Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Orthopaedics
Published in: International Orthopaedics 5/2016

01-05-2016 | Review Article

Intra-prosthetic dislocation of dual-mobility cups after total hip arthroplasty: potential causes from a clinical and biomechanical perspective

Authors: Christian Fabry, Jean Langlois, Moussa Hamadouche, Rainer Bader

Published in: International Orthopaedics | Issue 5/2016

Login to get access

Abstract

Introduction

Recurrent dislocation of total hip arthroplasty is a frequent indication for revision surgery. Hip joint stability depends on implant design, cup position and crucially on femoral head diameter. Due to an effective ultra-large diameter femoral head, dual-mobility cups are considered an attractive solution to prevent dislocation in unstable conditions. Although patients obviously benefit for many years in terms of mobility and pain, an increase of intra-prosthetic dislocation reports using dual-mobility cups has been recently observed. However, the failure mechanism of this implant-specific complication, which is characterized by the loss of the positive-locking between the femoral head and the mobile liner, is not yet completely understood.

Methods

A comprehensive search was performed with the PubMed database and a search engine to overview this topic and to identify potential causes for this implant-specific failure from a clinical and biomechanical perspective.

Results

Peri-operative findings indicate extensive fibrosis at the large articulation as well as cup loosening as potential causes. In addition, current research has shown that the failure mechanism is affected by the surface topography of the femoral neck and in particular by the design of the mobile liner.

Discussion

In clinical practice it is necessary to differentiate a classic dislocation between the mobile liner and the metallic shell from an intra-prosthetic dislocation between the femoral head and the liner.

