ArticleArthroplasty today2026
The Modular Cup-in-Cup Construct in Revision Total Hip Arthroplasty.
Article in Arthroplasty today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background: The modular cup-in-cup technique, in which a modular primary acetabular component is cemented into a highly porous monobloc tantalum revision shell, provides the intraoperative flexibility to change bearings if subsequent re-revision is required. This study seeks to characterize the early outcomes of this technique. Methods: A single-center retrospective review was performed of all patients who underwent revision total hip arthroplasty (rTHA) utilizing a modular acetabular component cemented into a highly porous monobloc tantalum revision shell. Preoperative and postoperative radiographs were assessed to quantify bone loss, cup position, and aseptic loosening. All-cause reoperation, revision for aseptic loosening, and revision for instability were estimated using the Kaplan-Meier method. Results: In total, 27 hips were identified with a mean follow-up of 21.6 months. The most common indication for revision was aseptic loosening (48.1%). Preoperatively, 16 (59.3%) hips had Paprosky 3A defects, 7 (25.9%) had Paprosky 3B, 2 (7.4%) had Paprosky 2C defects, and 1 (3.7%) had a Paprosky 2A defect. In total, 4 (14.8%) patients underwent reoperation, 3 (11.1%) for instability and 1 (3.7%) for irrigation and debridement. All patients revised for instability were converted from a dual mobility articulation to a constrained liner. No radiographic loosening was observed at final follow-up. Estimated 3-year survivorships for all-cause reoperation and revision for instability were 84.6% (95% confidence interval: 46.6-95.6%) and 88.5% (95% confidence interval, 48.8-97.6%), respectively. Conclusions: The modular cup-in-cup technique is a viable option for rTHA patients at increased risk of instability. This technique provides surgeons the flexibility to exchange the articulation if recurrent instability occurs.
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