Patil Nilesh, Deshmane Prashant, Deshmukh Ajit, Mow Christopher
Clinical Faculty, Department of Orthopedics, University of Pittsburgh Medical Center, Pittsburgh, PA USA.
SUNY Upstate Medical University, Syracuse, NY USA.
Indian J Orthop. 2021 Oct 13;55(5):1202-1207. doi: 10.1007/s43465-021-00471-w. eCollection 2021 Oct.
Dual-mobility (DM) articulations are increasingly utilized to prevent or manage hip instability after total hip arthroplasty (THA). DM cups offer enhanced stability due to the dual articulation resulting in larger jump distance and greater range of motion before impingement. Improvement in design features and biomaterials has contributed to increased interest in dual-mobility articulations due to lower risk of complications compared to their historic rates. The incidence of implant-specific complications like intra-prosthetic dislocation (IPD) and wear has reduced with newer-generation implants. DM THAs are used in primary THA in patients with high risk for dislocation, e.g. neuromuscular disorder, femoral neck fracture, spinopelvic deformity, etc. They offer an attractive alternative option to constrained liner for treatment of hip instability in revision THA. The medium- to short-term results with DM THA have been encouraging in primary and revision THA. However, there are concerns of fretting, corrosion and long-term survivorship with DM THA. Hence, longer-term studies and surveillance are required for the safe use of DM THA in clinical practice.
双动（DM）关节越来越多地用于预防或处理全髋关节置换术（THA）后的髋关节不稳定。由于双关节结构，DM髋臼杯提供了更高的稳定性，这导致在撞击前有更大的跳跃距离和更大的活动范围。设计特点和生物材料的改进使得人们对双动关节的兴趣增加，因为与过去相比，其并发症风险更低。新一代植入物降低了假体内部脱位（IPD）和磨损等特定植入物并发症的发生率。DM THA用于脱位高风险的初次THA患者，如神经肌肉疾病、股骨颈骨折、脊柱骨盆畸形等。在翻修THA中，它们为治疗髋关节不稳定提供了一种有吸引力的替代受限衬垫的选择。DM THA在初次和翻修THA中的中短期结果令人鼓舞。然而，人们担心DM THA存在微动、腐蚀和长期生存率问题。因此，为了在临床实践中安全使用DM THA，需要进行长期研究和监测。
