Dual-Mobility Constructs in Primary and Revision Total Hip Arthroplasty: A Systematic Review of Comparative Studies

Nicolas Reina, Ayoosh Pareek, Aaron Krych, Mark Pagnano, Daniel J. Berry, Matthew Abdel

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5 Citations (Scopus)

Abstract

Background: Utilization of dual-mobility constructs in total hip arthroplasties (THA) has increased in the recent years. Benefits and risks of these implants in terms of reducing dislocations, long-term survivorship, and associated complications are uncertain when compared to non-dual-mobility articulations. Methods: A systematic review of prospective and retrospective studies that compared dual-mobility constructs with controls for primary or revision THAs between 1986 and 2018 was performed. All articles in both English and French were reviewed. Results: Five studies with primary THAs and 6 with revision THAs were analyzed. For primary THAs, the overall rate of dislocation was 0.9% in the dual-mobility group compared to 6.8% in the control group (P < .001) at a mean follow-up of 7.6 years. The odds ratios for the control group to the dual-mobility group were 4.06 (P < .001) for dislocation, 1.18 (P = .87) for revision, 2.97 (P = .04) for revision due to dislocation, 1.67 (P = .57) for infection, 0.6 (P = .53) for fracture, and 1.21 (P = .81) for aseptic loosening. Similarly, for revision THAs, the overall dislocation rates were 2.2% compared to 7.1% (P < .001) at a mean follow-up of 4.1 years. The odds ratios for the control group to the dual-mobility group were 3.59 (P < .001) for dislocation, 2.46 (P < .001) for re-revision, 4.88 (P = .007) for re-revision due to dislocation, 1.51 (P = .32) for infection, 1.18 (P = .81) for fracture, and 2.71 (P = .003) for aseptic loosening. Conclusion: This systematic review of comparative studies supports the efficacy of dual-mobility constructs to minimize dislocation after both primary and revision THAs in addition to excellent mid-term survivorship compared to control constructs. However, further evidence is needed to evaluate the long-term risks and benefits of dual-mobility constructs in the primary and revision THA setting when compared to contemporary conventional implants. Level of Evidence: III, therapeutic.

Original languageEnglish (US)
JournalJournal of Arthroplasty
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Tacrine
Arthroplasty
Hip
Control Groups
Odds Ratio
Infection
Retrospective Studies
Prospective Studies

Keywords

  • dual mobility
  • primary
  • revision
  • systematic review
  • total hip arthroplasty

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

@article{76e4ba9c4a964f50bca3799d5a765a7b,
title = "Dual-Mobility Constructs in Primary and Revision Total Hip Arthroplasty: A Systematic Review of Comparative Studies",
abstract = "Background: Utilization of dual-mobility constructs in total hip arthroplasties (THA) has increased in the recent years. Benefits and risks of these implants in terms of reducing dislocations, long-term survivorship, and associated complications are uncertain when compared to non-dual-mobility articulations. Methods: A systematic review of prospective and retrospective studies that compared dual-mobility constructs with controls for primary or revision THAs between 1986 and 2018 was performed. All articles in both English and French were reviewed. Results: Five studies with primary THAs and 6 with revision THAs were analyzed. For primary THAs, the overall rate of dislocation was 0.9{\%} in the dual-mobility group compared to 6.8{\%} in the control group (P < .001) at a mean follow-up of 7.6 years. The odds ratios for the control group to the dual-mobility group were 4.06 (P < .001) for dislocation, 1.18 (P = .87) for revision, 2.97 (P = .04) for revision due to dislocation, 1.67 (P = .57) for infection, 0.6 (P = .53) for fracture, and 1.21 (P = .81) for aseptic loosening. Similarly, for revision THAs, the overall dislocation rates were 2.2{\%} compared to 7.1{\%} (P < .001) at a mean follow-up of 4.1 years. The odds ratios for the control group to the dual-mobility group were 3.59 (P < .001) for dislocation, 2.46 (P < .001) for re-revision, 4.88 (P = .007) for re-revision due to dislocation, 1.51 (P = .32) for infection, 1.18 (P = .81) for fracture, and 2.71 (P = .003) for aseptic loosening. Conclusion: This systematic review of comparative studies supports the efficacy of dual-mobility constructs to minimize dislocation after both primary and revision THAs in addition to excellent mid-term survivorship compared to control constructs. However, further evidence is needed to evaluate the long-term risks and benefits of dual-mobility constructs in the primary and revision THA setting when compared to contemporary conventional implants. Level of Evidence: III, therapeutic.",
keywords = "dual mobility, primary, revision, systematic review, total hip arthroplasty",
author = "Nicolas Reina and Ayoosh Pareek and Aaron Krych and Mark Pagnano and Berry, {Daniel J.} and Matthew Abdel",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.arth.2018.11.020",
language = "English (US)",
journal = "Journal of Arthroplasty",
issn = "0883-5403",
publisher = "Churchill Livingstone",

