Abstract
Abstract Dual Mobility (DM) implants provide greater stability especially in Revision Total Hip Arthroplasty (R-THA) when compared to primary THA. Aim: to identify the current evidence regarding outcomes of DM in R-THA when compared to fixed-bearing (FB) implants. Review in accordance with PRISMA guidelines. Structured electronic searches. Primary outcome measure: dislocation rate following R-THA. Secondary outcome measures: implant survival, aseptic loosening, infection rate. Studies' methodology quality assessed using MINORS criteria. All articles published from 2016 to December 2019 included. 1777 R-THAs were reported (49.9% with DM acetabular component, 50.1% with FB component). Sample size: 67-426 patients. Mean age: 57-73. Mean follow-up period: 12-60 months. Significant risk ratio of 1.08 [1.05, 1.12] (95% CI, I2 = 37%, P < 0.00001) with statistically significant difference between the two groups in favour of DM implant. Statistically significant difference in favour of DM group with respect to dislocation rate (risk ratio 0.22, 95% CI; P < 0.00001) and aseptic loosening (risk ratio 0.51, 95% CI; P < 0.05). No statistical difference between the groups on risk ratio for infection 0.94 (95% CI; P = 0.85). DM implants are beneficial in R-THA when compared to FB implants. However, one needs to balance the benefits of using DM implant considering the patient’s clinical conditions and the costs involved.
Highlights
Revision THA (R-THA) is known to be a challenging type of surgery
After carefully carrying out an exclusion procedure as explained, the eligible studies included for final consideration and analysis were only 8 [19,20,21,22,23,24,25,26]; out of those, none of the papers was classified as randomized controlled trial (RCT)
There was a statistically significant difference with regards to body mass index (BMI) reported in only one study [26], but this was considered an intrinsic feature of a specific study design
Summary
Revision THA (R-THA) is known to be a challenging type of surgery. This is thought to be caused by technical difficulties and higher complications rates in comparison with primary THA [1]. There are many factors able to cause the failure of R-THA: these have been found to be mostly instability and aseptic loosening. DM provides the opportunity to improve implant stability giving the presence of a large Polyethylene liner at the level of the internal bearing. This larger liner works as a large femoral head and is able to produce a rise in jump distance. DM does not cause increasing constraint at the level of the implantbone interface but allows improvements with regards to the load dispersion interface [8, 9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
