Use of dual-mobility cup in revision hip arthroplasty reduces the risk for further dislocation: analysis of seven hundred and ninety one first-time revisions performed due to dislocation, reported to the Swedish Hip Arthroplasty Register.
PURPOSE
Dislocation after total hip arthroplasty (THA) is a common reason for revision. The last decade fostered a significant increase in the use of dual-mobility cups (DMCs). Here we report our study on the short-term survival rate of a cemented DMC reported to the Swedish Hip Arthroplasty Register (SHAR) compared with other cemented designs used in first-time revision due to dislocation.


METHODS
During 2005-2015, 984 first-time revisions for dislocation were reported to SHAR. In 436 of these cases a cemented dual articular cup was used. During the same time period, 355 revisions performed with a standard cemented cup (femoral head size 28-36 mm) were reported to the SHAR. Patients receiving a DMC were slightly older (75 years, p = 0.005). Re-revision for all reasons was used as primary endpoint. We also anlaysed risk for re-revision of the acetabular component and re-revision due to dislocation. Kaplan-Meier implant survival and a Cox regression analyses adjusted for age and gender were performed.


RESULTS
Implant survival at 4 years for all reasons (91% ± 3.7% vs 86% ± 4.1%, p = 0.02), and especially for re-operation because of dislocation, favours the DMC group (96% ± 3.0% vs 92% ± 3.3%, p = 0.001).


DISCUSSION
Our findings indicate that use of a cemented DMC reduces the short- to mid-term risk of a second revision in first-time revisions compared with classic cup designs. Longer follow-up is needed to establish any long-term clinical advantages when DMCs are used in revisions performed due to dislocation.
['Mohaddes|Maziar|M|0000-0003-1848-9054', 'Cnudde|Peter|P|', 'Rolfson|Ola|O|', 'Wall|Alexander|A|', 'Kärrholm|Johan|J|']
D000328:Adult D000368:Aged D019644:Arthroplasty, Replacement, Hip D001843:Bone Cements D005260:Female D006617:Hip Dislocation D006621:Hip Joint D006622:Hip Prosthesis D006801:Humans D008297:Male D008875:Middle Aged D011475:Prosthesis Failure D012042:Registries D012086:Reoperation D015996:Survival Rate D013548:Sweden
Revision Dislocation Register studies