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 J.
AU - Pagnano, Mark W.
AU - Berry, Daniel J.
AU - Abdel, Matthew P.
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/3
Y1 - 2019/3
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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U2 - 10.1016/j.arth.2018.11.020
DO - 10.1016/j.arth.2018.11.020
M3 - Review article
C2 - 30554926
AN - SCOPUS:85058217390
SN - 0883-5403
VL - 34
SP - 594
EP - 603
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
IS - 3
ER -