Dual-mobility bearings in complex revision hip arthroplasty

• Published in: Hip international Vol. 32; no. 4; p. 460
• Main Authors: Wakeling, Christopher P, Sandiford, Nemandra A, Ghani, Rafia, Bridle, Simon J, Mitchell, Philip A, Hutt, Jonathan Rb
• Format: Journal Article
• Language: English
• Published: United States 01.07.2022
• Subjects: reconstruction; Arthroplasty; hip; complex; dual-mobility; revision
• ISSN: 1724-6067
• DOI: 10.1177/1120700021999795

Revision total hip arthroplasty (rTHA) is associated with an increased dislocation risk. Dual-mobility (DM) bearings have been used to address this issue. Such constructs offer increased range of motion and enhanced stability whilst avoiding some issues associated with fully-constrained devices. DM bearings have been used in our unit since 2013. All rTHA cases since 2013 were reviewed using the following criteria: (1) use of a DM bearing; (2) extensive soft tissue or bone loss resulting from ARMD, infection or multiple revisions, or requiring custom or megaprosthetic reconstruction; (3) minimum 2-month follow-up. 52 cases were identified with a median of 2 previous operations (range 1-6) and mean follow-up of 14 (2-41) months. The Novae-Stick component was used in 50 cases, the Avantage in 2 and the Trident MDM in 1 case. 19 required acetabular reconstruction using trabecular metal and four required custom acetabular components. 19 required femoral reconstruction with a proximal or total femoral replacement.Postoperatively, 8 patients (15.4%) sustained a dislocation at a mean of 1.6 (range 1-3) months. 3 (5.8%) requiring re-revision. 1 required excision arthroplasty and 2 a constrained liner, 1 of which went on to have further instability. There were no intraprosthetic dislocations. Dual-mobility components are a viable option in the complex rTHA setting. Early dislocations can occur but the rate of instability is acceptable in this high-risk group.