The advantages and drawbacks of dual mobility acetabular cups and its clinical application / 中华骨科杂志

ABSTRACT

Total hip arthroplasty plays a key role in the end-stage diagnosis and treatment of a variety of femoral and hip diseases, but the risk of dislocation caused by traditional bone cement prosthesis has always been one of the key constraints of total hip arthroplasty. Bousquet added a polymer lining between the femoral head and acetabulum to separate the activities between the lining and acetabulum. The dual mobility acetabular cup system can effectively reduce the incidence of prosthesis dislocation. The first generation of the dual mobility acetabular cup system is lined with polyethylene. With the progress of modern material medicine technology, a new type of the dual mobility acetabular cup system with smooth surface, bionic coating and high cross-linked polyethylene liner has been gradually formed, and its performance has been improved. Because of the existence of the inner liner, the distance between the femoral head and acetabulum of the dual mobility acetabular cup system is larger, which can allow greater range of motion, has higher stability, is not easy to dislocate, and has lower wear degree of the prosthesis at the same time. Therefore, the dual mobility acetabular cup system is more and more widely used in clinical practice, especially for the elderly with high risk of dislocation, revision surgery or neuromuscular dysfunction. But on the other hand, based on the design principle of dual motion total hip prosthesis, the disadvantages such as intraprosthetic dislocation caused by multiple factors and the lack of fixation holes result in the dual motion total hip system easily triggering acetabular loosening when targeting patients such as severe bone defects, thus limiting its further use. The dual motion total hip system can be tailored to different clinical applications, such as for populations with different characteristics, and for different methods of primary surgery, with different application strategies, thereby reducing the incidence of postoperative revision. In this paper, we take the application of the dual motion total hip acetabular system in the total hip arthroplasty as the core, and the system puts forth the principle of the dual motion total hip acetabular system, compared with traditional bone materials, introduces its advantages and disadvantages, and reveals its application strategy in the clinic, and gives an outlook for the future application of the dual motion total hip acetabular system in orthopedics.