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. 2022 Jan;37(1):83-88.
doi: 10.1016/j.arth.2021.09.002. Epub 2021 Sep 16.

Monobloc Dual Mobility With a Minimum 5-Year Follow-Up: A Safe and Effective Solution in Primary Total Hip Arthroplasty

Ioannis Gkiatas  1 , T David Tarity  1 , Allina A Nocon  1 , Chloe P Verwiel  1 , William Xiang  1 , Michael-Alexander Malahias  1 , Peter K Sculco  1 , Thomas P Sculco  1
Affiliations

Monobloc Dual Mobility With a Minimum 5-Year Follow-Up: A Safe and Effective Solution in Primary Total Hip Arthroplasty

Ioannis Gkiatas et al. J Arthroplasty. 2022 Jan.

Abstract

Background: Instability constitutes over 20% of revisions after total hip arthroplasty (THA). Dual mobility (DM) designs were introduced as a solution to this problem. However, the few publications that have reported promising results for monobloc DM constructs have been limited by sample size or length of follow-up. The purpose of this study is to evaluate mid-term outcomes (minimum 5-year follow-up) of a single-surgeon series utilizing a monobloc DM acetabular component in patients with high risk for dislocation.

Methods: This is a single-surgeon consecutive series of 207 primary THAs implanted with a monobloc DM component in patients who were considered at high risk for dislocation. Patient demographics and case-specific data were collected retrospectively. All patients had a minimum of 5-year follow-up. The Mann-Whitney U test was used to assess continuous variables, whereas categorical variables were analyzed using the chi-square test. Survival probability was calculated using the Kaplan-Meier method.

Results: Radiographic analysis did not reveal acetabular radiolucency in any patients, and there were no revisions for aseptic loosening. In addition, there were no dislocations. Seven of 205 patients (3.4%) were revised, 5 on the femoral side due to periprosthetic fracture and the remaining two for infection. Survivorship of the acetabular component from revision was 99%. The mean Veteran RAND (VR-12) physical score improved from 7 (standard deviation [SD]: 13.7) preoperatively to 9.5 (SD: 17.6) at the final follow-up. Similarly, the hip disability osteoarthritis score improved from 8 (SD: 17.9) preoperatively to 21.2 (SD: 37).

Conclusion: Monobloc DM components reliably prevent dislocation after primary THA in high-risk patients. At mid-term follow-up, this DM monobloc component demonstrates excellent implant survivorship, radiographic fixation, and improved functional outcomes.

Keywords: dislocation; dual mobility; instability; monobloc; primary THA.

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