Dual Mobility Reduces Dislocations-Why I Use It in All Revisions

Area of Science:

• Orthopedic Surgery
• Biomaterials Engineering
• Medical Device Technology

Background:

• Instability is the most frequent complication following revision total hip arthroplasty (THA).
• Dual mobility (DM) bearing articulations, used since the 1970s in France, are gaining wider adoption in the US.
• The role of DM bearings in revision THA is a subject of ongoing discussion.

Purpose of the Study:

• To discuss the application and efficacy of dual mobility (DM) bearings in revision total hip arthroplasty (THA).
• To evaluate the role of DM bearings in managing complex revision THA cases.

Main Methods:

• Systematic review of existing literature on DM bearing outcomes in revision THA.
• Presentation of case examples illustrating DM use in challenging revision THA scenarios.
• Discussion of limitations associated with DM bearing use.

Main Results:

• Large retrospective studies indicate DM bearings significantly decrease dislocation rates compared to conventional single-bearing THA.
• While polyethylene wear, loosening, intraprosthetic dislocation, and corrosion are noted concerns, these have improved with contemporary implant designs.
• DM bearings show promise in addressing acetabular bone loss, failed constrained liners, and adverse local tissue reactions.

Conclusions:

• Modern DM designs are recognized as effective for reducing instability in revision THA.
• Despite established efficacy, some concerns regarding DM bearings persist.
• Further high-quality prospective studies are required to fully elucidate the long-term role of DM bearings in revision THA.