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

Introduction. The aim of the study was to investigate re-revision rates of dual-mobility cups in comparison with other surgical options after first time total hip revisions performed due to recurrent dislocations. Patients and 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 1388 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 fractures - 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 dislocations and 3 times lower risk of revisions for all reasons (95%CI 1.3-7,3, p=0.011) as compared with other surgical options. Conclusion. Significantly lower re-revision rate was observed for patients revised due to recurrent dislocation when dual-mobility cup was used.