Retrieval Evidence of Impingement at the Third Articulation in Contemporary Dual Mobility Cups for Total Hip Arthroplasty

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2017 Jun 5

PMID 28578471

Citations 9

Authors

Anna Di Laura

Harry S Hothi

Johann Henckel

Arianna Cerquiglini

Ming Han Lincoln Liow

Young-Min Kwon

John A Skinner

Alister J Hart

Affiliations

Soon will be listed here.

Abstract

Purpose: We aimed to assess polyethylene liners of retrieved hips of one design of a dual mobility (DM) cup liner and two designs of femoral stems to better understand the role of femoral stem design on polyethylene impingement.

Methods: This was a case-control study involving 70 retrieved highly cross-linked polyethylene (X3) liners used with ABGII (n = 35) and Rejuvenate (n = 35) stems (Stryker). All polyethylene liners were assessed for evidence of rim deformation and the damage quantified using metrology methods.

Results: A total of 80% of polyethylene liners paired with ABGII necks had macroscopic evidence of neck impingement resulting in a raised lip whilst 23% of liners paired with Rejuvenate necks had evidence of a raised lip (p < 0.0001). The height of the raised rims of the DM cups paired with ABGII necks had a median (range) of 139 μm (72-255). The height of the raised rims of the DM cups paired with Rejuvenate necks had a median (range) of 52 μm (45-90) (p < 0.0001).

Conclusion: Our new findings from retrieved dual mobility bearings showed that polyethylene liner rim deformation resulting from impingement with the femoral neck occurs in early in-human function, is circumferential in distribution, and is affected by the stem neck design. We recommend the use of highly polished and non-edged neck designs when used in conjunction with DM cups.

Citing Articles

Femoral Neck Design Does Not Impact Revision Risk After Primary Total Hip Arthroplasty Using a Dual Mobility Cup.

van Dooren B, Peters R, Visser D, Van Steenbergen L, Bos P, Zijlstra W Arthroplast Today. 2024; 25:101281.

PMID: 38292143 PMC: 10826135. DOI: 10.1016/j.artd.2023.101281.

Analysis of an explanted dual mobility cup after 21 years, parabolic wear pattern: A case report.

Fessy M, Fessy A, Viste A SICOT J. 2023; 9:3.

PMID: 36661475 PMC: 9878998. DOI: 10.1051/sicotj/2022052.

Which femoral neck for a dual mobility cup? A biomechanical evaluation.

Wegrzyn J, Longaray J, Baez R, Herrera L Int Orthop. 2022; 46(8):1783-1793.

PMID: 35570206 PMC: 9349148. DOI: 10.1007/s00264-022-05415-z.

Late Breakage of a Dual-Mobility Polyethylene Insert in a Revision Total Hip Arthroplasty: An Unusual Failure Mode.

Rodriguez Perez D, Agullo Ferre J, Del Carmen Rodriguez M, Monsonet C Arthroplast Today. 2021; 12:7-11.

PMID: 34746346 PMC: 8551416. DOI: 10.1016/j.artd.2021.07.013.

Absence of instabilities and intra-prosthetic dislocations at 7 to 11 years following THA using a fourth-generation cementless dual mobility acetabular cup.

Chouteau J, Rollier J, Bonnin M, Saffarini M, Nover L, Chatelet J J Exp Orthop. 2020; 7(1):51.

PMID: 32661747 PMC: 7359208. DOI: 10.1186/s40634-020-00265-3.

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