Dual-Mobility Implants and Constrained Liners in Revision Total Hip Arthroplasty
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. Metho...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-02-01
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| Series: | Arthroplasty Today |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344121002041 |
| _version_ | 1818908531207700480 |
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| author | Emanuele Chisari, MD Blair Ashley, MD Ryan Sutton, MD Garrett Largoza, BS Marco Di Spagna, BS Nitin Goyal, MD P Maxwell Courtney, MD Javad Parvizi, MD |
| author_facet | Emanuele Chisari, MD Blair Ashley, MD Ryan Sutton, MD Garrett Largoza, BS Marco Di Spagna, BS Nitin Goyal, MD P Maxwell Courtney, MD Javad Parvizi, MD |
| author_sort | Emanuele Chisari, MD |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-19T22:12:30Z |
| format | Article |
| id | doaj.art-30213e79979c485b8d92a35de962060e |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-12-19T22:12:30Z |
| publishDate | 2022-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-30213e79979c485b8d92a35de962060e2022-12-21T20:03:52ZengElsevierArthroplasty Today2352-34412022-02-0113812Dual-Mobility Implants and Constrained Liners in Revision Total Hip ArthroplastyEmanuele Chisari, MD0Blair Ashley, MD1Ryan Sutton, MD2Garrett Largoza, BS3Marco Di Spagna, BS4Nitin Goyal, MD5P Maxwell Courtney, MD6Javad Parvizi, MD7Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USARothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USACorresponding author. Javad Parvizi MD, FRCS Rothman Orthopaedic Institute, 125 S 9th St. Ste 1000, Philadelphia, PA 19107. Tel.:+1 267-339-7813.; Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA, USABackground: 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.http://www.sciencedirect.com/science/article/pii/S2352344121002041Total hip arthroplastyRevisionConstrained linersDual mobility bearings |
| spellingShingle | Emanuele Chisari, MD Blair Ashley, MD Ryan Sutton, MD Garrett Largoza, BS Marco Di Spagna, BS Nitin Goyal, MD P Maxwell Courtney, MD Javad Parvizi, MD Dual-Mobility Implants and Constrained Liners in Revision Total Hip Arthroplasty Arthroplasty Today Total hip arthroplasty Revision Constrained liners Dual mobility bearings |
| title | Dual-Mobility Implants and Constrained Liners in Revision Total Hip Arthroplasty |
| title_full | Dual-Mobility Implants and Constrained Liners in Revision Total Hip Arthroplasty |
| title_fullStr | Dual-Mobility Implants and Constrained Liners in Revision Total Hip Arthroplasty |
| title_full_unstemmed | Dual-Mobility Implants and Constrained Liners in Revision Total Hip Arthroplasty |
| title_short | Dual-Mobility Implants and Constrained Liners in Revision Total Hip Arthroplasty |
| title_sort | dual mobility implants and constrained liners in revision total hip arthroplasty |
| topic | Total hip arthroplasty Revision Constrained liners Dual mobility bearings |
| url | http://www.sciencedirect.com/science/article/pii/S2352344121002041 |
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