Journal
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
Volume 105, Issue 3, Pages 250-261Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.2106/JBJS.22.00185
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Dual mobility (DM) is a widely used option for total hip replacement, which features a small inner head within a larger outer polyethylene head. It aims to increase stability and range of motion in the hip joint. However, long-term data, especially for modular DM implants, is lacking, and potential issues include accelerated polyethylene wear, intraprosthetic dislocation, and modular backside fretting corrosion.
Dual mobility (DM) refers to a now widely available option for total hip articulation. DM implants feature a small inner head, a hard bearing, that connects via a taper fit onto the femoral trunnion. This head freely rotates but is encased inside a larger, outer polyethylene head that articulates with a smooth acetabular component. DM acetabular components are available in the form of a monoblock shell or as a liner that is impacted into a modular shell, providing a metal articulation for the polyethylene outer head. DM is designed to increase hip stability by providing the arthroplasty construct with a higher jump distance, head-to-neck ratio, and range of motion prior to impingement. The use of DM in total hip arthroplasty continues to increase in the United States for both primary and revision arthroplasty. Surgeons should be aware of the potential benefits and pitfalls. Long-term data are lacking, especially for modular DM implants. Points of concern include a potential for accelerated polyethylene wear, intraprosthetic dislocation, and modular backside fretting corrosion.
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