Use of a dual mobility socket to manage total hip arthroplasty instability.
Unconstrained tripolar hip implants provide an additional bearing using a mobile polyethylene component between the prosthetic head and the outer metal shell. Such a design increases the effective head diameter and therefore is an attractive option in challenging situations of unstable total hip arthroplasties. We report our experience with 54 patients treated using this dual mobility implant in such situations. We ascertained its ability to restore and maintain stability, and examined component loosening and component failure. At a minimum followup of 2.2 years (mean, 4 years; range, 2.2-6.8 years), one hip had redislocated 2 months postoperatively and was managed successfully without reoperation by closed reduction with no additional dislocation. Two patients required revision of the implant because of dislocation at the inner bearing. Technical errors were responsible for these failures. Three patients had reoperations for deep infections. The postoperative radiographs at latest followup showed very satisfactory osseointegration of the acetabular component because no radiolucent line or osteolysis was reported. Use of this unconstrained tripolar design was successful in restoring and maintaining hip stability. We observed encouraging results at short-term followup regarding potential for loosening or mechanical failures.


METHODS
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Guyen
Olivier
O
Département de Chirurgie Orthopédique, Hôpital Edouard Herriot, Pavillon T, 5 Place d'Arsonval, 69437, Lyon Cedex 03, France. olivier.guyen@chu-lyon.fr
Pibarot
Vincent
V
Vaz
Gualter
G
Chevillotte
Christophe
C
Béjui-Hugues
Jacques
J
D019644:Arthroplasty, Replacement, Hip; D006621:Hip Joint; D006622:Hip Prosthesis; D006801:Humans; D007593:Joint Instability / Q000517:prevention & control; D015207:Osteoarthritis, Hip / Q000601:surgery; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies
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