Orthopaedic and Trauma Department, Hospital Santa Maria delle Croci, Ravenna, Italy.
Orthopaedic and Trauma Department, University Vita-Salute San Raffaele, Milan, Italy.
Acta Biomed. 2022 Mar 10;92(S3):e2021553. doi: 10.23750/abm.v92iS3.12541.
The concept of dual mobility (DM) is currently approved as a valid option for reducing the risk of dislocation, with an incidence ranging from 0% to 4.6%. The principle is to achieve a high joint stability through a large diameter polyethylene (PE) liner, and to reduce cutting forces due to a "low-friction" head-liner coupling mechanism.
From March 2015 to March 2020, 138 patients were treated with Dualis Cup (Gruppo Bioimpianti-Peschiera Borromeo, MI, Italy) for a total of 141 implants (three cases were bilateral). The average age at the time of the surgery was 77. Patients' clinical and X-ray follow-up was at 1, 3, 6, 12 months and then once a year.
Seven patients (4.9%) had complications which required a second surgery, but only one case (0.7%) of intraprosthetic dislocation (which required cup revision), was directly ascribable to the DM cup.
Improvements in design and materials of the third generation DM cups allowed both to reduce the rate of dislocations in high-risk patients (i.e., patients with neuro-muscular diseases and cognitive disorders, patients needing revisions, osteosynthesis failures, femoral neck fractures) and to achieve a survival rate similar to standard cups, ensuring a range of motion (ROM) very close to the physiological one. In our brief experience, Dualis Cups showed results comparable to those reported in the literature for Dual Mobility. If this data is confirmed by long-term studies, the use of DM cups could be extended even for young patients with high functional demands. (www.actabiomedica.it).
双动（DM）概念目前被认为是降低脱位风险的有效选择，其发生率为 0%至 4.6%。其原理是通过大直径聚乙烯（PE）衬垫实现高关节稳定性，并通过“低摩擦”头衬套耦合机制降低切割力。
从 2015 年 3 月至 2020 年 3 月，共有 138 名患者使用 Dualis Cup（Gruppo Bioimpianti-Peschiera Borromeo，MI，意大利）治疗了 141 个植入物（三个病例为双侧）。手术时的平均年龄为 77 岁。患者的临床和 X 射线随访分别在术后 1、3、6、12 个月进行，然后每年一次。
有 7 名患者（4.9%）发生并发症需要二次手术，但只有 1 例（0.7%）发生假体内脱位（需要更换杯），直接归因于 DM 杯。
第三代 DM 杯在设计和材料方面的改进，使得高危患者（即患有神经肌肉疾病和认知障碍的患者、需要翻修的患者、内固定失败、股骨颈骨折的患者）的脱位率降低，并实现了与标准杯相似的存活率，确保了接近生理的活动范围（ROM）。在我们的短期经验中，Dualis Cup 显示的结果与文献中报道的双动性相似。如果这些数据得到长期研究的证实，那么即使对于功能要求较高的年轻患者，也可以扩大 DM 杯的使用范围。（www.actabiomedica.it）。
