Clinical Research

Clinical Orthopaedics and Related Research®

, Volume 470, Issue 12, pp 3542-3548

A Dual-mobility Cup Reduces Risk of Dislocation in Isolated Acetabular Revisions

  • Roberto CivininiAffiliated withFirst Orthopaedic Clinic, Department of Special Surgical Science, University of Florence Email author 
  • , Christian CarulliAffiliated withFirst Orthopaedic Clinic, Department of Special Surgical Science, University of Florence
  • , Fabrizio MatassiAffiliated withFirst Orthopaedic Clinic, Department of Special Surgical Science, University of Florence
  • , Lorenzo NistriAffiliated withFirst Orthopaedic Clinic, Department of Special Surgical Science, University of Florence
  • , Massimo InnocentiAffiliated withFirst Orthopaedic Clinic, Department of Special Surgical Science, University of Florence

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Abstract

Background

Isolated acetabular revisions using standard cups are at risk of dislocation. The introduction of a nonconstrained dual-mobility cup was designed to improve prosthetic stability without increasing loosening rates, but it is unclear whether the risk of dislocation is reduced.

Questions/purposes

We therefore determined: (1) if the rate of dislocation in isolated acetabular revisions is lower with a dual-mobility cup, (2) implant survival, (3) patient function, and (4) radiographic incidence of migration, loosening, and osteolysis.

Methods

We prospectively followed 33 selected patients who underwent isolated acetabular revisions with a minimum of 2 years’ followup (mean, 3 years; range, 2–5 years). In 24 patients a stainless steel dual-mobility cup was cemented into an antiprotrusio cage, whereas in nine we used a hyaluronan dual-mobility revision cup with a foramen hook and superior and posterior flanges screw fixations. We determined Harris hip (HHS) and WOMAC scores and examined radiographs for migration, loosening, and osteolysis.

Results

There were no dislocations. Survivorship rates of the femoral and acetabular components were 97% at 5 years; the rerevision rate for any reason was 3%. At last followup, the mean HHS increased from 48 points preoperatively to 86 points. No patients had progressive osteolysis, component migration, or loosening on radiographs.

Conclusion

In this select group of isolated acetabular revisions, our data suggest the use of a dual-mobility cup reduced the risk of dislocation without increasing loosening from 2 to 5 years.

Level of Evidence

Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.