Conclusion

Due to the increasing popularity of dual-mobility cups in total hip arthroplasty, the understanding of which implant-specific features or tissue response may increase the risk of intra-prosthetic dislocation is of major importance for reduced revision rates by using optimized surgical techniques and implant designs.
Literature
1.
2.
3.
Abu-Amer Y, Darwech I, Clohisy JC (2007) Aseptic loosening of total joint replacements: mechanisms underlying osteolysis and potential therapies. Arthritis Res Ther 9 Suppl 1:S6
4.
Prudhon JL, Steffann F, Ferreira A, Verdier R, Aslanian T, Caton J (2014) Cementless dual-mobility cup in total hip arthroplasty revision. Int Orthop 38(12):2463–8CrossRefPubMed
5.
Bader R, Scholz R, Steinhauser E, Zimmermann S, Busch R, Mittelmeier W (2004) The influence of head and neck geometry on stability of total hip replacement: a mechanical test study. Acta Orthop Scand 75(4):415–21CrossRefPubMed
6.
Kluess D, Martin H, Mittelmeier W, Schmitz KP, Bader R (2007) Influence of femoral head size on impingement, dislocation and stress distribution in total hip replacement. Med Eng Phys 29(4):465–71CrossRefPubMed
7.
Blom AW, Rogers M, Taylor AH, Pattison G, Whitehouse S, Bannister GC (2008) Dislocation following total hip replacement: the Avon orthopaedic centre experience. Ann R Coll Surg Engl 90(8):658–62CrossRefPubMedPubMedCentral
8.
Mahomed NN, Barrett JA, Katz JN, Phillips CB, Losina E, Lew RA et al (2003) Rates and outcomes of primary and revision total hip replacement in the United States medicare population. J Bone Joint Surg Am 85-A(1):27–32PubMed
9.
Burroughs BR, Hallstrom B, Golladay GJ, Hoeffel D, Harris WH (2005) Range of motion and stability in total hip arthroplasty with 28-, 32-, 38-, and 44-mm femoral head sizes. J Arthroplasty 20(1):11–9CrossRefPubMed
10.
D’Lima DD, Urquhart AG, Buehler KO, Walker RH, Colwell CW (2000) The effect of the orientation of the acetabular and femoral components on the range of motion of the hip at different head-neck ratios. J Bone Joint Surg Am 82(3):315–21PubMed
11.
Bader R, Steinhauser E, Scholz R, Simnacher M, Mittelmeier W (2004) Experimental analysis of neutral, asymmetric and constraint liners for total hip replacement: Investigation of range of motion and stability against joint instability. Z Orthop Grenzgeb 142(5):577–85CrossRef
12.
Guyen O, Pibarot V, Vaz G, Chevillotte C, Bejui-Hugues J (2009) Use of a dual mobility socket to manage total Hip arthroplasty instability. Clin Orthop Relat Res 467(2):465–72CrossRefPubMedPubMedCentral
13.
14.
Thomsen M, Breusch SJ, Schneider U, Kubein-Meesenburg D, Nägerl H (2001) Developments in hip hemi-arthroplasty and theory of the link-chain dimeric hip prosthesis. Unfallchirurg 104(11):1061–7CrossRefPubMed
15.
Fabry C, Woernle C, Bader R (2014) Self-centering dual-mobility total hip systems: prediction of relative movements and realignment of different intermediate components. Proc Inst Mech Eng H 228(5):477–485CrossRefPubMed
16.
Chen QS, Lazennec JY, Guyen O, Kinbrum A, Berry DJ, An KN (2005) Technical note: validation of a motion analysis system for measuring the relative motion of the intermediate component of a tripolar total hip arthroplasty prosthesis. Med Eng Phys 27(6):505–12CrossRefPubMed
17.
Philippot R, Camilleri JP, Boyer B, Adam P, Farizon F (2009) The use of a dual-articulation acetabular cup system to prevent dislocation after primary total hip arthroplasty: analysis of 384 cases at a mean follow-up of 15 years. Int Orthop 33(4):927–32CrossRefPubMedPubMedCentral
18.
Hamadouche M, Biau DJ, Huten D, Musset T, Gaucher F (2010) The Use of a cemented dual mobility socket to treat recurrent dislocation. Clin Orthop Relat Res 468(12):3248–54CrossRefPubMedPubMedCentral
19.
20.
21.
Caton JH, Prudhon JL, Ferreira A, Aslanian T, Verdier R (2014) A comparative and retrospective study of three hundred and twenty primary charnley type hip replacements with a minimum follow up of ten years to assess whether a dual mobility cup has a decreased dislocation risk. Int Orthop 38(6):1125–9CrossRefPubMedPubMedCentral
22.
Leclercq S, Benoit JY, de Rosa JP, Tallier E, Leteurtre C, Girardin PH (2013) Evora® chromium-cobalt dual mobility socket: results at a minimum 10 years’ follow-up. Orthop Traumatol Surg Res 99(8):923–8CrossRefPubMed
23.
Odland AN, Sierra RJ (2014) Intraprosthetic dislocation of a contemporary dual-mobility design used during conversion THA. Orthopedics 37(12):e1124–8CrossRefPubMed
24.
Langlois J, El Hage S, Hamadouche M (2014) Intraprosthetic dislocation: a potentially serious complication of dual mobility acetabular cups. Skelet Radiol 43(7):1013–6
25.
Philippot R, Boyer B, Farizon F (2013) Intraprosthetic dislocation: a specific complication of the dual-mobility system. Clin Orthop Relat Res 471(3):965–70CrossRefPubMedPubMedCentral
26.
Combes A, Migaud H, Girard J, Duhamel A, Fessy MH (2013) Low rate of dislocation of dual-mobility cups in primary total hip arthroplasty. Clin Orthop Relat Res 471(12):3891–900CrossRefPubMedPubMedCentral
27.
Lecuire F, Benareau I, Rubini J, Basso M (2004) Intra-prosthetic dislocation of the bousquet dual mobility socket. Rev Chir Orthop Reparatrice Appar Mot 90(3):249–55CrossRefPubMed
28.
Hamadouche M, Arnould H, Bouxin B (2012) Is a cementless dual mobility socket in primary THA a reasonable option? Clin Orthop Relat Res 470(11):3048–53CrossRefPubMedPubMedCentral
29.
Massin P, Orain V, Philippot R, Farizon F, Fessy MH (2012) Fixation failures of dual mobility cups: a mid-term study of 2601 hip replacements. Clin Orthop Relat Res 470(7):1932–40CrossRefPubMedPubMedCentral
30.
Lautridou C, Lebel B, Burdin G, Vielpeau C (2008) Survival of the cementless bousquet dual mobility cup: minimum 15-year follow-up of 437 total hip arthroplasties. Rev Chir Orthop Reparatrice Appar Mot 94(8):731–9CrossRefPubMed
31.
Mertl P, Combes A, Leiber-Wackenheim F, Fessy MH, Girard J, Migaud H (2012) Recurrence of dislocation following total hip arthroplasty revision using dual mobility cups was rare in 180 hips followed over 7 years. HSS J 8(3):251–6CrossRefPubMedPubMedCentral
32.
Lee HH, Lo YC, Lin LC, Wu SS (2008) Disassembly and dislocation of a bipolar hip prosthesis. J Formos Med Assoc 107(1):84–8CrossRefPubMed
33.
Banka TR, Ast MP, Parks ML (2014) Early intraprosthetic dislocation in a revision dual-mobility hip prosthesis. Orthopedics 37(4):e395–7CrossRefPubMed
34.
35.
Langlais FL, Ropars M, Gaucher F, Musset T, Chaix O (2008) Dual mobility cemented cups have low dislocation rates in THA revisions. Clin Orthop Relat Res 466(2):389–95CrossRefPubMedPubMedCentral
36.
Fabry C, Kaehler M, Herrmann S, Woernle C, Bader R (2014) Dynamic behavior of tripolar hip endoprostheses under physiological conditions and their effect on stability. Med Eng Phys 36(1):65–71CrossRefPubMed
Metadata
Title
Intra-prosthetic dislocation of dual-mobility cups after total hip arthroplasty: potential causes from a clinical and biomechanical perspective
Authors
Christian Fabry
Jean Langlois
Moussa Hamadouche
Rainer Bader
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 5/2016
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-015-3000-7

Other articles of this Issue 5/2016

International Orthopaedics 5/2016 Go to the issue

Orthopaedic Heritage

The Vienna and German heritage of orthopaedics from the first half of the twentieth century: Adolf Lorenz, Lorenz Böhler, Friedrich Pauwels, Gerhard Küntscher

Letter to the Editor

Comments on “Adductor canal block provides better performance after total knee arthroplasty compared with femoral nerve block: a systematic review and meta-analysis”

Original Paper

Which AO/OTA 31-A2 pertrochanteric fractures can be treated with a dynamic hip screw without developing a lateral wall fracture? A CT-based study

Review

Adductor canal block provides better performance after total knee arthroplasty compared with femoral nerve block: a systematic review and meta-analysis

Review Article

Reverse shoulder prosthesis in patients with rheumatoid arthritis: a systematic review

Original Paper

Equivalent results of medial and lateral parapatellar approach for total knee arthroplasty in mild valgus deformities