Salvage of Monoblock Metal-on-Metal Acetabular Components Using a Dual-Mobility Bearing

Abstract

Background: Large-diameter, monoblock acetabular components have been used for both hip resurfacing arthroplasty and metal-on-metal (MoM) total hip arthroplasty (THA). If revision is required, one solution is to retain the shell and use a dual-mobility bearing.

Methods: We reviewed the results of 25 revision THAs including 11 hip resurfacing arthroplasty and 14 MoM THAs where a monoblock acetabular component was mated to a dual-mobility bearing.

Results: At a mean of 29 months, there was one failure, an intraprosthetic dislocation of the dual-mobility bearing. There was a significant decrease in serum metal ion levels postoperatively.

Conclusion: Retention of a well-fixed, monoblock MoM acetabular shell and mating it to a dual-mobility bearing in the setting of revision surgery seems to be a reasonable, low-morbidity option at short-term follow-up in appropriately positioned cups.

Keywords: adverse local tissue reaction; bearing surfaces; metal-on-metal; revision total hip arthroplasty; salvage monoblock metal-on-metal; total hip arthroplasty.