CORR Insights®: Is Isolated Mobile Component Exchange an Option in the Management of Intraprosthetic Dislocation of a Dual Mobility Cup?

摘要

While certainly not new to the European environment [2, 6], the use of dual mobility bearings for THA has only recently been more widely accepted in North America and Oceania [5, 9]. Recent data from the highly regarded Australian Orthopaedic Association National Joint Replacement Registry suggests that dual mobility construct use has increased more than 10-fold in the last 5 years [1]. While touted by many as the panacea for THA bearing instability—seemingly incorporating the advantages of both the low-friction Charnley hip with the mechanical features of a “large-head” design—the increased use of dual mobility bearings [9] has bought with it a class of novel wear and failure characteristics. Unique to dual mobility (and arguably bipolar) hips are the phenomena of wear between the two articulating heads, and unintended separation of them—the latter being known as intraprosthetic dislocation. Although these are thought to be uncommon, they can be challenging to manage when they occur [3].