Document Type
Article
Publication Date
12-6-2021
Abstract
Background
Instability remains the most common complication after revision total hip arthroplasty (THA). The purpose of this study was to determine whether there was a difference in aseptic revision rates and survivorship between dual-mobility (DM) and constrained liners (CL) in revision THA.
Methods
We reviewed a consecutive series of 2432 revision THA patients from 2008 to 2019 at our institution and identified all patients who received either a CL or DM bearing. We compared demographics, comorbidities, indications, dislocations, and aseptic failure rates between the two groups. Bivariate and multivariate regression analyses were used to determine risk factors for failure, and a Kaplan-Meier survivorship analysis was performed with an aseptic re-revision as the endpoint.
Results
Of the 191 patients, 139 (72%) received a DM bearing, and 52 (28%) had a CL. At a mean follow-up of 14.3 months, there was no statistically significant difference in rates of dislocation (10.4% vs 14.0%, P = .667), aseptic revision (30.9% vs 46.2%, P = .073), or time to revision (3.78 vs 6 months, P = .565) between the two groups. The multivariate analysis revealed CL had no difference in aseptic re-revision rates when compared with DM (odds ratio 1.47, 95% confidence interval 0.84-2.52, P = .177). The survivorship analysis found no difference in aseptic failure between the groups at 12 months (P = .059).
Conclusion
Both CL and DM bearings have high aseptic failure rates at intermediate term follow-up after revision THA. CL did show a higher risk of failure than DM bearings, but it was not statistically significant with the numbers available for this study. Further prospective studies are needed to determine the optimal treatment for recurrent instability.
Recommended Citation
Chisari, Emanuele; Ashley, Blair; Sutton, Ryan; Largoza, Garrett; DiSpagna, Marco; Goyal, Nitin; Courtney, P. Maxwell; and Parvizi, Javad, "Dual-Mobility Implants and Constrained Liners in Revision Total Hip Arthroplasty" (2021). Rothman Institute Faculty Papers. Paper 152.
https://jdc.jefferson.edu/rothman_institute/152
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Language
English
Comments
This article is the authors’ final published version in Arthroplasty Today, Volume 13, December 2021, Pages 8 - 12.
The published version is available at https://doi.org/10.1016/j.artd.2021.10.012. Copyright © Chisari et al.