Modular dual mobility articulation in primary and revision hip arthroplasty: lights and shadows
Abstract Purpose The use of dual mobility cups in total hip arthroplasty has gained popularity in light of the fact it enables to reduce dislocation through increased jumping distance (JD) and impingement-free arc of movement. Modular Dual Mobility Cup (modular DMC) systems have been recently introd...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-03730-8 |
| _version_ | 1797849976545476608 |
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| author | Alessandro Moghnie Domenico Tigani Alberto Consoli Emanuela Castiello Marco Ganci Luca Amendola |
| author_facet | Alessandro Moghnie Domenico Tigani Alberto Consoli Emanuela Castiello Marco Ganci Luca Amendola |
| author_sort | Alessandro Moghnie |
| collection | DOAJ |
| description | Abstract Purpose The use of dual mobility cups in total hip arthroplasty has gained popularity in light of the fact it enables to reduce dislocation through increased jumping distance (JD) and impingement-free arc of movement. Modular Dual Mobility Cup (modular DMC) systems have been recently introduced to enable the use of dual mobility cups with standard metal-backed shells. The objective of this study was twofold: calculate the JD for each modular DMC system and conduct a systematic literature review to report clinical outcomes and reasons for failure of this construct. Methods The JD was calculated using the Sariali formula: JD = 2Rsin [(π/2 − Ψ − arcsin (offset/R))/2]. A qualitative systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search for English and French articles between January 2000 and July 2020 was run on PubMed, EMBASE, Google Scholar, and Scopus with the primary objective of finding articles about modular DMC systems. Results We identified eight 8 different manufacturers of modular DMC systems and 327 publications on the subject. After screening for duplicates and eligibility, we identified 229 publications: 206 articles were excluded because they contained no reports on modular DMC systems, whereas other three were not included because they focused on biomechanical aspects. Among the 11 included articles, 2 were prospective case series, 9 were retrospective case series. True dislocation occurred in 25 cases (0.9%), and six of them were solved by closed reduction without necessity of revision, while all 5 intraprosthetic dislocations were operated. Conclusions Modular DMCs are a valid method to deal with complex THA instability, with good clinical and patient-reported outcomes, low complication rates, and low revision rates at early follow-up. We would advise cautious optimism on the role of modular DMC implants, as it seems safer to use ceramic instead of metallic heads whenever possible to avoid the increase cobalt and chromium trace ion serum levels. |
| first_indexed | 2024-04-09T18:52:54Z |
| format | Article |
| id | doaj.art-88f9132914024f91b3029ad7763fe5a0 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-09T18:52:54Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-88f9132914024f91b3029ad7763fe5a02023-04-09T11:22:32ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-04-0118111010.1186/s13018-023-03730-8Modular dual mobility articulation in primary and revision hip arthroplasty: lights and shadowsAlessandro Moghnie0Domenico Tigani1Alberto Consoli2Emanuela Castiello3Marco Ganci4Luca Amendola5Department of Orthopaedic Surgery, Ospedale Maggiore C.A. PizzardiDepartment of Orthopaedic Surgery, Ospedale Maggiore C.A. PizzardiDepartment of Orthopaedic Surgery, Ospedale Maggiore C.A. PizzardiDepartment of Orthopaedic Surgery, Ospedale Maggiore C.A. PizzardiDepartment of Orthopaedic Surgery, Ospedale Maggiore C.A. PizzardiDepartment of Orthopaedic Surgery, Ospedale Maggiore C.A. PizzardiAbstract Purpose The use of dual mobility cups in total hip arthroplasty has gained popularity in light of the fact it enables to reduce dislocation through increased jumping distance (JD) and impingement-free arc of movement. Modular Dual Mobility Cup (modular DMC) systems have been recently introduced to enable the use of dual mobility cups with standard metal-backed shells. The objective of this study was twofold: calculate the JD for each modular DMC system and conduct a systematic literature review to report clinical outcomes and reasons for failure of this construct. Methods The JD was calculated using the Sariali formula: JD = 2Rsin [(π/2 − Ψ − arcsin (offset/R))/2]. A qualitative systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search for English and French articles between January 2000 and July 2020 was run on PubMed, EMBASE, Google Scholar, and Scopus with the primary objective of finding articles about modular DMC systems. Results We identified eight 8 different manufacturers of modular DMC systems and 327 publications on the subject. After screening for duplicates and eligibility, we identified 229 publications: 206 articles were excluded because they contained no reports on modular DMC systems, whereas other three were not included because they focused on biomechanical aspects. Among the 11 included articles, 2 were prospective case series, 9 were retrospective case series. True dislocation occurred in 25 cases (0.9%), and six of them were solved by closed reduction without necessity of revision, while all 5 intraprosthetic dislocations were operated. Conclusions Modular DMCs are a valid method to deal with complex THA instability, with good clinical and patient-reported outcomes, low complication rates, and low revision rates at early follow-up. We would advise cautious optimism on the role of modular DMC implants, as it seems safer to use ceramic instead of metallic heads whenever possible to avoid the increase cobalt and chromium trace ion serum levels.https://doi.org/10.1186/s13018-023-03730-8Modular dual mobility cupJumping distanceTotal hip arthroplastyDislocation |
| spellingShingle | Alessandro Moghnie Domenico Tigani Alberto Consoli Emanuela Castiello Marco Ganci Luca Amendola Modular dual mobility articulation in primary and revision hip arthroplasty: lights and shadows Journal of Orthopaedic Surgery and Research Modular dual mobility cup Jumping distance Total hip arthroplasty Dislocation |
| title | Modular dual mobility articulation in primary and revision hip arthroplasty: lights and shadows |
| title_full | Modular dual mobility articulation in primary and revision hip arthroplasty: lights and shadows |
| title_fullStr | Modular dual mobility articulation in primary and revision hip arthroplasty: lights and shadows |
| title_full_unstemmed | Modular dual mobility articulation in primary and revision hip arthroplasty: lights and shadows |
| title_short | Modular dual mobility articulation in primary and revision hip arthroplasty: lights and shadows |
| title_sort | modular dual mobility articulation in primary and revision hip arthroplasty lights and shadows |
| topic | Modular dual mobility cup Jumping distance Total hip arthroplasty Dislocation |
| url | https://doi.org/10.1186/s13018-023-03730-8 |
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