}

TY - JOUR

T1 - Dual-Mobility Constructs in Primary and Revision Total Hip Arthroplasty

T2 - A Systematic Review of Comparative Studies

AU - Reina, Nicolas

AU - Pareek, Ayoosh

AU - Krych, Aaron

AU - Pagnano, Mark

AU - Berry, Daniel J.

AU - Abdel, Matthew

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Utilization of dual-mobility constructs in total hip arthroplasties (THA) has increased in the recent years. Benefits and risks of these implants in terms of reducing dislocations, long-term survivorship, and associated complications are uncertain when compared to non-dual-mobility articulations. Methods: A systematic review of prospective and retrospective studies that compared dual-mobility constructs with controls for primary or revision THAs between 1986 and 2018 was performed. All articles in both English and French were reviewed. Results: Five studies with primary THAs and 6 with revision THAs were analyzed. For primary THAs, the overall rate of dislocation was 0.9% in the dual-mobility group compared to 6.8% in the control group (P < .001) at a mean follow-up of 7.6 years. The odds ratios for the control group to the dual-mobility group were 4.06 (P < .001) for dislocation, 1.18 (P = .87) for revision, 2.97 (P = .04) for revision due to dislocation, 1.67 (P = .57) for infection, 0.6 (P = .53) for fracture, and 1.21 (P = .81) for aseptic loosening. Similarly, for revision THAs, the overall dislocation rates were 2.2% compared to 7.1% (P < .001) at a mean follow-up of 4.1 years. The odds ratios for the control group to the dual-mobility group were 3.59 (P < .001) for dislocation, 2.46 (P < .001) for re-revision, 4.88 (P = .007) for re-revision due to dislocation, 1.51 (P = .32) for infection, 1.18 (P = .81) for fracture, and 2.71 (P = .003) for aseptic loosening. Conclusion: This systematic review of comparative studies supports the efficacy of dual-mobility constructs to minimize dislocation after both primary and revision THAs in addition to excellent mid-term survivorship compared to control constructs. However, further evidence is needed to evaluate the long-term risks and benefits of dual-mobility constructs in the primary and revision THA setting when compared to contemporary conventional implants. Level of Evidence: III, therapeutic.

AB - Background: Utilization of dual-mobility constructs in total hip arthroplasties (THA) has increased in the recent years. Benefits and risks of these implants in terms of reducing dislocations, long-term survivorship, and associated complications are uncertain when compared to non-dual-mobility articulations. Methods: A systematic review of prospective and retrospective studies that compared dual-mobility constructs with controls for primary or revision THAs between 1986 and 2018 was performed. All articles in both English and French were reviewed. Results: Five studies with primary THAs and 6 with revision THAs were analyzed. For primary THAs, the overall rate of dislocation was 0.9% in the dual-mobility group compared to 6.8% in the control group (P < .001) at a mean follow-up of 7.6 years. The odds ratios for the control group to the dual-mobility group were 4.06 (P < .001) for dislocation, 1.18 (P = .87) for revision, 2.97 (P = .04) for revision due to dislocation, 1.67 (P = .57) for infection, 0.6 (P = .53) for fracture, and 1.21 (P = .81) for aseptic loosening. Similarly, for revision THAs, the overall dislocation rates were 2.2% compared to 7.1% (P < .001) at a mean follow-up of 4.1 years. The odds ratios for the control group to the dual-mobility group were 3.59 (P < .001) for dislocation, 2.46 (P < .001) for re-revision, 4.88 (P = .007) for re-revision due to dislocation, 1.51 (P = .32) for infection, 1.18 (P = .81) for fracture, and 2.71 (P = .003) for aseptic loosening. Conclusion: This systematic review of comparative studies supports the efficacy of dual-mobility constructs to minimize dislocation after both primary and revision THAs in addition to excellent mid-term survivorship compared to control constructs. However, further evidence is needed to evaluate the long-term risks and benefits of dual-mobility constructs in the primary and revision THA setting when compared to contemporary conventional implants. Level of Evidence: III, therapeutic.

KW - dual mobility

KW - primary

KW - revision

KW - systematic review

KW - total hip arthroplasty

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