title: Causes for revision of dual-mobility and standard primary total hip arthroplasty : Matched case-control study based on a prospective multicenter study of two thousand and forty four implants.
abstract: The causes for revision of primary total hip arthroplasty (THA) are various and quite well known. The developing use of dual-mobility THA (DM-THA) seems a relevant option to decrease the risk of instability. Due to lack of long-term follow-up, this innovative retentive concept is suspected to increase the risk of polyethylene (PE) wear. the aim of the study was to analyse the causes for DM-THA revision and assess whether or not its occurrence is different from that of fixed-standard (FS) THA , particularly for aseptic loosening or wear and/or osteolysis.
  
  
  
  The SoFCOT group conducted an observational prospective multicentre study from 1 January 2010 to 31 December 2011. Inclusion criteria comprised an exhaustive collection of 2044 first-revision THAs with 251 DM-THAs and 1793 FS-THAs. After excluding complications linked to patient factors (infection and periprosthetic fractures), we performed a matched case-control study (matching ratio 1:1) comparing two groups of 133 THAs.
  
  
  
  Revisions for aseptic loosening or osteolysis/wear were as frequent in DM-THA (58.7 %) as in FS-THA (57.1 %) (p 0.32); 7.5 % of DM-THA were revised for dislocation versus 19.5 % of FS-THA (p 0.007).
  
  
  
  Revision for osteolysis/wear and aseptic loosening were as frequent in DM-THA as in FS-THA; revision for dislocation was less frequent in DM-THA. This confirms the efficiency of the DM concept regarding the risk of dislocation. Causes for revision were different between groups, and revisions for dislocation were less frequent in DM-THA. Only prospective comparative studies could provide reliable information that may support broader use of the DM concept.
authors.affiliation: Clinique des Cèdres, 21, rue Albert Londre, 38432, Echirolles, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Prudhon
authors.affiliation: Centre Hospitalier Lyon Sud, 165, chemin du Grand Revoyet, 69495, Pierre Bénite, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Desmarchelier
authors.affiliation: Hôpital Cochin, 27, rue du Faubourg-Saint Jacques, 75679, Paris Cedex 14, France.
authors.forename: Moussa
authors.initials: M
authors.lastname: Hamadouche
authors.affiliation: Clinique de l'Yvette, 67, route Corbeil, 91160, Lonjumeau, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Delaunay
authors.affiliation: Groupe Lépine, 175 rue Jacquard, CS 50307, 69727, Genay Cedex, France. r.verdier@groupe-lepine.com.
authors.forename: Régis
authors.initials: R
authors.lastname: Verdier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000209:etiology*; D012086:Reoperation / Q000009:adverse effects / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Dual mobility; Revision; Total hip arthroplasty