Abstract
Dual mobility significantly reduces the risk of prosthetic instability. This mechanical complication occurs when the prosthetic head moves out from the retentive polyethylene liner, such phenomenon called intra-prosthetic dislocation reports a ten-year incidence of 2% in the literature.
We prospectively analysed all intra-prosthetic dislocations having occurred since 1985 in our department in order to investigate patient- and implant-related risk factors.
91 intra-prosthetic dislocations occurred with NOVAE (SERF) cups in 85 patients of mean age 50.7 years. Intra-prosthetic dislocation occurred after a mean period of 8.8 years.
A PRO (SERF) stem was implanted in 56 cases and a PF (SERF) stem in 35. The stems were different from one another in their neck diameter and material: 13 mm titanium neck and 16 mm stainless steel neck respectively.
When taking both prosthetic features into account, no significant difference could be established regarding the time between implantation and dislocation.
Comparison between these two prosthetic features was performed by means of two continuous homogeneous series which included 240 patients implanted with PF stems and 382 patients with PRO stems. At a mean 15-year follow-up, the two series reported a non-statistically different intra-prosthetic dislocation rate of 4%.
In both series, young age and large diameter cups were considered predisposing factors for intra-prosthetic dislocation.
Therefore, unlike suggested by several authors, prosthetic neck material and diameter do not appear as the main predictors for intra-prosthetic dislocation which is highly promoted by patient-related features.
