Dual mobility cups in revision total hip arthroplasty

Area of Science:

• Orthopedic Surgery
• Biomaterials Science

Background:

• Revision total hip arthroplasty (THA) presents challenges, including instability and aseptic loosening.
• Dual mobility constructs are increasingly used to address these complications.

Purpose of the Study:

• To evaluate the rates of dislocation and aseptic loosening associated with dual mobility constructs in revision THA.
• To assess the efficacy of dual mobility cups across different indications for revision surgery.

Main Methods:

• Retrospective analysis of 334 revision THAs performed between 2006 and 2011.
• Inclusion criteria: use of a dual mobility cup; minimum follow-up of five years.
• Indications for revision included aseptic loosening (70%), infection (21%), and recurrent instability (9%).

Main Results:

• Overall dislocation rate was low, with 11 episodes reported.
• Aseptic loosening occurred in 10 cases, with a higher incidence when a cemented cup within a reinforcement ring was used (OR=14, p=0.0001).
• Specific dislocation rates varied by indication: 1.3% for aseptic loosening, 2.8% for infection, and 3.4% for recurrent dislocation.

Conclusions:

• Dual mobility cups demonstrate significant advantages in revision total hip arthroplasty.
• These constructs are effective in reducing dislocation and aseptic loosening across all revision indications.
• The findings support the use of dual mobility cups as a reliable option for complex hip revision cases.