No Difference in Dislocation Rates Comparing Large Diameter Jumbo Femoral Heads and Dual-Mobility Bearings in Revision Total Hip Arthroplasty

• Published in: The Journal of arthroplasty Vol. 36; no. 11; pp. 3716 - 3721
• Main Authors: Sonn, Kevin A., Deckard, Evan R., Meneghini, R. Michael
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-11-2021
• Subjects: dislocation; dual mobility; large femoral heads; reoperation; revision total hip arthroplasty; large femoral heads; reoperation; dislocation; dual mobility; revision total hip arthroplasty
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2021.07.008

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.
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.
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.
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 III.