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Early intraprosthetic dislocation in dual-mobility implants: a systematic review
Ivan De Martino1,2, Rocco D'Apolito2, Bradford S Waddell2
1Department of Orthopaedic Surgery, Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA.
Arthroplasty Today
|September 16, 2017
Summary
Intraprosthetic dislocation (IPD) in dual mobility implants can occur early, often after closed reduction attempts for dislocation. Recognizing this potential iatrogenic cause is crucial for preventing and treating this complication in hip arthroplasty.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Materials Science
Background:
- Dual mobility implants are prone to intraprosthetic dislocation (IPD), where the liner separates from the femoral head.
- While older designs failed due to wear, contemporary designs are experiencing early IPD.
- This complication involves the dissociation of the polyethylene liner from the femoral head within the implant.
Purpose of the Study:
- To systematically review the literature on early intraprosthetic dislocation (IPD) in dual mobility implants.
- To investigate the potential causes and contributing factors of early IPD.
- To highlight the importance of recognizing iatrogenic causes for prevention and treatment.
Main Methods:
- A systematic literature review was conducted following PRISMA guidelines.
- Searches were performed on PubMed, MEDLINE, Embase, and Google Scholar for English articles from 1974 to 2016.
- Keywords included "intraprosthetic dislocation," "dual mobility," and related terms for hip arthroplasty.
Main Results:
- Sixteen articles comprising 19 total hip arthroplasties met inclusion criteria.
- Early IPD occurred in 15 patients after attempted closed reduction (mean follow-up 3.2 months).
- Early IPD occurred in 4 patients without prior closed reduction (mean follow-up 15.1 months).
Conclusions:
- Most early IPD cases were preceded by attempted closed reduction for dislocation.
- This suggests a potential iatrogenic etiology for early intraprosthetic dislocation.
- Early recognition of this failure mode is essential for effective prevention and management strategies.
