Ko L Matsen, Hozack W J
Rothman Institute Orthopaedics, Egg Harbor Township, New Jersey, 08234, USA.
Bone Joint J. 2016 Jan;98-B(1 Suppl A):60-3. doi: 10.1302/0301-620X.98B1.36332.
Dual mobility cups have two points of articulation, one between the shell and the polyethylene (external bearing) and one between the polyethylene and the femoral head (internal bearing). Movement occurs at the inner bearing; the outer bearing only moves at extremes of movement. Dislocation after total hip arthroplasty (THA) is a cause of much morbidity and its treatment has significant cost implications. Dual mobility cups provide an increased range of movement and a may reduce the risk of dislocation. This paper reviews the use of these cups in THA, particularly where stability is an issue. Dual mobility cups may be of benefit in primary THA in patients at a high risk of dislocation, such as those who are older with increased comorbidities and a higher American Association of Anesthesiology grade and those with a neuromuscular disease. They may be used at revision surgery where the risk of dislocation is high, such as in patients with many prior dislocations, or those with abductor deficiency. They may also be used in THA for displaced fractures of the femoral neck, which has a notoriously high rate of dislocation.
双动髋臼杯有两个活动关节，一个在髋臼杯外杯与聚乙烯内衬之间（外关节），另一个在聚乙烯内衬与股骨头之间（内关节）。运动发生在内关节；外关节仅在极端运动时才会活动。全髋关节置换术（THA）后脱位是导致诸多发病情况的原因，其治疗会产生重大的成本影响。双动髋臼杯可增加活动范围，并可能降低脱位风险。本文综述了这些髋臼杯在全髋关节置换术中的应用，尤其是在稳定性成为问题的情况下。双动髋臼杯可能对初次全髋关节置换术中有高脱位风险的患者有益，比如那些年龄较大、合并症增多、美国麻醉医师协会分级较高的患者以及患有神经肌肉疾病的患者。它们可用于翻修手术中脱位风险较高的情况，比如有多次既往脱位的患者或外展肌功能不全的患者。它们还可用于股骨颈移位骨折的全髋关节置换术，此类骨折脱位率极高。
