Dual-Mobility Constructs in Primary and Revision Total Hip Arthroplasty: A Systematic Review of Comparative Studies

Abstract Background Utilization of dual-mobility constructs in total hip arthroplasties (THA) has increased in the recent years. Benefits and risks of these implants in terms of reducing dislocations, long-term survivorship, and associated complications are uncertain when compared to non-dual-mobility articulations. Methods A systematic review of prospective and retrospective studies that compared dual-mobility constructs with controls for primary or revision THAs between 1986 and 2018 was performed. All articles in both English and French were reviewed. Results Five studies with primary THAs and 6 with revision THAs were analyzed. For primary THAs, the overall rate of dislocation was 0.9% in the dual-mobility group compared to 6.8% in the control group ( P P P  = .87) for revision, 2.97 ( P  = .04) for revision due to dislocation, 1.67 ( P  = .57) for infection, 0.6 ( P  = .53) for fracture, and 1.21 ( P  = .81) for aseptic loosening. Similarly, for revision THAs, the overall dislocation rates were 2.2% compared to 7.1% ( P P P P  = .007) for re-revision due to dislocation, 1.51 ( P  = .32) for infection, 1.18 ( P  = .81) for fracture, and 2.71 ( P  = .003) for aseptic loosening. Conclusion This systematic review of comparative studies supports the efficacy of dual-mobility constructs to minimize dislocation after both primary and revision THAs in addition to excellent mid-term survivorship compared to control constructs. However, further evidence is needed to evaluate the long-term risks and benefits of dual-mobility constructs in the primary and revision THA setting when compared to contemporary conventional implants. Level of Evidence III, therapeutic.