Dual-Mobility Constructs in Revision Total Hip Arthroplasties

Dislocation after revision total hip arthroplasty (THA) continues to be one of the most common and concerning complications after the procedure. As with every hip arthroplasty, it is essential to optimize component positioning, minimize impingement, and maintain the integrity of the abductor complex during the revision THAs. However, in several revision circumstances, additional strategies are required to mitigate the risk of dislocation, particularly those being revised for instability or those with cognitive or neuromuscular disorders. In such revision THAs, dual-mobility constructs offer lower rates of dislocations and re-revisions for dislocations in the midterm. However, it is important to note that dualmobility constructs should not be considered as compensation for poor surgical technique or technical errors such as poor cup orientation or inappropriate restoration of soft-tissue tension. While intra-prosthetic dislocations are a unique complication to dual-mobility constructs, they are exceedingly rare. Furthermore, additional follow-up is required with modular dual-mobility constructs utilized with increasing frequency during revision THAs in North America. (C) 2018 Elsevier Inc. All rights reserved.