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Modern Dual-Mobility Cups in Revision Total Hip Arthroplasty: A Systematic Review and Meta-Analysis

Jay M Levin1, Assem A Sultan1, Jeffrey A O'Donnell1

  • 1Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH.

The Journal of Arthroplasty
|September 10, 2018
PubMed

Insights

Dual-mobility cups show excellent survivorship and low dislocation rates in revision total hip arthroplasty. These implants are a safe and effective option for high-risk patients needing hip revision surgery.

Area of Science:

  • Orthopedic Surgery
  • Arthroplasty Research
  • Biomaterials Engineering

Background:

  • Revision total hip arthroplasty (THA) presents unique challenges, including higher risks of instability and complications.
  • Dual-mobility (DM) cups have emerged as a potential solution to improve outcomes in complex THA cases.
  • Assessing the efficacy of DM cups specifically in revision THA settings is crucial for clinical decision-making.

Purpose of the Study:

  • To systematically review and analyze the outcomes of dual-mobility (DM) cups in revision total hip arthroplasty (THA).
  • To evaluate survivorship rates (all-cause and aseptic), dislocation rates, and overall complication profiles associated with DM cups in revision THA.
  • To assess clinical outcomes using validated health status measures in patients who received DM cups during revision THA.

Main Methods:

  • A comprehensive literature search was conducted to identify relevant studies on DM cups in revision THA.
  • Inclusion criteria focused on studies reporting re-revision rates, complications, and clinical outcomes, specifically excluding primary THA analyses and non-modern implant data (pre-2010).
  • Nine studies met the selection criteria for final meta-analysis and outcome assessment.

Main Results:

  • Dual-mobility cups demonstrated high aseptic (97.7%) and all-cause (94.5%) survivorship rates in revision THA.
  • The overall dislocation rate was low at 2.2%, with intraprosthetic dislocation at 0.3%. Meta-analysis confirmed significantly lower dislocation odds compared to fixed-bearing prostheses (OR 0.24, P = .002).
  • Complications occurred in 7.4% of cases, with infection rates at 3.3%. Postoperative outcomes measured by Harris Hip Scores showed no statistically significant improvement (P > .05).

Conclusions:

  • Dual-mobility cups exhibit excellent survivorship and low rates of dislocation and overall complications in revision total hip arthroplasty.
  • The findings support DM cups as a safe and effective implant choice, particularly for high-risk patient populations undergoing revision THA.
  • Further research may explore factors influencing clinical outcome scores in this patient cohort.
Abstract

Keywords:
dislocationsdual mobilityfixed bearingmeta-analysistotal hip arthroplasty

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