Evidence map›Paper›PMID 42238177›Full record

ReviewCureus2026

Dual Mobility vs Constrained Liners in Managing Instability After Revision Total Hip Arthroplasty: A Systematic Review and Exploratory Cost-Effectiveness Model.

Arfaz Shaik, Nimra Akram, Mustafa Al-Saadi, Umar Hayat, Irrum Afzal, Sarkhell Radha

Abstract readReview
In one paragraph

Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Arfaz ShaikOrthopaedics and Trauma, Croydon University Hospital, Croydon Health Services NHS Trust, London, GBR.
Nimra AkramOrthopaedics, Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, GBR.
Mustafa Al-SaadiOrthopaedics, Medway Maritime Hospital, Medway NHS Foundation Trust, Gillingham, GBR.
Umar HayatOrthopaedics, Medway Maritime Hospital, Medway NHS Foundation Trust, Gillingham, GBR.
Irrum AfzalOrthopaedics, Croydon University Hospital, Croydon Health Services NHS Trust, London, GBR.
Sarkhell RadhaOrthopaedics, Croydon University Hospital, Croydon Health Services NHS Trust, London, GBR.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Recurrent dislocation following revision total hip arthroplasty (THA) remains a major clinical challenge. Dual-mobility (DM) constructs and constrained liners (CLs) are commonly used to improve stability; however, direct comparative evidence remains limited. A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Multiple databases were searched from January 2000 to October 2025 for studies comparing DM constructs and CLs in revision THA. The primary outcomes were dislocation and aseptic re-revision, while secondary outcomes included implant survivorship, patient-reported outcome measures (PROMs), patient- and construct-related risk factors, and non-revision complications. Due to heterogeneity in study designs, results were synthesized descriptively. Ten comparative observational studies comprising 2,046 revision hips (1,237 DM and 809 CL) were included. DM constructs were associated with lower reported dislocation and aseptic re-revision rates compared with CLs. Five-year re-dislocation-free survivorship ranged from 78% to 85% across comparative cohorts. In registry-based analyses, the 10-year cumulative aseptic re-revision rate was 8.6% for DM and 13.1% for CLs. PROMs, assessed using the modified Harris Hip Score (mHHS), improved similarly in both groups. No included comparative study reported primary cost or cost-utility data. However, external economic models suggest potential cost-effectiveness advantages with DM constructs. These benefits were driven primarily by lower complication rates and fewer re-revisions. In revision THA, DM constructs are consistently associated with lower postoperative instability compared with CLs in comparative observational studies. Evidence regarding reductions in aseptic re-revision is heterogeneous, reflecting competing failure mechanisms and the limitations of non-randomized data. Economic implications remain uncertain due to the absence of primary cost-utility analyses. Implant selection should therefore be individualized, and high-quality prospective comparative studies with standardized outcome reporting are needed to define optimal construct selection in revision THA.

Indexed as

constrained linersdislocationsdual-mobilityinstabilitymeta-analysisre-revisionrevision thasurvivorship

Identifiers

PMID42238177
PMCPMC13229384

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.