi.org/10.1007/s11999-012-2639-2

    Article  PubMed  Google Scholar 

  41. Malatray M, Roux JP, Gunst S, Pibarot V, Wegrzyn J (2017) Highly crosslinked polyethylene: a safe alternative to conventional polyethylene for dual mobility cup mobile component. A biomechanical validation. Int Orthop 41:507–512. https://doi.org/10.1007/s00264-016-3334-9

    Article  PubMed  Google Scholar 

  42. Oral E, Muratoglu OK (2011) Vitamin E diffused, highly crosslinked UHMWPE: a review. Int Orthop 35:215–223. https://doi.org/10.1007/s00264-010-1161-y

    Article  PubMed  Google Scholar 

Download references

Funding

There is no funding source.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yeesuk Kim.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The Human Research Ethics Committees at each institution approved the study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Hwang, Jh., Kim, SM., Oh, KJ. et al. Dislocations after use of dual-mobility cups in cementless primary total hip arthroplasty: prospective multicentre series. International Orthopaedics (SICOT) 42, 761–767 (2018). https://doi.org/10.1007/s00264-017-3660-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-017-3660-6

Keywords

  • Dislocation
  • Hip
  • Dual mobility cup
  • Total hip arthroplasty