Dual-Mobility versus Fixed-Bearing Constructs in Revision Total Hip Arthroplasty: A Systematic Review of Comparative...

Dual-mobility (DM) constructs were developed to improve stability in total hip arthroplasty (THA) and may be of particular utility in revision THA, given the increased risk of instability. The aim of this systematic review was to assess dislocation rates of DM versus fixed-bearing (FB) constructs in revision THA.

PubMed and Embase database searches were performed for studies published between database inception and December 31, 2024. Inclusion criteria consisted of studies evaluating dislocation rates of DM versus FB constructs in revision THA. Levels of evidence and modified Coleman Methodology scores were determined. Studies with a mean follow-up of less than two years, studies with fewer than 30 patients in each group, and non-English manuscripts were excluded. A total of 22 studies were included. All studies were level III evidence, except for one study (level II). Of the 22 revision THA manuscripts, the mean modified Coleman Methodology score was 55.1 (range, 45 to 79).

A total of 21 studies demonstrated favorable dislocation rates for DM compared to FB constructs in revision THA. There were 15 studies that met statistical significance (P < 0.05). When limiting analysis to the 15 studies that met statistical significance, the overall rates of dislocation were 4.4 versus 6.9% for DM versus FB, respectively. Dislocation rates for the DM cohort ranged from 0 to 8.3%, and the FB cohort dislocation rate ranged from 3.4 to 15.5%.

Given the currently available literature, the use of DM constructs is associated with a lower dislocation risk in revision THA.