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. 2017 Feb 5;3(3):197-202.
doi: 10.1016/j.artd.2016.12.002. eCollection 2017 Sep.

Early intraprosthetic dislocation in dual-mobility implants: a systematic review

Ivan De Martino  1   2 , Rocco D'Apolito  2 , Bradford S Waddell  2 , Alexander S McLawhorn  2 , Peter K Sculco  2 , Thomas P Sculco  1   2
Affiliations

Early intraprosthetic dislocation in dual-mobility implants: a systematic review

Ivan De Martino et al. Arthroplast Today. .

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.

Keywords: Complication; Dual mobility cup; Hip dislocation; Hip reduction; Intraprosthetic dislocation; Unconstrained tripolar.

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Figures

Figure 1
Figure 1
PRISMA flow diagram outlining the systematic review process. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2
Figure 2
(a) Six-week postoperative radiograph of modular dual mobility cup in place. (b) Same patient after an intraprosthetic dislocation, the femoral head is eccentric inside the acetabular cup.
See this image and copyright information in PMC

References

    1. Bousquet G., Gazielly D.F., Girardin P. The ceramic coated cementless total hip arthroplasty. Basic concepts and surgical technique. J Orthop Surg Tech. 1985;1:15.
    1. De Martino I., Triantafyllopoulos G.K., Sculco P.K., Sculco T.P. Dual mobility cups in total hip arthroplasty. World J Orthop. 2014;5:180. - PMC - PubMed
    1. Waddell B.S., De Martino I., Sculco T.P., Sculco P.K. Total hip arthroplasty dislocation: more complex than they appear. A case report of intra-prosthetic dislocation of a dual mobility implant after closed reduction. Ochsner J. 2016;16:185. - PMC - PubMed
    1. Schirmers J., Horazdovsky R., Marston S. Early intraprosthetic dislocation of dual-mobility total hip arthroplasty implant following attempted closed reduction: a case report. Reconstructive Review. 2015;5:47.
    1. Mohammed R., Cnudde P. Severe metallosis owing to intraprosthetic dislocation in a failed dual-mobility cup primary total hip arthroplasty. J Arthroplasty. 2012;27:493.e1. - PubMed

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