{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:12:25Z","timestamp":1789675945663,"version":"4.0.1"},"reference-count":35,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100016052","name":"Friends of The Mater Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100016052","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012341","name":"Corin Group","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012341","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HIP International"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Dual-mobility (DM) prostheses have been developed to reduce dislocation risk of total hip arthroplasty (THA), but concerns exist regarding potential local and systemic metal ion release. The study aimed to assess the 2-year clinical outcomes, and whole blood metal ions levels following THA with the Trinity DM system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Eligible patients (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009104) underwent consecutive primary THA with a Trinity DM prosthesis. Patient-reported outcome measures (PROMs) were completed by 101 (99%) at baseline and 2\u2009years. Whole blood cobalt (Co), chromium (Cr) and titanium (Ti) levels were measured at baseline in 19 and 2\u2009years in 53. PROMs included Oxford Hip Score (OHS), HOOS-JR, and satisfaction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      At 2\u2009years, 96% were satisfied or very satisfied. PASS thresholds were achieved by 85% for HOOS-JR and 87% for OHS. Mean blood levels increased from baseline to 2\u2009years for Co 6 to 8\u2009nmol\/L (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.348), Cr 10 to 11\u2009nmol\/L (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.824) and Ti 44 to 86\u2009nmol\/L (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.001). Elevated levels (&gt;1.0\u2009\u00b5g\/L) were observed for Co 7.5%, Cr 1.8%; and Ti &gt;5\u2009\u00b5g\/L in 9 (17%), but were well below thresholds associated with significant prosthetic wear.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The Trinity modular DM system demonstrated excellent 2-year clinical outcomes and acceptable low blood metal ion levels. Baseline and periodic 5-year metal ion surveillance is recommended after modular DM THA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>ANZCTR Clinical Trial No:<\/jats:title>\n                    <jats:p>ACTRN12622000003774<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11207000261474376","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:39:58Z","timestamp":1789533598000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Total hip arthroplasty with dual-mobility components is associated with excellent clinical outcomes and low metal ion blood levels at 2\u2009years"],"prefix":"10.1177","author":[{"given":"Karan","family":"Sandhu","sequence":"first","affiliation":[{"name":"North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0548-8573","authenticated-orcid":false,"given":"Lucy J","family":"Salmon","sequence":"additional","affiliation":[{"name":"North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, NSW, Australia"},{"name":"North Sydney Orthopaedic Research Group, Sydney, NSW, Australia"},{"name":"University of Notre Dame, School of Medicine, Sydney, NSW, Australia"},{"name":"University of Sydney, School of Medicine, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew C","family":"Lyons","sequence":"additional","affiliation":[{"name":"North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, NSW, Australia"},{"name":"North Sydney Orthopaedic Research Group, Sydney, NSW, Australia"},{"name":"Mater Hospital Sydney, Wollstonecraft, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin R","family":"Gooden","sequence":"additional","affiliation":[{"name":"North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, NSW, Australia"},{"name":"North Sydney Orthopaedic Research Group, Sydney, NSW, Australia"},{"name":"Mater Hospital Sydney, Wollstonecraft, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D","family":"O\u2019Sullivan","sequence":"additional","affiliation":[{"name":"North Sydney Orthopaedic and Sports Medicine Centre, Wollstonecraft, NSW, Australia"},{"name":"North Sydney Orthopaedic Research Group, Sydney, NSW, Australia"},{"name":"Mater Hospital Sydney, Wollstonecraft, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.25310\/MXFR3061"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2013.08.004"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/4125965"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.11.020"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000002275"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2016.12.012"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2016.09.038"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2015.07.035"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.3109\/17453674.2013.792034"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2020.08.019"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.21037\/aoj.2019.10.01"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jor.2021.02.018"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-025-06507-2"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.artd.2025.101727"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.78B2.0780185"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-4718-2"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.3109\/07853890109002087"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/17453674.2020.1750877"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.21.00550"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.93B10.26249"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.5301\/HIP.2011.8643"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtemb.2019.09.005"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.92B1.22770"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.93B2.25099"},{"key":"e_1_3_2_27_2","volume-title":"Information Statement. Current concerns with metal-on-metal hip arthroplasty","author":"American Academy of Orthopaedic Surgeons","year":"2012","unstructured":"American Academy of Orthopaedic Surgeons. Information Statement. Current concerns with metal-on-metal hip arthroplasty. AAOS, Rosemont, IL, 2012."},{"key":"e_1_3_2_28_2","volume-title":"AOA PROMs Pilot Project: Final report","author":"Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR)","year":"2020","unstructured":"Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). AOA PROMs Pilot Project: Final report. 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