Lee Anderson, Arthur Jaymeson, Najdawi Jawad, Durst Caleb R, Rajaee Sean S, Spitzer Andrew I
Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Arthroplast Today. 2024 Jul 3;28:101452. doi: 10.1016/j.artd.2024.101452. eCollection 2024 Aug.
Dual mobility (DM) implants in primary total hip arthroplasty (THA) have gained recent popularity; however, safety concerns persist. The purpose of this study was twofold: 1) assess trends in DM implant adoption; and 2) evaluate the impact of modular DM implants on dislocation and all-cause revision rates at short-term follow-up.
This retrospective study identified patients in our institutional arthroplasty database who underwent primary posterior approach THA for degenerative conditions from November 2013 to December 2020. Patients undergoing primary THA for fracture were excluded. Patients were divided into two cohorts: modular DM and non-DM implants. Annual DM utilization and dislocation rates were recorded. Patient records were reviewed to determine implant selection and identify indications for dislocations and reoperations.
Institutional adoption was rapid, increasing from 3.4% in 2013 to 47.1% in 2020. Of the 4548 primary THA cases from 2013 to 2020, 2859 (62.9%) had minimum one-year follow-up data for inclusion. There were 724 (25.3%) with DM implants and 2135 (74.7%) with non-DM implants. The DM group had a significantly lower dislocation rate (0.14% vs 0.84%, = .04), with similar all-cause revision rates (2.49% vs 2.72%, = .74) at one-year follow-up. No cases of DM-specific complications (metallosis or intraprosthetic dislocations) were noted.
From 2013 to 2020, DM implant utilization in primary THA steadily increased. Use of modular DM implants is associated with a decreased dislocation rate without compromised survivorship at one-year follow-up when compared to non-DM implants. No instances of modular DM-specific complications were identified; however, longer-term surveillance is necessary to verify these findings.
Prognostic Level III.
双动（DM）植入物在初次全髋关节置换术（THA）中近来颇受青睐；然而，安全问题依然存在。本研究的目的有两个：1）评估DM植入物的采用趋势；2）在短期随访中评估模块化DM植入物对脱位率和全因翻修率的影响。
这项回顾性研究在我们机构的关节置换数据库中确定了2013年11月至2020年12月因退行性疾病接受初次后路THA的患者。因骨折接受初次THA的患者被排除。患者被分为两个队列：模块化DM植入物和非DM植入物。记录每年的DM使用率和脱位率。查阅患者记录以确定植入物的选择，并确定脱位和再次手术的指征。
机构采用率迅速上升，从2013年的3.4%增至2020年的47.1%。在2013年至2020年的4548例初次THA病例中，2859例（62.9%）有至少一年的随访数据可供纳入。其中724例（25.3%）使用DM植入物，2135例（74.7%）使用非DM植入物。DM组的脱位率显著更低（0.14%对0.84%，P = .04），在一年随访时全因翻修率相似（2.49%对2.72%，P = .74）。未发现DM特异性并发症（金属沉着症或假体内部脱位）的病例。
从2013年到2020年，初次THA中DM植入物的使用率稳步上升。与非DM植入物相比，使用模块化DM植入物在一年随访时脱位率降低且生存率不受影响。未发现模块化DM特异性并发症的实例；然而，需要长期监测以验证这些发现。
预后III级。
