scholarly journals Incomplete Seating of Modular Dual Mobility Metal Liner within a Hemispherical Acetabular Shell

2020 ◽  
Vol 33 (1) ◽  
pp. 30-33
Author(s):  
Murukan Babu ◽  
Philip K Thomas ◽  
Paul K Jose
Keyword(s):  
Dual Mobility ◽  
Acetabular Shell ◽  
Metal Liner

Fretting and corrosion of metal liners from modular dual mobility constructs

2021 ◽  
Vol 103-B (7) ◽  
pp. 1238-1246
Author(s):  
Kimberly J. Hemmerling ◽  
Lydia Weitzler ◽  
Thomas W. Bauer ◽  
Douglas E. Padgett ◽  
Timothy M. Wright
Keyword(s):  
Crevice Corrosion ◽  
Corrosion Products ◽  
Chromium Alloy ◽  
Cobalt Chromium ◽  
Metal Shell ◽  
Implant Surface ◽  
Dual Mobility ◽  
Metal Liner ◽  
Scanning Electron ◽  
Cobalt Chromium Alloy

Aims Dual mobility implants in total hip arthroplasty are designed to increase the functional head size, thus decreasing the potential for dislocation. Modular dual mobility (MDM) implants incorporate a metal liner (e.g. cobalt-chromium alloy) in a metal shell (e.g. titanium alloy), raising concern for mechanically assisted crevice corrosion at the modular liner-shell connection. We sought to examine fretting and corrosion on MDM liners, to analyze the corrosion products, and to examine histologically the periprosthetic tissues. Methods A total of 60 retrieved liners were subjectively scored for fretting and corrosion. The corrosion products from the three most severely corroded implants were removed from the implant surface, imaged using scanning electron microscopy, and analyzed using Fourier-transform infrared spectroscopy. Results Fretting was present on 88% (53/60) of the retrieved liners, and corrosion was present on 97% (58/60). Fretting was most often found on the lip of the taper at the transition between the lip and the dome regions. Macrophages and particles reflecting an innate inflammatory reaction to corrosion debris were noted in six of the 48 cases for which periprosthetic tissues were examined, and all were associated with retrieved components that had high corrosion scores. Conclusion Our results show that corrosion occurs at the interface between MDM liners and shells and that it can be associated with reactions in the local tissues, suggesting continued concern that this problem may become clinically important with longer-term use of these implants. Cite this article: Bone Joint J 2021;103-B(7):1238–1246.

scholarly journals Treatment of Severe Acetabular Bone Loss Using a Tantalum Acetabular Shell and a Cemented Monoblock Dual Mobility Acetabular Cup

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Christopher M. Melnic ◽  
Wayne B. Cohen-Levy ◽  
Santiago A. Lozano-Calderon ◽  
Marilyn Heng
Keyword(s):  
Bone Loss ◽  
Acetabular Cup ◽  
Dual Mobility ◽  
Acetabular Bone ◽  
Acetabular Bone Loss ◽  
Acetabular Shell

scholarly journals Adverse reaction to metal debris due to fretting corrosion between the acetabular components of modular dual-mobility constructs in total hip replacement: a systematic review and meta-analysis

2021 ◽  
Vol 6 (5) ◽  
pp. 343-353
Author(s):  
Jonathan M. R. French ◽  
Paul Bramley ◽  
Sean Scattergood ◽  
Nemandra A. Sandiford
Keyword(s):  
Systematic Review ◽  
Adverse Reaction ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Meta Analysis ◽  
Fretting Corrosion ◽  
Metal Debris ◽  
Dual Mobility ◽  
Total Hip ◽  
Metal Liner

