Hip Stability Parameters with Dual Mobility, Modular Dual Mobility and Fixed Bearing in Total Hip Arthroplasty: an Analytical Evaluation

Abstract Background. Use of dual mobility in total hip arthroplasty has gained popularity due to the ability to reduce dislocation through increased jumping distance and impingement-free arc of movement. Recently, modular dual mobility systems were introduced to give the possibility to use dual mobility with standard metal-backed shells, however few has been studied to date regarding how jumping distance and the center of rotation changed with modular dual mobility. The objective of this study was to evaluate, through analytical simulation, how jumping distance and center of rotation change between dual mobility and standard cup with modular dual mobility or fixed bearings. Methods. 3D-models of dual mobility and standard press-fit cups with modular dual mobility or fixed bearings liners were used to simulate dual mobility, modular dual mobility and fixed bearings implant configurations, matched for same cup size, according to same cup position, different femoral head diameters. Jumping distance was calculated and center of rotation lateralization was measured for different sizes.Results. Jumping distance with modular dual mobility was reduced by -3.9mm to -8.6mm in comparison with dual mobility, from 48 to 64mm sizes. Jumping distance with modular dual mobility resulted comparable to jumping distance with polyethylene fixed bearings with Ø36mm femoral head but increased by +1.1mm and +1.4mm than jumping distance with ceramic fixed bearings with Ø36 and Ø40mm femoral heads for sizes >54mm. Modular dual mobility lateralized the center of rotation up to +2.5mm and +4.0mm in comparison with dual mobility and fixed bearings, respectively. Conclusions. Jumping distance with modular dual mobility resulted lower than dual mobility and comparable to fixed bearings polyethylene liner with Ø36mm femoral head for larger sizes. Modular dual mobility lateralized the center of rotation in comparison with both dual mobility and fixed bearings cups.Trial Registration. Not applicable.

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Hip Stability Parameters with Dual Mobility, Modular Dual Mobility and Fixed Bearing in Total Hip Arthroplasty: an Analytical Evaluation.

10.21203/rs.3.rs-864696/v1 ◽

2021 ◽

Author(s):

Domenico Tigani ◽

Lorenzo Banci ◽

Riccardo Valtorta ◽

Luca Amendola

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

3D Models ◽

Stability Parameters ◽

Dual Mobility ◽

Center Of Rotation ◽

Total Hip ◽

Press Fit ◽

Hip Stability

Abstract Background. Use of dual mobility in total hip arthroplasty has gained popularity due to the ability to reduce dislocation through increased jumping distance and impingement-free arc of movement. Recently, modular dual mobility systems were introduced to give the possibility to use dual mobility with standard metal-backed shells, however few has been studied to date regarding how jumping distance and the center of rotation changed with modular dual mobility. The objective of this study was to evaluate, through analythical simulation, how jumping distance and center of rotation change between dual mobility and standard cup with modular dual mobility or fixed bearings. Methods. 3D-models of dual mobility and standard press-fit cups with modular dual mobility or fixed bearings liners were used to simulate dual mobility, modular dual mobility and fixed bearings implant configurations, matched for same cup size, according to same cup position, different femoral head diameters. Jumping distance was calculated and center of rotation lateralization was measured for different sizes.Results. Jumping distance with modular dual mobility was reduced by -3.9mm to -8.6mm in comparison with dual mobility, from 48 to 64mm sizes. Jumping distance with modular dual mobility resulted comparable to jumping distance with polyethylene fixed bearings with Ø36mm femoral head but increased by +1.1mm and +1.4mm than jumping distance with ceramic fixed bearings with Ø36 and Ø40mm femoral heads for sizes >54mm. Modular dual mobility lateralized the center of rotation up to +2.5mm and +4.0mm in comparison with dual mobility and fixed bearings, respectively. Conclusions. Jumping distance with modular dual mobility resulted lower than dual mobility and comparable to fixed bearings polyethylene liner with Ø36mm femoral head for larger sizes. Modular dual mobility lateralized the center of rotation in comparison with both dual mobility and fixed bearings cups.

