Do Modular Dual Mobility Cups Offer a Reliable Benefit? Minimum 5-Year Follow-Up of 102 Cups.

Abstract

Among various options suggested to prevent hip instability after total hip replacement, the MDM-tritanium (modular dual mobility) cup features a cobalt-chrome liner (CoCr) positioned in a titanium acetabular shell and matched with a mobile insert in highly cross-linked annealed X3 polyethylene. The purpose of this study aimed to confirm whether there was no significant release of ions (Co and Cr) or higher occurrence of dislocation or even cases of aseptic loosening of the cementless shell with the use of MDM-tritanium cups at minimum of 5-year follow-up. The clinical study was carried out on a homogeneous consecutive and nonselective series with 102 MDM cups (98 patients) implanted in 2 centers. This MDM-tritanium cup had been systematically used for surgical revisions (70% of cases) or for patients with major hip dysplasia or in elderly patients with poor bone quality. A biological assessment of ion releases has been performed in a specific cohort of 39 cases that had an internal ceramic head. None of the following complications was observed: no case of immunoallergic event, no aseptic loosening, and the dislocation rate was 4.9% involving only the difficult primary and revision cases. The clinical results were encouraging, with 89.7 points for Harris Hip Score, 41.16 points/48 for the OHS-12. The Agora Roentgenographic Assessment (ARA) radiologic score was graded "excellent" in 94.4%. The MDM-tritanium survivorship with revision for any cause in 102 cups at 7.95 years was 92.7%. Based on the results of our first 102 cases, there were no immunoallergic complications-contrary to what was initially feared with the CoCr bearing-titanium pair-and no postoperative instability, including for complex primary and revisions total hip replacements. Individual Cohort Study: 2B.