Dual mobility components may be justified for high-risk THA patients
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Proven to decrease dislocation rates, dual mobility components may be justified in high-risk total hip arthroplasty patients independent of surgical approach, according to a presenter here.
In a debate at the Current Concepts of Joint Replacement Winter Meeting, Rafael J. Sierra, MD, noted use of dual mobility components increases stability by improving the jump distance and providing larger range of motion before impingement, both of which can decrease problems in high-risk patients. Published research with mid-term follow-up showed a low risk of dislocation as well as minimal risk of cup loosening when dual mobility components are used in high-risk patients, according to Sierra.
“There have been previous papers to show the cost effectiveness, as well, of dual mobility cups in primary total hip arthroplasty,” Sierra said in his presentation.
Although surgeons can mitigate the risk of redislocation and re-revision by using a direct anterior or lateral approach to improve stability, Sierra noted a risk of dislocation still exists.
“If you look at this large nonconsecutive series of anterior approach hips, we can see that there are a number of patients that did have dislocations and, even more recently, contemporary comparisons between different approaches does not show a difference in dislocation rates between approaches,” Sierra said.
However, Sierra added there are still downsides with the use of dual mobility components in the high-risk patient.
“There is a risk of intraprosthetic dislocation, we have to compromise, occasionally, for fixation if you’re going to use a monoblock dual mobility and then there are some concerns with the use of modular dual mobility,” Sierra said.
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Sierra RJ. Use dual mobility in all high-risk THA patients: Absolutely yes, why risk the grief? Presented at: Current Concepts in Joint Replacement Winter Meeting; Dec. 8-11, 2021; Orlando (hybrid meeting).
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