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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
Summary
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.
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.
