Dual-Mobility Cups in Primary Total Hip Arthroplasty

Petri Bellova; Jens Goronzy; Roman Riedel; Tim Grothe; Albrecht Hartmann; Klaus-Peter Günther

doi:10.1055/s-0044-1800904

The Journal of Hip Surgery, Table of Contents

The Journal of Hip Surgery 2024; 08(02): 065-074
DOI: 10.1055/s-0044-1800904

Review Article

Dual-Mobility Cups in Primary Total Hip Arthroplasty

Tripolare Pfannen in der Primärhüftendoprothetik

Petri Bellova

¹Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, Dresden, Germany

,

Jens Goronzy

¹Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, Dresden, Germany

,

Roman Riedel

¹Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, Dresden, Germany

,

Tim Grothe

¹Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, Dresden, Germany

,

Albrecht Hartmann

¹Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, Dresden, Germany

,

Klaus-Peter Günther

¹Orthopaedics, Trauma and Plastic Surgery, University Hospital Carl Gustav Carus, Dresden, Germany

› Author Affiliations

Abstract

Dual-mobility cups (DMCs) were introduced in France more than 40 years ago and are increasingly used not only in hip revision but also primary hip arthroplasty. Due to a simulated large-head articulation and increased jumping distance, DMCs can contribute to a high range of motion in the hip joint and reduce the risk of instability. Numerous studies have reported low dislocation rates and high survival rates in the mid-term follow-up. Nevertheless, long-term data, especially on primary hip replacement, remain limited, and the effect of recent designs and material innovations is still unclear. Therefore, primary DMCs are mainly proposed in patients at high risk for dislocation (i.e. pelvitrochanteric insufficiency, compromised spinopelvic mobility, neuromuscular disorders, obesity and femoral neck fractures). Based on a review of recently published studies referring to these indications, the current study discusses the advantages and disadvantages of DMCs.

Zusammenfassung

Tripolare Pfannen bzw. Dual-Mobility-Pfannen (dual mobility cups, DMCs) wurden bereits vor über 40 Jahren in Frankreich eingeführt und erfahren nun auch in Deutschland zunehmende Anwendung – nicht nur in der Revisionsendoprothetik, sondern auch in der Primärendoprothetik. Durch das simulierte Großkopfprinzip mit doppelter Artikulation sollen DMCs einen hohen Bewegungsumfang im Hüftgelenk mit reduzierter Luxationsgefahr gewährleisten. Inzwischen zeigen zahlreiche Studien geringe Dislokationsraten sowie hohe Überlebensraten im mittelfristigen Follow-up. Es gibt allerdings noch relativ wenige Langzeitdaten, insbesondere zum Einsatz in der Primärendoprothetik und der Stellenwert von Material- bzw. Designvarianten ist bislang noch unklar. Aus diesem Grund werden DMCs in der Primärendoprothetik aktuell vor allem bei Patient*innen mit erhöhtem Instabilitätsrisiko propagiert. Dazu gehören insbesondere eine Insuffizienz der pelvitrochantären Muskulatur, die eingeschränkte spinopelvine Mobilität, neuromuskuläre Erkrankungen oder Adipositas permagna sowie der Einsatz in der Frakturendoprothetik. Basierend auf einer Literaturübersicht zu diesen Indikationen wird der aktuelle Diskussionsstand zusammengefasst.

Key words

dual mobility - tripolar cups - hip arthroplasty - dislocation - instability

Schlüsselwörter

Dual Mobility - tripolare Pfannen - Hüftendoprothetik - Luxation - Instabilität

Full Text

References

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