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Revisión de la literatura sobre la artroplastia total de cadera primaria: comparación entre prótesis convencional y de doble movilidad

Authors: Ravery Morovati, Vandad Shahzad;

Revisión de la literatura sobre la artroplastia total de cadera primaria: comparación entre prótesis convencional y de doble movilidad

Abstract

La artroplastia total de cadera (ATC) es un procedimiento ampliamente utilizado para el tratamiento de enfermedades articulares avanzadas y fracturas de cadera. Con el aumento de la expectativa de vida, la demanda de este procedimiento ha crecido significativamente, lo que ha impulsado avances en el diseño de los implantes. Las copas acetabulares de doble movilidad han surgido como una alternativa a las convencionales, lo que reduce la tasa de luxación, una de las complicaciones más frecuentes de la ATC. El presente trabajo realizó una revisión sistemática de la literatura para comparar los resultadosclínicos ybiomecánicos entrelascopasacetabulares convencionalesylasdedoble movilidad. Los estudios revisados indican que la doble movilidad ofrece una reducción significativa en la tasa de luxación posoperatoria, particularmente en pacientes de alto riesgo. Además, los pacientes con doble movilidad presentan una recuperación funcional más rápida, con menos restricciones de movimiento en el posoperatorio temprano. En cuanto a las complicaciones, no se encontraron diferencias significativas en la tasa de infección periprotésica ni en el riesgo de fractura periprotésica entre ambas opciones. Cabe destacar que las copas de doble movilidad pueden presentar un riesgo particular de luxación intraprotésica, el cual es exclusivo de este implante. La literatura revisada también señala que la evidencia sobre la durabilidad a largo plazo de estas prótesis en pacientes jóvenes es limitada. Por lo tanto, no se tiene la posibilidad de generar conclusiones sobre su uso en este grupo poblacional. Se concluye que la selección del implante debe basarse en una evaluación individualizada del paciente. Las copas de doble movilidad representan una opción efectiva en escenarios de alto riesgo de luxación, mientras que las copas convencionales son una opción confiable en pacientes sin factores predisponentes. La evidencia actual respalda el uso de copas de doble movilidad en situaciones específicas. Pero, se requiere más investigación a largo plazo para establecer su papel definitivo en la artroplastia primaria de cadera.

Total hip arthroplasty (THA) is a widely used procedure for treating advanced joint diseases and hip fractures. With increasing life expectancy, its demand has significantly grown, driving advancements in implant design. In this context, dual mobility acetabular cups have emerged as an alternative to conventional cups, providing greater stability and reducing the rate of dislocation, one of the most frequent complications of THA. This study conducted a systematic review of the literature to compare the clinical and biomechanical outcomes between conventional and dual mobility acetabular cups. The reviewed studies indicate that dual mobility significantly reduces the rate of postoperative dislocation, particularly in high-risk patients, such as those with hip fractures, developmental dysplasia, or revision surgeries. Additionally, patients with dual mobility implants experience a faster functional recovery with fewer movement restrictions in the early postoperative period. Regarding additional complications, no significant differences were found in the rate of periprosthetic infection or the risk of periprosthetic fracture between both options. However, dual mobility cups pose a particular risk of intraprosthetic dislocation, a complication unique to this design. The reviewed literature also highlights that evidence on the long-term durability of these prostheses in younger patients remains limited, requiring further studies to evaluate their performance in this population. In conclusion, implant selection should be based on an individualized assessment of the patient. Dual mobility cups represent an effective alternative in high-risk dislocation scenarios, while conventional cups remain a reliable option for patients without predisposing factors. Current evidence supports the use of dual mobility in specific situations, but further long-term research is needed to establish its definitive role in primary total hip arthroplasty.

Vicerrectoría de Investigación::Sistema de Estudios de Posgrado::Salud::Especialidad en Ortopedia y Traumatología

Country
Costa Rica
Related Organizations
Keywords

Doble Movilidad, Reemplazo de cadera, Estabilidad en remplazo de cadera, Artroplastía, Copa Convencional, Artroplastía total de cadera primario

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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