Conclusion Based on the current data , the use of DM acetabular components are effective in minimising the risk of instability after both primary and revision THA .
This benefit must be balanced against continuing concerns about the additional modularity , and the new mode of failure of intraprosthetic dislocation .
Aims The aim of this systematic review was to report the rate of dislocation following the use of dual mobility ( DM ) acetabular components in primary and revision total hip arthroplasty ( THA ) .
The Frank Stinchfield Award: Dislocation in Revision THA: Do Large Heads (36 and 40 mm) Result in Reduced Dislocation Rates in a Randomized Clinical Trial?
Background Dislocation after revision THA is a common complication . Large heads have the potential to decrease dislocation rate , but it is unclear whether they do so in revision THA . Questions / purpose sWe therefore determined whether a large femoral head ( 36 and 40 mm ) result ed in a decreased dislocation rate compared to a st and ard head ( 32 mm ) . Methods We r and omized 184 patients undergoing revision THA to receive either a 32-mm head ( 92 patients ) or 36- and 40-mm head ( 92 patients ) and stratified patients by surgeon . The two groups had similar baseline demographics . The primary end point was dislocation . Quality -of-life ( QOL ) measures were WOMAC and SF-36 . The mean followup for dislocation was 5 years ( range , 2–7 years ) ; the mean followup for QOL was 2.2 years ( range , 1.6–4 years ) . Results In the 36- and 40-mm head group , the dislocation rate was 1.1 % ( one of 92 ) versus 8.7 % ( eight of 92 ) for the 32-mm head . There was no difference in QOL outcomes between the two groups . Conclusions Our observations confirm a large femoral head ( 36 or 40 mm ) reduces dislocation rates in patients undergoing revision THA at short-term followup . We now routinely use large heads with a highly crosslinked polyethylene acetabular liner in all revision THAs . Level of Evidence Level I , therapeutic study . See Guidelines for Authors for a complete description of levels of evidence
Conclusion Based on the current data , the use of DM acetabular components are effective in minimising the risk of instability after both primary and revision THA .
This benefit must be balanced against continuing concerns about the additional modularity , and the new mode of failure of intraprosthetic dislocation .
Aims The aim of this systematic review was to report the rate of dislocation following the use of dual mobility ( DM ) acetabular components in primary and revision total hip arthroplasty ( THA ) .