Meta-analysis of efficacy and safety of modular dual mobility for revision hip arthroplasty

Background: This meta-analysis aimed to evaluate the efficacy and safety of modular dual mobility (MDM) in revision hip arthroplasty. Methods: We conducted a systematic search of databases. The primary outcome of interest was complications, while quality of life or functionality was evaluated using the Harris Hip Score (HHS) and Short Form-12 (SF-12). Data were combined using Review Manager 5.4. 9 studies ( n = 648) were included. Results: The results indicated a statistically significant improvement in the quality of life or functionality of patients at the end of the follow-up period (standardised mean difference −1.48, 95% CI, −2.24–−0.72). The incidences of dislocation, revision, infection, aseptic loosening, and periprosthetic fracture were 8.69%, 11.92%, 11.38%, 5.69%, and 1.27%, respectively. The revision and aseptic loosening survivorship rates were 91% (95% CI, 80–96%) and 98% (95% CI 89–99%), respectively, at 36 months. Blood loss was similar among studies, while corrosion measured by cobalt-chromium levels in blood exceeded clinically relevant limits in some studies. Radiolucency around the acetabular shell, cup inclination, and anteversion were assessed. Conclusions: This meta-analysis suggests that modular dual mobility is a safe and effective option for revision hip arthroplasty, with significant improvement in the quality of life of patients. However, the possibility of corrosion by modular dual mobility should be carefully monitored in selected patients. PROSPERO registration: CRD42023424561