Dual mobility in primary total hip arthroplasty: current concepts.

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Clinical Biomechanics

Background:

• Total hip arthroplasty (THA) is highly successful but instability remains a leading cause for revision.
• Dual mobility (DM) was developed to address THA instability.
• Early DM designs faced challenges with polyethylene wear and intraprosthetic dislocation (IPD).

Purpose of the Study:

• To provide a comprehensive literature review of dual mobility implants in THA.
• To evaluate the efficacy and safety of contemporary DM designs.
• To assess the clinical and economic impact of DM in THA.

Main Methods:

• Systematic review of existing literature on dual mobility THA.
• Analysis of studies comparing DM implants to standard bearing THA.
• Evaluation of data on dislocation rates, functional outcomes, and costs.

Main Results:

• Contemporary DM implants, with improved materials and design, have largely eliminated IPD.
• Multiple studies show significantly lower dislocation rates with DM compared to standard THA.
• DM demonstrates promising results in high-risk populations and for femoral neck fractures, with improved function and lower costs.

Conclusions:

• Dual mobility implants represent a significant advancement in reducing THA instability.
• Further high-quality, long-term studies are needed to solidify DM as the gold standard.
• DM shows potential as the future standard of care for specific THA indications, pending long-term evidence.