Dual mobility total hip arthroplasty: should everyone get one?

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Materials Science

Background:

• Hip instability is a significant complication of total hip arthroplasty (THA), frequently necessitating revision surgery.
• Dual mobility (DM) implants, featuring a mobile head within a liner, were developed to address THA instability.
• Early DM designs faced challenges with wear and intra-prosthetic dislocation, limiting their clinical application.

Purpose of the Study:

• To review the efficacy of dual mobility implants in reducing dislocation rates in total hip arthroplasty.
• To assess the evolution of DM implant designs and their impact on clinical outcomes.
• To evaluate the suitability of modern DM THA for a wider patient population.

Main Methods:

• Systematic review of existing literature on dual mobility implants in THA.
• Analysis of studies comparing dislocation rates between DM and fixed-bearing THA.
• Evaluation of data on wear and intra-prosthetic dislocation in successive generations of DM implants.

Main Results:

• Numerous studies confirm that DM implants significantly decrease the incidence of dislocation compared to fixed-bearing inserts.
• Latest generation DM prostheses have successfully addressed prior issues of wear and intra-prosthetic dislocation.
• Evidence suggests improved performance and safety profiles in contemporary DM implant designs.

Conclusions:

• Dual mobility total hip arthroplasty demonstrates a reduced rate of dislocation.
• Modern DM implants have overcome limitations of earlier designs, showing improved wear and stability.
• Surgeons can now consider dual mobility THA for a wider patient selection due to enhanced outcomes.