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Dual-mobility cups may mitigate dislocation in primary, revision settings

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Craig J. Della Valle

ORLANDO, Fla. — Initial results with a dual-mobility acetabular cup for hip instability achieved by an investigator and his colleagues show the design can be a viable alternative to a constrained liner.

Craig J. Della Valle, MD, discussed what surgeons need to know about these cups at the Current Concepts in Joint Replacement Winter Meeting, here. He urged anyone wanting to try these hip articulations to first identify the primary cause of instability and, based on that information, plan the appropriate treatment.

A study by Della Valle, Wera DG and colleagues from 2012 is a helpful guide to understanding why total hip arthroplasty dislocation occurs, he noted.

“Dual mobility is a compelling option. Again, its big advantage is a decreased risk of instability. We have used it for patients at high risk in primary total hips. We have used it in revisions, specifically to treat instability, as well as in lieu of a constrained liner,” he said.

In a series published in Journal of Arthroplasty last year, Della and colleagues followed 36 of these cups used during revision THA for a minimum of 2 years. There were two deep infections.

“We had one dislocation that was closed [and] reduced,” Della Valle said.

Improvements being made in surface finishes, counter bearings and shapes that avoid psoas impingement will only make these articulations better in the future, according to Della Valle. – by Susan M. Rapp

References:

• Della Valle CJ. Paper #25. Presented at: Current Concepts in Joint Replacement Winter Meeting; Dec. 13-16, 2017; Orlando, Florida.
• Plummer DR, et al. J Arthroplasty. 2016;doi:10.1016/j.arth.2016.03.021.
• Wera GD, et al. J Arthroplasty. 2012;doi:10.1016/j.arth.2011.09.010.

Disclosure: Della Valle reports he receives stock/stock options from CD Diagnostics; is a paid consultant to and receives research support from DePuy Synthes; is a paid for consulting for and receives research support from Smith & Nephew; received paid research and research support from Stryker; and receives consulting fees and royalties for intellectual property from and is paid for research by Zimmer Biomet.