Ciriello Vincenzo, La China Roberta, Chirillo Danilo Francesco, Bianco Giuseppe, Fusini Federico, Scarlato Ugo, Albanese Carlo, Bonzanini Giancarlo, Banci Lorenzo, Piovani Lucio
Ortopedia e Traumatologia, Ospedale Santa Croce e Carle, 12100 Cuneo, Italy.
Ortopedia e Traumatologia, Ospedale Santo Spirito, 15033 Casale Monferrato, Italy.
J Clin Med. 2023 Jun 21;12(13):4200. doi: 10.3390/jcm12134200.
Dual mobility (DM) has been proven to reduce dislocation risk after total hip arthroplasty (THA). In the last decade modular DM (modDM) constructs have been introduced to allow the use of DM articulation with standard cementless acetabular shells. However, clinical evidence of modDM effectiveness is still low in primary THA and concerns about implant-related complications are increasing. This retrospective comparative multicenter study is aimed to investigate if the dislocation rate after primary THA could be reduced with modDM in comparison to standard bearing (SB).
262 THAs were performed between 2017 and 2019, using SB (129 hips) or modDM (133) with the same cementless highly porous modular acetabular cup. Dislocations, complications and revisions were recorded and implant survival was analyzed.
At 2.5-year mean follow-up, dislocation occurred in 4 hips (3.1%) within the SB group while intraprosthetic dislocation in 2 hips (1.5%) within the modDM group ( = 0.44). Implant survivals with revision due to dislocation were 95.2% and 95.9% at 4-year follow-up for SB and modDM, respectively ( = 0.50).
modDM used in primary THA might reduce dislocation rate in comparison to SB, even in high-risk patients, however, caution is advocated due to specific intraprosthetic dislocation.
双动（DM）已被证明可降低全髋关节置换术（THA）后脱位风险。在过去十年中，模块化双动（modDM）结构被引入，以允许在标准非骨水泥髋臼杯上使用双动关节。然而，在初次全髋关节置换术中，modDM有效性的临床证据仍然不足，并且对植入物相关并发症的担忧正在增加。这项回顾性比较多中心研究旨在调查与标准关节（SB）相比，modDM在初次全髋关节置换术后是否可降低脱位率。
在2017年至2019年期间进行了262例全髋关节置换术，使用SB（129髋）或modDM（133髋），髋臼杯均为相同的非骨水泥高孔隙率模块化髋臼杯。记录脱位、并发症和翻修情况，并分析植入物生存率。
平均随访2.5年时，SB组有4髋（3.1%）发生脱位，而modDM组有2髋（1.5%）发生假体内部脱位（P = 0.44）。SB组和modDM组因脱位翻修的植入物生存率在4年随访时分别为95.2%和95.9%（P = 0.50）。
与SB相比，初次全髋关节置换术中使用modDM可能降低脱位率，即使在高危患者中也是如此，然而，由于特定的假体内部脱位，仍需谨慎。
