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Is a cementless dual mobility socket in primary THA a reasonable option?
Moussa Hamadouche1, Hervé Arnould, Bertrand Bouxin
1Department of Orthopaedic and Reconstructive Surgery, Clinical Orthopaedic Research Center, Service A, Centre Hospitalo-Universitaire Cochin-Port Royal, 27 Rue du Faubourg St Jacques, 75014 Paris, France. moussah@club-internet.fr
Clinical Orthopaedics and Related Research
|May 29, 2012
Summary
Dual mobility sockets in primary total hip arthroplasty (THA) offer pain-free hips and durable fixation. However, avoid the long-neck option to prevent intraprosthetic dislocation complications.
Area of Science:
- Orthopedic Surgery
- Biomaterials Engineering
Background:
- Total hip arthroplasty (THA) dislocation remains a significant complication.
- Dual mobility sockets (DMS) are increasingly used to mitigate dislocation risk.
- Potential complications of DMS in primary THA require further investigation.
Purpose of the Study:
- To evaluate the efficacy of cementless DMS in reducing dislocation rates after primary THA.
- To assess functional outcomes, including pain and mobility, following primary THA with DMS.
- To determine the long-term radiographic fixation and identify any unique failure modes associated with DMS.
Main Methods:
- Retrospective review of 168 patients undergoing primary THA with cementless DMS (2000-2002).
- Assessment of dislocation rates, hip function, and acetabular component fixation via serial radiographs.
- Clinical and radiographic follow-up at a minimum of 5 years for 119 patients.
Main Results:
- No dislocations were reported when the Morse taper was fully covered.
- Four cases of intraprosthetic dislocation (femoral head/mobile insert) required revision surgery.
- These four revisions occurred exclusively in hips with an uncovered Morse taper due to the long-neck option.
Conclusions:
- Cementless DMS can provide pain-free, mobile hips with durable acetabular fixation in primary THA.
- The use of the long-neck option with DMS is associated with a risk of intraprosthetic dislocation.
- Surgeons must be aware of and avoid the long-neck option to prevent this specific complication.
