Dual mobility (DM) is an established option in THA but limited long term reports are available, especially considering whole construct outcome. We report a consecutive series of high-risk patients stratified on evidence-based criteria to receive a DM primary THA. Importantly documenting re-operation for any reason including peri-prosthetic fracture (PPF). Retrospective review of patients under-going a DM THA between 1st March 2006 - 1st October 2024. Individual national digital records were reviewed that identify all healthcare episodes. Primary outcome measures were whole construct outcome with survivorship for all-cause revision and any major re-operation. Secondary outcomes dislocation, PPF and PROMS. Cohort of 318 cases with a mean age of 74.4 years (21.3–94.1). Using Kaplan Meier analysis at median F/U of 7.4 years (19.6–1.0) survivorship free of all-cause revision & major re-operation was 97.9% (95% CI 94.8%–99.1%) where non-OA was indication in 39.6%. We observed 2 dislocations (0.63%). With 5 revisions identified (2 PJI, 2 PPF, 1 instability). A further 4 patients had a PPF treated by fixation (1 type B & 3 type C) and one PPF treated non-operative (AG). Post-operative PPF was the most observed complication (2.2%) occurring a mean of 3.5 years (0.7–10.6). Mean gain in OHS 24.6. Our results demonstrate the successful use of DM in patients’ high risk for instability undergoing THA at a maximum follow-up approaching 20 years and confirm PPF is the most common reason for re-operation. We believe our cohort as well as high-risk for instability is also a high falls risk population. This re-enforces the need to consider all patient and implant factors when deciding bearing.
Hallikeri et al. (Thu,) studied this question.
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