AAHKS Symposium: Dual Mobility Reduces Dislocations – Why I Use It in All Revisions

Abstract Introduction Instability remains the most common complication following revision THA and presents a unique treatment dilemma for the orthopaedic surgeon. Dual mobility (DM) bearing articulations have been used in France since the 1970s, but have only become more widely adopted in the United States over the last decade. The purpose of this symposium was to discuss the role for DM bearings in revision THA. Methods We reviewed the existing literature on outcomes following dual mobility bearing articulations in revision THA. We also report several case examples of the use of dual mobility in difficult revision THA cases, including acetabular bone loss, failed constrained liner, and adverse local tissue reaction. Finally, we briefly discuss the limitations associated with the use of DM. Results Several large retrospective series demonstrate that DM bearings reduce the incidence of dislocation following revision THA when compared to conventional single bearing THA. Specific complications related to DM bearings including polyethylene wear, loosening, intra-prosthetic dislocation, and corrosion remain a concern, but appear to have drastically improved over time with modern implant designs. Conclusion Contemporary DM designs have been established as an effective bearing option to reduce instability in revision THA, although concerns do exist. High-quality prospective studies are necessary to further define the role this bearing option has in the coming years.