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THA revision to dual mobility construct may reduce early complication rates

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Nicholas D. Colacchio

DALLAS — Results presented at the American Association of Hip and Knee Surgeons Annual Meeting showed significantly fewer early complications among patients who underwent limited revision by conversion to a dual mobility construct for failed monoblock metal-on-metal total hip arthroplasty compared with full acetabular cup revision.

Nicholas D. Colacchio , MD, and colleagues collected patient demographics, acetabular component design and position, exterior findings, serum metal ion levels, complications and clinical outcome scores for 143 patients undergoing revision of a monoblock metal-on-metal THA with either a complete revision of the acetabular component (n=114) or limited revision to dual mobility constructs (n=29).

“We had encouraging clinical outcome results with a [hip disability and osteoarthritis outcome score] HOOS Jr. of 85 and we did see a significant drop in the cobalt and chromium serum metal ion levels from preop to postop,” Colacchio said in his presentation here.

He noted an early re-revision rate of 3.4%, and no radiographic signs of component loosening or migration or evidence of polyethylene wear in the dual mobility group.

“We did have one patient with a small posterior meta-diaphyseal lesion,” Colacchio said. “However, the significance of this is unclear, as the patient had excellent outcomes.”

Colacchio noted patients who underwent full cup acetabular revision had more than a 4.5-times higher rate of re-revision surgery vs. patients in the dual mobility group.

“Although we did not find a statistical significance with these small cohorts, we did feel that this is highly clinically significant, particularly because of those 18 patients in the full acetabular revision cohort,” Colacchio said. “Many of them had to undergo multiple revisions, with five of them ending up with custom implants.” – by Casey Tingle

Reference:

Colacchio ND, et al. Paper 13. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 1-4, 2018; Dallas.

Disclosure: Colacchio reports no relevant financial disclosures.