Is Modular Dual Mobility Superior to Standard Bearings for Reducing Dislocation Risk after Primary Total Hip Arthroplasty? A Retrospective Comparative Multicenter Study

Vincenzo Ciriello; Roberta La China; Danilo Francesco Chirillo; Giuseppe Bianco; Federico Fusini; Ugo Scarlato; Carlo Albanese; Giancarlo Bonzanini; Lorenzo Banci; Lucio Piovani

doi:10.3390/jcm12134200

Is Modular Dual Mobility Superior to Standard Bearings for Reducing Dislocation Risk after Primary Total Hip Arthroplasty? A Retrospective Comparative Multicenter Study

J Clin Med. 2023 Jun 21;12(13):4200. doi: 10.3390/jcm12134200.

Affiliations

¹ Ortopedia e Traumatologia, Ospedale Santa Croce e Carle, 12100 Cuneo, Italy.
² Ortopedia e Traumatologia, Ospedale Santo Spirito, 15033 Casale Monferrato, Italy.
³ Ortopedia e Traumatologia, Ospedale Regina Montis Regalis, 12084 Mondovì, Italy.
⁴ Ortopedia e Traumatologia, Ospedale Civile, 10015 Ivrea, Italy.
⁵ Ortopedia e Traumatologia, Ospedale Sant'Antonio e Margherita, 15057 Tortona, Italy.
⁶ Clinical Research Department, Permedica Orthopaedics, 23807 Merate, Italy.

Abstract

Background: 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).

Methods: 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.

Results: 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 (p = 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 (p = 0.50).

Conclusions: 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.

Keywords: dislocation; intraprosthetic dislocation; modular dual mobility; standard bearing; total hip arthroplasty.

Grants and funding

This research received no external funding but was partially supported for concept, design and coordination by Permedica Orthopaedics. Permedica Orthopaedics had no role in data collection or data analysis. The APC was funded by Permedica Orthopaedics.