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World J Orthop. Jul 18, 2014; 5(3): 180-187
Published online Jul 18, 2014. doi: 10.5312/wjo.v5.i3.180
Dual mobility cups in total hip arthroplasty
Ivan De Martino, Georgios Konstantinos Triantafyllopoulos, Peter Keyes Sculco, Thomas Peter Sculco
Ivan De Martino, Georgios Konstantinos Triantafyllopoulos, Peter Keyes Sculco, Thomas Peter Sculco, Department of Orthopaedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY 10021, United States
Author contributions: De Martino I, Triantafyllopoulos GK and Sculco PK performed the literature review and drafted the article; Sculco TP revised the article critically for important intellectual content; De Martino I, Triantafyllopoulos GK, Sculco PK and Sculco TP finally approved for print.
Correspondence to: Thomas Peter Sculco, MD, Department of Orthopedic Surgery, Division of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, United States. sculcot@hss.edu
Telephone: +1-212-6061475 Fax: +1-212-7349572
Received: January 6, 2014
Revised: February 21, 2014
Accepted: April 17, 2014
Published online: July 18, 2014
Processing time: 194 Days and 22.4 Hours
Abstract

Total hip arthroplasty (THA) is considered one of the most successful surgical procedures in orthopaedics. With the increase in the number of THAs performed in the world in the next decades, reducing or preventing medical and mechanical complications such as post-operative THA instability will be of paramount importance, particularly in an emerging health care environment based on quality control and patient outcome. Dual mobility acetabular component (also known as unconstrained tripolar implant) was introduced in France at the end of the 1970s as an alternative to standard sockets, to reduce the risk of THA dislocation in patients undergoing primary THA in France. Dual mobility cups have recently gained wider attention in the United States as an alternative option in the prevention and treatment of instability in both primary and revision THA and offer the benefit of increased stability without compromising clinical outcomes and implant longevity. In this article, we review the use of dual mobility cup in total hip arthroplasty in terms of its history, biomechanics, outcomes and complications based on more than 20 years of medical literature.

Keywords: Dual mobility; Total hip arthroplasty; Dislocation; Revision total hip arthroplasty; Instability

Core tip: Instability remains a significant issue after both primary and revision total hip arthroplasty. Dual mobility or tripolar unconstrained acetabular components can provide a viable alternative in preventing and treating instability. Reported outcomes of several European studies using dual mobility cups with mid- to long-term follow up support their effectiveness. Concerns such as intra-prosthetic dislocation and accelerated wear have been emphasized, although they seem to be less significant in older, low-demand patients. The use of dual mobility cups in younger patients should be viewed with caution based on a lack of current data concerning this high demand patient population.