Early complications after revision total hip arthroplasty with cemented dual-mobility socket and reinforcement ring

Encouraged by the success of dual-mobility sockets in achieving implant stability in primary hip replacement, surgeons have started to use the implant in revision hip arthroplasty. However, very little is known yet about the postoperative complication rate of this type of implant when fixation in a reinforcement ring is required. In our department, 37 dual-mobility sockets were cemented in a reinforcement ring for revision hip arthroplasty in 36 patients over a period of two years. The mean follow-up period was 16 months (range, 6-27 months). Indications for revision hip arthroplasty included, among others, recurrent dislocation (3 cases) and implant loosening (9 cases) with extensive bone loss. We observed two single re-dislocations (5.40%), one infection and one mechanical failure of the reinforcement ring; the literature mentions dislocation rates of 2.7 to 10.6% after revisions not specifically for recurrent dislocation. Revision hip arthoplasty combining dual-mobility sockets with reinforcement ring fixation thus had a relatively low early postoperative complication rate in this challenging group of patients. The design therefore seems to be a valid alternative to constrained implants, especially in high-risk revision cases. Despite the short follow-up period, cemented dual-mobility sockets seem to be a valuable option when reinforcement rings need to be used, with an acceptable dislocation rate in this challenging group of patients. But long-term survival studies are mandatory to evaluate stability and fixation longevity.