Abstract
Background
Dual-mobility (DM) bearings reduce instability in revision total hip arthroplasty
(THA); however, DM bearings are costly and reports of corrosion have recently emerged.
Furthermore, no study has compared DM to standard bearings with large diameter femoral
heads ≥40-mm. This study’s purpose was to compare postoperative dislocation rates
of standard and DM bearings with large femoral heads after revision THA.
Methods
A retrospective review of 301 consecutive revision THAs was performed. The mean follow-up
was 37.1 months. To isolate the effect of the double articulation, standard and DM
bearings with femoral heads ≥40-mm were compared. Outcomes were postoperative dislocation
and reoperation within 90 days.
Results
The cohort consisted of 182 standard bearings and 75 DM bearings. There were no differences
in revision indication comparing standard and DM bearings (P = .258). Overall dislocation rate was 8.6% (22 of 257). The dislocation rate was
5.7% for standard bearings with ≥40-mm femoral heads compared with 6.9% in DM bearings
with ≥40-mm femoral heads (P = 1.000). In multivariate analysis, lower body mass index (odds ratio 1.72), female
sex (odds ratio 2.01), and decreased outer femoral head diameter–to–cup component
size ratio (odds ratio 1.64) were predictors of postoperative dislocation regardless
of bearing type.
Conclusion
This study showed no difference in dislocation rates between standard and DM bearings
when comparing similar femoral head diameters of ≥40-mm used in revision THAs. Considering
the cost and potential deleterious issues associated with additional interfaces, DM
bearings should be used judiciously considering similar results may be achieved with
single-articulation bearings using large femoral heads.
Level of Evidence
Level III.
Keywords
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Article info
Publication history
Published online: July 29, 2021
Accepted:
July 21,
2021
Received in revised form:
July 18,
2021
Received:
April 15,
2021
Footnotes
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2021.07.008.
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