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 language | English (US) |
|---|---|
| Journal | Journal of Arthroplasty |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
Fingerprint
Keywords
- dual mobility
- primary
- revision
- systematic review
- total hip arthroplasty
ASJC Scopus subject areas
- Orthopedics and Sports Medicine
Cite this
Dual-Mobility Constructs in Primary and Revision Total Hip Arthroplasty : A Systematic Review of Comparative Studies. / Reina, Nicolas; Pareek, Ayoosh; Krych, Aaron; Pagnano, Mark; Berry, Daniel J.; Abdel, Matthew.
In: Journal of Arthroplasty, 01.01.2018.Research output: Contribution to journal › Article
}
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
UR - http://www.scopus.com/inward/record.url?scp=85058217390&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85058217390&partnerID=8YFLogxK
U2 - 10.1016/j.arth.2018.11.020
DO - 10.1016/j.arth.2018.11.020
M3 - Article
C2 - 30554926
AN - SCOPUS:85058217390
JO - Journal of Arthroplasty
JF - Journal of Arthroplasty
SN - 0883-5403
ER -