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Cost Analysis of Dual-Mobility Versus Large Femoral Head Constructs in Revision Total Hip Arthroplasty

The Journal of Arthroplasty ◽

10.1016/j.arth.2018.09.085 ◽

2019 ◽

Vol 34 (2) ◽

pp. 260-264 ◽

Cited By ~ 8

Author(s):

Matthew P. Abdel ◽

Larry E. Miller ◽

Arlen D. Hanssen ◽

Mark W. Pagnano

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Cost Analysis ◽

Hip Arthroplasty ◽

Revision Total Hip Arthroplasty ◽

Dual Mobility ◽

Large Femoral Head ◽

Total Hip

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Hip Stability in Primary Total Hip Arthroplasty Using an Anatomically Sized Femoral Head

Orthopedics ◽

10.3928/01477447-20090527-09 ◽

2009 ◽

Vol 32 (7) ◽

pp. 489-492 ◽

Cited By ~ 6

Author(s):

Milton J. Smit

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Total Hip ◽

Hip Stability ◽

Primary Total Hip Arthroplasty

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The Current Role of Dual Mobility Articulations in Total Hip Arthroplasty

The Journal of Hip Surgery ◽

10.1055/s-0038-1676637 ◽

2018 ◽

Vol 02 (04) ◽

pp. 194-204

Author(s):

Hari Parvataneni ◽

Luis Pulido ◽

Hernan Prieto ◽

Arnold Silverberg

Keyword(s):

High Risk ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Clinical Success ◽

The United States ◽

Revision Hip Arthroplasty ◽

Dual Mobility ◽

Total Hip ◽

Hip Stability

AbstractThe concept of dual mobility (DM) bearings in total hip arthroplasty was first introduced by Professors Gilles Bousquet and Andre Rambert in France in 1974 with the goal of enhancing hip stability. Although DM did not receive U.S. Food and Drug Administration approval for commercial use in the United States until 2009, there has been a surge in popularity of DM implants over the past several years, evidenced by the American Joint Replacement Registry data. The enthusiasm for DM stems from a growing body of literature that supports its use across a range of patient populations, most notably revision hip arthroplasty and high-risk primary scenarios. DM has been shown to effectively reduce the risk of dislocation while also exhibiting excellent survivorship. DM does incur some unique risks, namely, intraprosthetic dissociation, but many of the early concerns with DM have not been realized in the literature and do not seem to negatively impact its long-term survivorship. The exact indications for DM have yet to be defined and remain a matter of debate. It should be considered as an alternative for any primary or revision hip arthroplasty at high risk for postoperative instability. In this article, the authors review the current literature regarding the clinical success of DM implants for a variety of indications, all of which predispose to hip instability. The history, basic biomechanics, modern designs, and unique complications are also discussed.

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Relevance of a press-fit dual mobility cup to deal with recurrent dislocation of conventional total hip arthroplasty: a 29-case series

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-012-1002-3 ◽

2012 ◽

Vol 23 (4) ◽

pp. 431-436 ◽

Cited By ~ 23

Author(s):

D. Saragaglia ◽

S. Ruatti ◽

R. Refaie

Keyword(s):

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Case Series ◽

Recurrent Dislocation ◽

Dual Mobility Cup ◽

Dual Mobility ◽

Total Hip ◽

Press Fit

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Early Intraprosthetic Dislocation of Dual-Mobility Total Hip Arthroplasty Implant Following Attempted Closed Reduction: A Case Report

Reconstructive Review ◽

10.15438/rr.4.3.76 ◽

2014 ◽

Vol 5 (2) ◽

pp. 23-26 ◽

Cited By ~ 2

Author(s):

Joseph Schirmers, MD ◽

Ryan Horazdovsky, MD ◽

Scott Marston, MD

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Late Complication ◽

Polyethylene Liner ◽

Consecutive Series ◽

Original Design ◽

Dual Mobility ◽

Total Hip ◽

Intraprosthetic Dislocation

Introduced in 1974 by Bousquet, the dual-mobility bearing for use in total hip arthroplasty (THA) confers increased jump distance and improved overall stability relative to conventional THA designs [1-3]. The dual-mobility bearing incorporates a relatively small (22-28mm) metal or ceramic femoral head press fit into a larger polyethylene liner which articulates with the acetabular component. Dissociation of the femoral head from the polyethylene liner (intraprosthetic dislocation) is a known late complication thought to be related to polyethylene liner wear and has been previously reported [2-7]. In a consecutive series of 384 primary THAs employing Bousquet’s original design, there were 14 intraprosthetic dislocations over 15 years (3.6%). The authors cited polyethylene wear as causative and mean time to intraprosthetic dislocation was 8.9 years [2].

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