WAILEA, Hawaii – Despite some concerns he has, a presenter at Orthopedics Today Hawaii recommended dual mobility total hip replacement for its ability to reduce hip dislocation in some high-risk primary and revision THA patients. .
Christopher L. Peters, MD, Said, in general, dual mobility and tripolar THR joints are gaining popularity.
“Built with dual mobility in the primaries and revisions [are] very effective in reducing dislocation. Now there are concerns, ”he said.
Christophe L. Peters
Although generally in favor of dual mobility THR systems when properly indicated, Peters cited case reports and reported “extremely low” rates in the literature that he found to be “acceptable” for sleeve misalignment, intraprosthetic dislocation, corrosion and potential ion release with these joints.
“I think the evidence for their effectiveness far outweighs any small concerns about the ion issues at this point and so, I think [the systems are] highly recommended for high risk primary dislocation patient and high risk revision patient, ”he said.
The indications for dual mobility PTH primary prostheses are patients at high risk of dislocation, with neuromuscular or connective tissue disorders, or with stiffness of the spine.
Patients with small anatomy are also indicated for dual mobility THA, such as women who require a cup size less than 50mm ”and our poly options are limited to 28 [mm] or 32 [mm] in these 40-[mm] to 48mm sockets, ”said Peters.
“Conversely, great anatomy – when you are size 60 [mm] and above the cups – when using a 36 [mm] or lower joint – we have a lot of dead space, and it is beneficial to potentially keep a femoral design closer to the patient’s femoral head, ”he said.
According to Peters, additional indications include patients with a femoral neck fracture operated posteriorly and patients undergoing conversion after previous hip surgery.
Regarding the dual mobility builds for the THR overhaul, Peters said: “Any overhaul, I think, now becomes a relative indication for using dual mobility. Fracture case, periprosthetic fracture case, secondary [periprosthetic joint infection] The PJI cases, when we come back to the second stage, I think that’s a good indication, and some cases of abductor deficiency, if our implants are in the right position, I think these are good indications for double mobility.