Cotilos de doble movilidad. Uso para la revisión femoral aislada de prótesis de cadera con fricción metal/metal con cabezas grandes. [Use of dual mobility acetabular cups for isolated femoral revision of metal on metal hip resurfacing arthroplasty using larger femoral heads]

Sebastián Enrique Valdez


Los recambios de cadera con cabezas metálicas grandes provocan una mayor tasa de complicaciones, principalmente asociadas al retiro del componente acetabular, como al par fricción utilizado. En casos determinados, pueden realizarse revisiones femorales aisladas, conservando la copa acetabular, disminuyendo la morbilidad quirúrgica.

Presentamos un caso tratado exitosamente con una copa de doble movilidad, en un paciente con una prótesis de superficie con un seudotumor que generó dolor e inestabilidad.

El conocimiento de esta técnica quirúrgica permite al cirujano de cadera resolver problemas complejos de forma sencilla y segura, con una baja tasa de complicaciones.




Large head metal on metal hip arthroplasty revision has a significant complication rate, mainly related to the removal of the acetabular component, as well as to the friction pair used. In some cases, an isolated femoral revision can be made, sparing the acetabular cup and, thus, decreasing surgical morbidity.

This paper discusses a case successfully treated with a dual mobility acetabular cup in a patient with a resurfacing hip replacement and a pseudotumor that caused pain and instability.

Mastering this surgical approach allows hip surgeons to solve complex problems in a simple and safe manner, and with a low complication rate.

Palabras clave

Copas de doble movilidad; revisión; prótesis de superficie; artroplastías metal/metal. Dual mobility cups; resurfacing hip revision; metal on metal hip arthroplasty

Texto completo:

PDF PDF (English)

Cantidad de visitas / Visitor counter
Resumen - 184
PDF - 0 PDF (English) - 0


Snir N, Park BK, Garofalo G, Marwin SE. Revision of failed hip resurfacing and large metal no metal total hip arthroplasty using dual mobility components. Orthopedics 2015;38(6):369-74.

DOI: 10.3928/01477447-20150603-04

Grammatoupolos G, Pandit H, Kwon YM. Hip resurfacing revised for inflammatory pseudotumour have a poor outcame. J Bone Joint Surg Br 2009;91(8):1019-24. DOI: 10.1302/0301-620X.91B8.22562

Browne JA, Bechtold CD, Berry DJ, Hanssen AD, Lewanllen DG. Failed metal-on-metal hip arthroplasties: a spectrum of clinical presentations and operative findings. Clin Orthop Relat Res 2010;468(9):2313-20. DOI: 10.1007/s11999-010-1419-0

Su EP, Su SL. Surface replacement conversion: results depend upon reason for revision. Bone Joint J 2013;95(11 Suppl A):88-91. DOI: 10.1302/0301-620X.95B11.32663

Matharu GS, Pynsent PB, Dunlop DJ. Revision of metal and metal hip replacements and resurfacings for adverse reaction to metal debris: a systematic review of outcomes. Hip Int 2014;24:311-320. DOI: 10.5301/hipint.5000140

Combes A, Migaud H, Girard J, Duhamel A, Fessy MH. Low rate of dislocation of dual mobility cups in primary total hip arthroplasty. Clin Orthop Relat Res 2013;471(12):3891-900. DOI: 10.1007/s11999-013-2929-3

Guyen O, Pibarot V, Vaz G, Chevillte C, Bejui-Hegues J. Use a dual mobility socket to manage total hip arthroplasty instability. Clin Orthop Relat Res 2009;467(2):465-72. DOI: 10.1007/s11999-008-0476-0

National Joint Registry for England and Wales. National Joint Registry for England and Wales 8th Annual Report 2011. Hertforshire, United Kingdom: National Joint Registry for England and Wales; 2011.

Haddad FS, Thakrar RR, Hart AJ. Metal on metal bearings: the evidence so far. J Bone Joint Surg Br 2011;93:572-79.

DOI: 10.1302/0301-620X.93B4.26429

De Smet KA, Van Der Straeten C, Van Orsouw M, Doubi R, Backers K, Grammatopoulus G. Revisions of metal on metal hip resurfacing: lessons learned and improved outcome. Orthop Clin North Am 2011;42(2):259-69. DOI: 10.1016/j.ocl.2011.01.003

Rajpura A, Porter ML, Gambhir AK, Freemont AJ, Board TN. Clinical experience of revisions of metal on metal hip arthroplasty for aseptic lymphocyte dominated vasculitis associated lesions (ALVAL). Hip Int 2011;21:43-51. DOI: 10.5301/HIP.2011.6276

Pritchett JW. Once component revision of failed hip resurfacing from adverse reaction to metal wear debris. J Arthroplasty 2014;29:219-24. DOI: 10.1016/j.arth.2013.04.011

Verhelst LA, Van der Bracht H, Vanhegan IS, Van Backlé B, De Schepper J. Revising the well fixed, painful resurfacing using a double mobility head: a new strategy to address metal on metal complications. J Arthroplasty 2012;27(10):1857-62.

DOI: 10.1016/j.arth.2012.05.012

Plummer DR, Botero HG, Berend KR. Salvage of monoblock metal on metal acetabular components using a dual mobility bearing. J Arthroplasty 2016;31(4):846-9. DOI: 10.1016/j.arth.2015.08.016

Figueras G, Planell RV, Serra Fernandez R, Biayna JC. Revision of metal-on-metal hip arthroplasty with well fixed and positioned acetabular component using a dual- mobility head and review of literature. Open Orthop J 2016;10:512-21.

DOI: 10.2174/1874325001610010512

Sassoon AA, Barrack RL. Pseudotumour formation and subsequent resolution in metal-on-metal total hip arthroplasty following revision. Bone Joint J Br 2016;98(6):736-40.

DOI: 10.1302/0301-620X.98B6.36908

Valdez S, Bouxin B. Cotilos con doble movilidad: principios, ventajas y resultados. Rev Asoc Argent Ortop Traumatol 2009;74:102-10.

Hamadouche M, Arnould H, Bouxin B. Is cementless dual mobility socket in primary THA a reasonable option? Clin Orthop Relat Res 2012;470(11):3048-53. DOI: 10.1007/s11999-012-2395-3


Enlaces refback

  • No hay ningún enlace refback.

URL de la licencia:

Registro de la Propiedad Intelectual Nº 22171081 (en línea).

ISSN 1852-7434 (en línea).

Esta Revista está bajo una Licencia Creative Commons Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional. (CC-BY-NC-SA 4.0)