Comparison of dual-mobility cups and other surgical options used for 362 first time total hip revisions due to recurrent dislocations. Results from Lithuanian arthroplasty register

Abstract

Background: The aim of the sudy was to investigate the re-revision rate of dual-mobility cups in comparison with other surgical options after first time total hip revisions performed due to recurrent dislocations. Methods: Data were derived from the Lithuanian Arthroplasty Register, and we calculated the cumulative re-revision rates after surgery. For survival analysis, we used re-revision for all reasons and for dislocations as an end-point. Cox proportional hazards models were used to analyze the influence of various covariates (age, gender, diagnosis of primary operation and implant concept). Results: A total of 1,388 revisions were recorded from 2011 to 2015, of which 362 were performed due to recurrent dislocation. Out of 362 revisions, 247 were performed using dual-mobility cups, while others were operated using a variety of other surgical options including conventional cup, stem, femoral head exchange or anti-luxation ring. 27 patients had been re-revised for the following reasons: dislocations - 15, infections - 7, periprosthetic fracture - 3, and cup loosening - 2. Cox regression adjusting for age, gender and diagnosis of primary operation showed that the use of dual-mobility cup had 7 times (95% confidence intervals (CI): 1.8-27.5, p=0.005) lower risk of revision due to dislocation and 3 times lower risk of revision for all reasons (95%CI 1.3-7.3, p=0.011) as compared with other surgical options. Interpretation: Significantly lower re-revision rate was observed for patients revised due to recurrent dislocation when dual-mobility cups were used.