De Martino I, D'Apolito R, Soranoglou V G, Poultsides L A, Sculco P K, Sculco T P
Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA.
Catholic University of the Sacred Heart, Agostino Gemelli University Hospital, Largo Agostino Gemelli 8, Rome, 00168, Italy.
Bone Joint J. 2017 Jan;99-B(ASuppl1):18-24. doi: 10.1302/0301-620X.99B1.BJJ-2016-0398.R1.
The aim of this systematic review was to report the rate of dislocation following the use of dual mobility (DM) acetabular components in primary and revision total hip arthroplasty (THA).
A systematic review of the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines was performed. A comprehensive search of Pubmed/Medline, Cochrane Library and Embase (Scopus) was conducted for English articles between January 1974 and March 2016 using various combinations of the keywords "dual mobility", "dual-mobility", "tripolar", "double-mobility", "double mobility", "hip", "cup", "socket". The following data were extracted by two investigators independently: demographics, whether the operation was a primary or revision THA, length of follow-up, the design of the components, diameter of the femoral head, and type of fixation of the acetabular component.
In all, 59 articles met our inclusion criteria. These included a total of 17 908 THAs which were divided into two groups: studies dealing with DM components in primary THA and those dealing with these components in revision THA. The mean rate of dislocation was 0.9% in the primary THA group, and 3.0% in the revision THA group. The mean rate of intraprosthetic dislocation was 0.7% in primary and 1.3% in revision THAs.
Based on the current data, the use of DM acetabular components are effective in minimising the risk of instability after both primary and revision THA. This benefit must be balanced against continuing concerns about the additional modularity, and the new mode of failure of intraprosthetic dislocation. Longer term studies are needed to assess the function of these newer materials compared with previous generations. Cite this article: Bone Joint J 2017;99-B(1 Supple A):18-24.
本系统评价旨在报告初次和翻修全髋关节置换术(THA)中使用双动(DM)髋臼组件后的脱位率。
根据系统评价和Meta分析的首选报告项目指南对文献进行系统评价。使用关键词“双动”“双动性”“三极”“双活动”“双活动度”“髋关节”“髋臼杯”“髋臼”的各种组合,对1974年1月至2016年3月期间的英文文章在Pubmed/Medline、Cochrane图书馆和Embase(Scopus)数据库进行全面检索。由两名研究人员独立提取以下数据:人口统计学资料、手术是初次还是翻修THA、随访时间、组件设计、股骨头直径以及髋臼组件的固定类型。
共有59篇文章符合我们的纳入标准。这些文章共涉及17908例THA,分为两组:处理初次THA中DM组件的研究和处理翻修THA中这些组件的研究。初次THA组的平均脱位率为0.9%,翻修THA组为3.0%。初次THA中假体内部脱位的平均发生率为0.7%,翻修THA中为1.3%。
基于目前的数据,使用DM髋臼组件可有效降低初次和翻修THA后不稳定的风险。这一益处必须与对额外模块化以及假体内部脱位这种新失效模式的持续担忧相权衡。需要进行长期研究以评估这些新材料与前代材料相比的功能。引用本文:《骨关节杂志》2017;99-B(增刊A):18 - 24。