Mid-Term Outcomes of Dual Mobility Acetabular Cups for Revision Total Hip Arthroplasty

• Published in: The Journal of arthroplasty 2018-05, Vol.33 (5), p.1494-1500
• Main Authors: Harwin, Steven F., Sultan, Assem A., Khlopas, Anton, Chughtai, Morad, Sodhi, Nipun, Piuzzi, Nicolas S., Mont, Michael A.
• Format: Article
• Language: English
• Subjects: Acetabulum - surgery; Adult; Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - instrumentation; dual mobility; Female; Hip Prosthesis; Humans; Joint Dislocations - surgery; Kaplan-Meier Estimate; Male; mid-term; Middle Aged; Osteolysis - etiology; outcomes; Postoperative Period; Prosthesis Design; Prosthesis Failure; Prosthesis Retention; Range of Motion, Articular; Reoperation - statistics & numerical data; revision; survivorships; total hip arthroplasty; Treatment Outcome
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2017.12.008

This study evaluated (1) survivorship, (2) clinical outcomes, (3) complications, and (4) radiographic outcomes of dual mobility (DM) systems when compared to fixed-bearing prostheses in revision total hip arthroplasty (THA). A cohort of 85 patients who underwent revision THA using DM implants were compared to a prior matching cohort of 170 patients who received fixed-bearing implants. Mean follow-up time was 4 years in the DM cohort and 10 years in the fixed-bearing cohort. Kaplan-Meier analysis was performed to assess survivorships. Clinical outcomes were evaluated using the Harris Hip Score (HHS). Complications and radiographs were evaluated and reported at the final follow-up. Overall aseptic and all-cause survivorships of the DM cohort were 96.5% and 95.3% compared to 94.7% and 93.5% in fixed-bearing cohort (P = .01 for aseptic and all-cause survivorships). The DM cohort had statistically significant higher survivorship when compared at equivalent follow-up interval in the fixed-bearing cohort. There were 3 aseptic (one due to dislocation) and 1 septic revision in the DM cohort compared to 9 aseptic (6 due to dislocation) and 2 septic revisions in the fixed-bearing cohort. Postoperative HHS scores were 88 and 86 points in the DM and fixed-bearing cohorts. However, the difference in mean improvement in HHS scores from preoperative to postoperative (ΔHHS) was not statistically significant (35 vs 34, P = .533). Except for the aforementioned revisions, there were no progressive radiolucencies or osteolysis on radiographic evaluation in both cohorts. DM articulations demonstrated superior survivorship at equal follow-up intervals when compared to fixed-bearing implants and showed a trend toward lower dislocation rates.