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Indications for Use of Dual Mobility Demonstrate Significant Differences in Subsequent Instability.

Kelechi Nwachuku1, Angel Xiao1, Abbott Gifford2

  • 1Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.

The Journal of Arthroplasty
|April 18, 2026
PubMed
Summary
This summary is machine-generated.

Dual mobility constructs reduce dislocation in total hip arthroplasty (THA), but success varies by indication. Revision THA for adverse reaction to metallic debris (ARMD) shows a high dislocation risk, requiring tailored surgical approaches.

Keywords:
adverse reaction to metal debris (ARMD)dislocationdual mobilityinstabilityrevision THAtotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science

Background:

  • Dual mobility (DM) constructs are widely used in total hip arthroplasty (THA) to prevent dislocations and instability.
  • Their effectiveness may differ based on the specific reason for the hip surgery.

Purpose of the Study:

  • To evaluate the dislocation rates of DM constructs across different primary and revision THA indications.
  • To identify factors influencing dislocation risk in DM constructs.

Main Methods:

  • Retrospective analysis of 488 THA procedures using DM implants.
  • Patients categorized into primary, conversion, and revision THA groups.
  • Revision group further analyzed by reason: instability, infection, loosening, fracture, or ARMD.
  • Multivariable analysis assessed influence of indication, approach, demographics, anatomy, and comorbidities on dislocation.

Main Results:

  • Overall dislocation rate was 4.7% (23/488) with a mean follow-up of 36.1 months.
  • Dislocation rates varied: 3.1% (primary), 0% (conversion), and 7.1% (revision) THA (P=0.05).
  • In revision THA, ARMD cases had a 25% dislocation rate, significantly higher than other causes and strongly associated with failure (P<0.001).

Conclusions:

  • The benefit of DM constructs in preventing dislocation is indication-dependent.
  • Revision THA due to ARMD presents a high risk of subsequent dislocation, even with DM constructs.
  • Patients undergoing revision for ARMD require careful counseling and potentially more robust surgical stabilization strategies.