# Utilization of Jumbo-Sized Cups in Conjunction With Dual-Mobility Constructs Does Not Increase Risk of Re-Revision in Revision Hip Arthroplasty

## TL;DR

Using large jumbo cups with dual-mobility systems in hip replacement surgery does not increase the risk of needing further surgery compared to standard cups.

## Contribution

This study is the first to show that jumbo cups with dual-mobility constructs do not raise re-revision risk in revision hip surgery.

## Key findings

- Re-revision rates were similar between jumbo and regular cups (11.6% vs 10.3%).
- Instability-related re-revisions were also comparable (7% vs 5.1%).
- Prior surgeries increased the risk of re-revision, but cup size did not.

## Abstract

Dual-mobility (DM) articulations are increasingly used in revision total hip arthroplasty (THA) to reduce instability, but their effectiveness in conjunction with jumbo cups is unclear. This study evaluated the risk of all-cause and instability-related re-revision when DM articulations were used with jumbo vs standard cups in revision THA.

A retrospective review included 199 revision THA patients with DM articulations: 156 with regular cups and 43 with jumbo cups (≥62 mm for females, ≥66 mm for males). Exclusion criteria were cup-cage constructs, cemented DM liners in pre-existing cups, and tumor cases. The primary outcome was re-revision, with focus on instability. Student's t-test compared revision rates, and multivariable logistic regression with backward selection was used to assess the relationship between cup size and re-revision risk.

At a mean 4.6-year follow-up, re-revision rates were similar between groups (10.3% regular vs 11.6% jumbo, P = .79). Instability-related re-revisions were also comparable (5.1% regular vs 7% jumbo; P = .64). Logistic regression demonstrated that jumbo cup utilization was not associated with risk of all-cause revision (P = .99) or instability-related re-revision (P = .77). However, the number of prior surgeries increased risk for both all-cause (OR: 1.32 [1.07, 1.63], P = .009) and instability-related (OR: 1.46 [1.13, 1.87], P = .003) re-revisions.

Our results demonstrate satisfactory midterm outcomes in both jumbo and regular cup patients implanted with DM systems. These findings demonstrate that the use of DM liners in jumbo cups does not portend increased risk of re-revision compared to use of DM in regular sized cups.