Comparison of dual mobility cup and other surgical construts used for three hundred and sixty two first time hip revisions due to recurrent dislocations: five year results from Lithuanian arthroplasty register
- 608 Downloads
Recently, there has been increasing interest in the use of dual mobility systems in the treatment of hip instability. The aim of this study was to investigate the re-revision rate of dual mobility cup compared to different surgical concepts when used for first-time hip revisions due to recurrent dislocations.
The data were derived from the Lithuanian Arthroplasty Register. For survival analysis, we used both re-revision for all reasons and for dislocations as an end-point. Cox proportional hazards models were used to analyze the influence of various covariates (age, gender, and implant concept).
A total of 1388 revisions were recorded from 2011 to 2015, of which 362 were performed due to recurrent dislocation. Of the revisions, 247 were performed using dual mobility cups, while 115 were performed using a variety of other surgical constructs including constrained acetabular cups, conventional cups, femoral head exchanges, stem exchanges or anti-luxation rings. There were 27 re-revisions of which 15 were for additional dislocations. There were only 2% re-revisions due to dislocation with dual mobility vs 9% when using other surgical constructs. Cox regression adjusting for age and gender showed that in the short-term, dual mobility cup had a lower risk of revision due to dislocation as well as for all reasons compared to the other surgical constructs.
In revision of total hip arthroplasties for dislocation, significantly lower short-term re-revision rate was observed for patients revised with dual mobility cup.
KeywordsArthroplasty Revision Dislocation Dual mobility Register
This research was funded by a grant (No. MIP-049/2012) from the Research Council of Lithuania.
Compliance with ethical standards
Conflict of interest
All authors declare no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the ethical committee (No. BE-2-17).
Informed consent was obtained from all individual participants included in the study.
- 11.Vasukutty NL, Middleton RG, Matthews EC, Young PS, Uzoigwe CE, Minhas TH (2012) The double-mobility acetabular component in revision total hip replacement. The United Kingdom experience. J Bone Joint Surg Br 94:603–608Google Scholar
- 17.Mohaddes M, Cnudde P, Rolfson O, Wall A, Kärrholm J (2017) Use of dual-mobility cup in revision hip arthroplasty reduces the risk for further dislocation: analysis of seven hundred and ninety one first-time revisions performed due to dislocation, reported to the Swedish hip Arthroplasty register. Int Orthop 41(3):583–588CrossRefPubMedGoogle Scholar
- 21.StataCorp (2013) Stata statistical software: release 13. StataCorp LP, College StationGoogle Scholar
- 30.Hailer NP, Weiss RJ, Stark A, Kärrholm J (2012) The risk of revision due to dislocation after total hip arthroplasty depends on surgical approach, femoral head size, sex, and primary diagnosis. An analysis of 78,098 operations in the Swedish Hip Arthroplasty register. Acta Orthop 83(5):442–448CrossRefPubMedPubMedCentralGoogle Scholar