Dual mobility constructs in revision total hip arthroplasty: survivorship analysis in recurrent dislocation versus other indications at three to twelve-year follow-up

  • Nicolas de l’EscalopierEmail author
  • Valérie Dumaine
  • Guillaume Auberger
  • Antoine Babinet
  • Jean-Pierre Courpied
  • Philippe Anract
  • Moussa Hamadouche
Original Paper



The aim of this retrospective study was to evaluate the clinical, radiologic, and survival results of dual mobility (DM) sockets in revision total hip arthroplasty (THA) performed for instability versus revision THAs performed for other reasons.


From a computerized database, we identified 84 revision THAs using a modern DM socket performed in 81 patients with a mean age of 71 years. Indication for revision was recurrent dislocation in 47 hips, and other reasons in the remaining 37 hips. A survivorship analysis according to the actuarial method was carried out on the entire series using revision for any cause, revision for dislocation, and radiological cup loosening revised or not, as the end points.


Of the 81 patients, twelve died, six were lost to follow-up, eight had been revised, and 55 patients (58 hips) were unrevised and alive at a mean follow-up of 6.4 years. Dislocation occurred in four of the 47 (8.5%) hips for which indication for revision was dislocation versus one of the remaining 37 (2.7%) hips [odds ratio = 3.4 (0.4–31.3), p = 0.07]. According to our criteria, three acetabular components of which one was revised were considered as loosened. When using revision for dislocation as the end-point, the survival rate at seven years was 90.4 ± 5.3% (IC95%, 79.9–100) in the 47 hips for which the indication for revision was dislocation versus 100% in the remaining 37 hips (log-rank, p = 0.5).


The current study indicated that DM sockets represent an interesting solution to prevent dislocation in revision THAs at mid-term follow-up.


