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11.01.2017 | Original Paper | Ausgabe 3/2017 Open Access

International Orthopaedics 3/2017

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

Zeitschrift:
International Orthopaedics > Ausgabe 3/2017
Autoren:
Maziar Mohaddes, Peter Cnudde, Ola Rolfson, Alexander Wall, Johan Kärrholm
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00264-016-3381-2) contains supplementary material, which is available to authorized users.

Abstract

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.

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