Comparing Dual-mobility Cups Versus Unipolar Cups for Unselected Primary Total Hip Arthroplasty by Direct Anterior Approach

THA comprises the replacement of the damaged bone and cartilage with prosthetic components. The proximal end of the femur is replaced with a stem and ball/head, while the acetabulum is most commonly replaced with a unipolar cup (UP) that consists of a liner inside of a metal shell. UP cups are associated with risks of dislocations, especially in elderly and female patients, as well as in patients with lumbar stiffness or operated for femoral neck fractures. In fact, one of the most common reasons for early revision of UP cups are dislocations. Dual-mobility (DM) cups were introduced in the 1970s by the French surgeon Gilles Bousquet, as an alternative to UP cups. They are made up of two articulations, a femoral head moving inside a mobile polyethylene liner, which in turn moves inside a metal shell. This design allows for a greater jump distance and range of motion (ROM) compared to UP cups, thus resulting in reduced rates of dislocation. A recent systematic review that evaluated 5 case-control studies (549 DM cups vs 649 UP cups) and 3 registry studies (5935 DM cups vs 217362 UP) found that in case-control studies, the dislocation rates were 0.2% for DM cups versus 7.1% for UP cups (p=0.009). Furthermore, in registry studies the revision rates due to dislocation were 0.2% for DM cups versus 0.5% for UP cups (p=0.050). Nonetheless, there have been some concerns associated with the use of DM cups, including intra-prosthetic dislocations (IPD), polyethylene wear, and iliopso…

This description comes directly from the study's public registry record.

Nicolas Verdier  ·  +33(0)535549569  ·  dr.nicolas.verdier@gmail.com

Charlène Py  ·  +33(0)556003048  ·  charlene.py@elsan.care

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