A New Path for Patients Needing A Second Hip Replacement

By Jane Farrell

A newer type of artificial hip could be a good option for patients who need their original replacement taken out, according to a new study.

Although hip replacement surgery is great at relieving pain and restoring mobility, dislocation is a common complication of the procedure. The risk of this is highest in patients who have had a second hip replacement, and that procedure is known as “revision surgery.”

Now, though, research conducted by Dr. Geoffrey Westrich and colleagues at Hospital for Special Surgery, in New York City, and other joint replacement centers indicates that a newer type of artificial hip known as a “modular dual mobility” implant could be a good choice for patients who need a revision surgery.

The study represents good news for patients who need to have their original hip replacement taken out.

Their study was presented at the annual meeting of the American Association of Hip and Knee Surgeons in Dallas.

“Although the concept of dual mobility was originally developed in France in the 1970s, the technology is relatively new in the United States,” said Westrich, director of research of the Adult Reconstruction and Joint Replacement Service at HSS. “Our study found that the newer technology with modular dual mobility components offered increased stability, lowering the risk of dislocation, without compromising hip range of motion in patients having a revision surgery.” (See “Better Hip Replacements.”)

“Currently, there are few large-scale outcome studies on the modular dual mobility device in revision hip replacement,” Westrich said. “We set out to determine the rate of dislocation and the need for another surgery following revision hip replacement using this implant.”

The investigators’ study included 370 patients who underwent revision hip replacement with the dual mobility implant between April 2011 and April 2017. The average patient age at the time of surgery was 65.8 years. Clinical, radiographic and patient reported-outcome information was collected.

To be included in the final report, patients needed to be seen for follow-up for at least two years after their surgery, and the average follow-up was 3.3 years. “At the latest follow-up, we found that surgery with the dual mobility implant resulted in a very low rate of instability for the revision patients, namely 2.9 percent, with good functional improvement and a low rate of reoperation,” Westrich noted. “While longer-term follow-up is needed to fully assess the newer device, in our study there was clearly a benefit provided by the dual mobility implant in the first few years following revision surgery.”