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

Abstract

Purpose

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.

Methods

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).

Results

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.

Conclusion

In revision of total hip arthroplasties for dislocation, significantly lower short-term re-revision rate was observed for patients revised with dual mobility cup.

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Funding

This research was funded by a grant (No. MIP-049/2012) from the Research Council of Lithuania.

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Correspondence to Justinas Stucinskas.

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All authors declare no conflict of interest.

Ethical approval

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

Informed consent was obtained from all individual participants included in the study.

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Stucinskas, J., Kalvaitis, T., Smailys, A. et al. 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. International Orthopaedics (SICOT) 42, 1015–1020 (2018). https://doi.org/10.1007/s00264-017-3702-0

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Keywords

  • Arthroplasty
  • Revision
  • Dislocation
  • Dual mobility
  • Register