Revision Total hip arthroplasty Dual mobility cup Dislocation 



  1. 1.
    Langlais FL, Ropars M, Gaucher F et al (2008) Dual mobility cemented cups have low dislocation rates in THA revisions. Clin Orthop Relat Res 466:389–395. CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Lebeau N, Bayle M, Belhaouane R et al (2017) Total hip arthroplasty revision by dual-mobility acetabular cup cemented in a metal reinforcement: a 62 case series at a minimum 5 years’ follow-up. Orthop Traumatol Surg Res 103:679–684. CrossRefPubMedGoogle Scholar
  3. 3.
    Vasukutty NL, Middleton RG, Matthews EC et al (2012) The double-mobility acetabular component in revision total hip replacement: the United Kingdom experience. Bone Joint J 94-B:603–608. CrossRefGoogle Scholar
  4. 4.
    Sutter EG, McClellan TR, Attarian DE et al (2017) Outcomes of modular dual mobility acetabular components in revision total hip arthroplasty. J Arthroplast 32:S220–S224. CrossRefGoogle Scholar
  5. 5.
    Philippot R, Adam P, Reckhaus M et al (2009) Prevention of dislocation in total hip revision surgery using a dual mobility design. Orthop Traumatol Surg Res 95:407–413. CrossRefPubMedGoogle Scholar
  6. 6.
    Prudhon JL, Steffann F, Ferreira A et al (2014) Cementless dual-mobility cup in total hip arthroplasty revision. Int Orthop 38:2463–2468. CrossRefPubMedGoogle Scholar
  7. 7.
    Schneider L, Philippot R, Boyer B, Farizon F (2011) Revision total hip arthroplasty using a reconstruction cage device and a cemented dual mobility cup. Orthop Traumatol Surg Res 97:807–813. CrossRefPubMedGoogle Scholar
  8. 8.
    Simian E, Chatellard R, Druon J et al (2015) Dual mobility cup in revision total hip arthroplasty: dislocation rate and survival after 5 years. Orthop Traumatol Surg Res 101:577–581. CrossRefPubMedGoogle Scholar
  9. 9.
    Viste A, Desmarchelier R, Fessy MH (2017) Dual mobility cups in revision total hip arthroplasty. Int Orthop 41:535–542. CrossRefPubMedGoogle Scholar
  10. 10.
    Wegrzyn J, Tebaa E, Jacquel A et al (2015) Can dual mobility cups prevent dislocation in all situations after revision total hip arthroplasty? J Arthroplast 30:631–640. CrossRefGoogle Scholar
  11. 11.
    Civinini R, Carulli C, Matassi F et al (2012) A Dual-mobility cup reduces risk of dislocation in isolated acetabular revisions. Clin Orthop Relat Res 470:3542–3548. CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Pattyn C, Audenaert E (2012) Early complications after revision total hip arthroplasty with cemented dual-mobility socket and reinforcement ring. Acta Orthop Belg 78:357–361PubMedGoogle Scholar
  13. 13.
    Philippot R, Boyer B, Farizon F (2013) Intraprosthetic dislocation: a specific complication of the dual-mobility system. Clin Orthop Relat Res 471:965–970. CrossRefPubMedGoogle Scholar
  14. 14.
    Fabry C, Langlois J, Hamadouche M, Bader R (2016) Intra-prosthetic dislocation of dual-mobility cups after total hip arthroplasty: potential causes from a clinical and biomechanical perspective. Int Orthop 40:901–906. CrossRefPubMedGoogle Scholar
  15. 15.
    Fabry C, Woernle C, Bader R (2014) Self-centering dual-mobility total hip systems: Prediction of relative movements and realignment of different intermediate components. Proc Inst Mech Eng H 228:477–485. CrossRefPubMedGoogle Scholar
  16. 16.
    Wegrzyn J, Pibarot V, Jacquel A et al (2014) Acetabular reconstruction using a Kerboull cross-plate, structural allograft and cemented dual-mobility cup in revision THA at a minimum 5-year follow-up. J Arthroplast 29:432–437. CrossRefGoogle Scholar
  17. 17.
    Guyen O, Pibarot V, Vaz G et al (2009) Use of a dual mobility socket to manage total hip arthroplasty instability. Clin Orthop Relat Res 467:465–472. CrossRefPubMedGoogle Scholar
  18. 18.
    Hamadouche M, Ropars M, Rodaix C et al (2017) Five to thirteen year results of a cemented dual mobility socket to treat recurrent dislocation. Int Orthop 41:513–519. CrossRefPubMedGoogle Scholar
  19. 19.
    Leiber-Wackenheim F, Brunschweiler B, Ehlinger M et al (2011) Treatment of recurrent THR dislocation using of a cementless dual-mobility cup: a 59 cases series with a mean 8 years’ follow-up. Orthop Traumatol Surg Res 97:8–13. CrossRefPubMedGoogle Scholar
  20. 20.
    Mertl P, Combes A, Leiber-Wackenheim F et al (2012) Recurrence of dislocation following total hip arthroplasty revision using dual mobility cups was rare in 180 hips followed over 7 years. HSS J 8:251–256. CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Hailer NP, Weiss RJ, Stark A, Kärrholm J (2012) Dual-mobility cups for revision due to instability are associated with a low rate of re-revisions due to dislocation. Acta Orthop 83:566–571. CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    van Heumen M, Heesterbeek PJC, Swierstra BA et al (2015) Dual mobility acetabular component in revision total hip arthroplasty for persistent dislocation: no dislocations in 50 hips after 1–5 years. J Orthop Traumatol 16:15–20. CrossRefPubMedGoogle Scholar
  23. 23.
    Jakobsen T, Kappel A, Hansen F, Krarup N (2014) The dislocating hip replacement - revision with a dual mobility cup in 56 consecutive patients. Open Orthop J 8:268–271. CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Carulli C, Macera A, Matassi F, Civinini R, Innocenti M (2016) The use of a dual mobility cup in the management of recurrent dislocations of hip hemiarthroplasty. J Orthop Traumatol 17(2):131–136. CrossRefGoogle Scholar
  25. 25.
    Hartzler MA, Abdel MP, Sculco PK, et al. (2018) Otto Aufranc Award: dual-mobility constructs in revision THA reduced dislocation, rerevision, and reoperation compared with large femoral heads. 293–301. CrossRefGoogle Scholar

Copyright information

© SICOT aisbl 2019

Authors and Affiliations

  1. 1.Clinical Orthopaedics Research Center, Department of Orthopaedic and Reconstructive Surgery, Hôpitaux Universitaires Paris Centre (HUPC), Site Cochin-Port Royal, Assitance Publique-Hôpitaux de Paris (AP-HP)Université Paris 5ParisFrance

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