Comparison of dual-mobility cup and unipolar cup for prevention of dislocation after revision total hip arthroplasty

Acta Orthop. 2017 Feb;88(1):18-23. doi: 10.1080/17453674.2016.1255482. Epub 2016 Nov 14.

Abstract

Background and purpose - Revision total hip arthroplasty (THA) is associated with higher dislocation rates than primary THA. We compared the risk of dislocation within 6 months and all-cause re-revision during the whole study period using either the dual-mobility cup or the unipolar cup. Methods - We used a prospective hospital registry-based cohort including all total and cup-only revision THAs performed between 2003 and 2013. The cups used were either dual-mobility or unipolar; the choice was made according to the preference of the surgeon. 316 revision THAs were included. The mean age of the cohort was 69 (25-98) years and 160 THAs (51%) were performed in women. The dual-mobility group (group 1) included 150 THAs (48%) and the mean length of follow-up was 31 (0-128) months. The unipolar group (group 2) included 166 THAs (53%) and the mean length of follow-up was 52 (0-136) months. Results - The incidence of dislocation within 6 months was significantly lower with the dual-mobility cup than with the unipolar cup (2.7% vs. 7.8%). The unadjusted risk ratio (RR) was 0.34 (95% CI: 0.11-1.02) and the adjusted RR was 0.28 (95% CI: 0.09-0.87). The number of patients needed to treat with a dual-mobility cup in order to prevent 1 case of dislocation was 19. The unadjusted incidence rate ratio for all-cause re-revision in the dual-mobility group compared to the unipolar group was 0.6 (95% CI: 0.3-1.4). Interpretation - Use of a dual-mobility rather than a unipolar cup in revision THA reduced the risk of dislocation within 6 months.

Publication types

  • Comparative Study

MeSH terms

  • Acetabulum / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Hip / methods*
  • Female
  • Follow-Up Studies
  • Hip Dislocation / epidemiology
  • Hip Dislocation / prevention & control*
  • Hip Prosthesis*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prospective Studies
  • Prosthesis Design
  • Prosthesis Failure
  • Reoperation
  • Switzerland / epidemiology
  • Time Factors