Modular dual-mobility (MDM) constructs can be used to reduce dislocation rates after total hip replacement (THR). However, there are concerns about adverse reaction to metal debris (ARMD) as a result of fretting corrosion between the metal liner and shell. This systematic review reports outcomes following THR using MDM components. It was registered with PROSPERO and conducted in line with Cochrane and PRISMA recommendations. Sixteen articles were included overall, with meta-analysis performed on relevant subsets using a random intercept logistic regression model. Estimated median incidence of ARMD requiring revision surgery within study follow-up period was 0.3% (95% CI 0.1 – 1.8%, from 11 cohort studies containing 1312 cases). Serum metal ion levels were mildly raised in 7.9% of cases, and significantly raised in 1.8%, but there was no correlation with worse clinical hip function scores within studies. Dislocation rate was 0.8%. Revision rate was 3.3%. There are mixed reports of wear on the backside of the metal liner from the acetabular shell and screw heads. Both implant design and component malseating are implicated, but currently it is unclear to what extent each factor is responsible. Studies were poor quality with high risk of confounding, especially from trunnion corrosion. We have made recommendations for further work. In the meantime, surgeons should be aware of the potential risk of ARMD when considering using an MDM prosthesis, and, if selecting one, must ensure proper seating of the liner and screws intraoperatively. Cite this article: EFORT Open Rev 2021;6:343-353. DOI: 10.1302/2058-5241.6.200146

Conversion of Hip Resurfacing With Retention of Monoblock Acetabular Shell Using Dual-Mobility Components

2019 ◽  
Vol 34 (9) ◽  
pp. 2037-2044 ◽  
Author(s):  
Jason L. Blevins ◽  
Tony S. Shen ◽  
Rachelle Morgenstern ◽  
Thomas A. DeNova ◽  
Edwin P. Su
Keyword(s):  
Hip Resurfacing ◽  
Dual Mobility ◽  
Acetabular Shell

scholarly journals Canted seating of the Stryker Modular Dual Mobility liner within a Trident hemispherical acetabular shell

2016 ◽  
Vol 2 (1) ◽  
pp. 19-22 ◽  
Author(s):  
Scott M. Eskildsen ◽  
Erik C. Olsson ◽  
Daniel J. Del Gaizo
Keyword(s):  
Dual Mobility ◽  
Acetabular Shell

Ionenfreisetzung von modularen Dual Mobility Implantaten

2020 ◽  
Author(s):  
C Bader ◽  
A Pfaff ◽  
N Reina ◽  
KD Heller ◽  
H Haas ◽  
...  
Keyword(s):  
Dual Mobility

scholarly journals Trends and developments in hip and knee arthroplasty technology

2021 ◽  
Vol 8 ◽  
pp. 205566832095204
Author(s):  
Martin Marsh ◽  
Simon Newman
Keyword(s):  
Knee Arthroplasty ◽  
Standard Of Care ◽  
Hip Resurfacing ◽  
Implant Survival ◽  
Dual Mobility ◽  
Joint Replacements ◽  
Robotic Assisted Surgery ◽  
Hip And Knee Arthroplasty ◽  
Hip Stems ◽  
Hip And Knee Surgery

The developments in hip and knee arthroplasty over recent years have aimed to improve outcomes, reduce complications and improve implant survival. This review describes some of the most interesting trends and developments in this important and fast-moving field. Notable developments have included ceramic hip resurfacing, mini hip stems, cementless knee replacement and the wider adoption of the dual mobility articulation for hip arthroplasty. Advances in additive manufacturing and the surface modification of joint replacements offer increasing options for more challenging arthroplasty cases. Robotic assisted surgery is one of the most interesting developments in hip and knee surgery. The recent growth in the use of this technology is providing data that will help determine whether this approach should become the standard of care for hip and knee arthroplasty in the future.

scholarly journals What Factors Reduce the Incidence of Early Dislocations in Aseptic Total Hip Revisions with Stem Retention?

2021 ◽  
Author(s):  
Jesus M. Villa ◽  
Tejbir S. Pannu ◽  
Preetesh D. Patel ◽  
Wael K. Barsoum ◽  
Carlos A. Higuera ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Surgical Approach ◽  
Preoperative Diagnosis ◽  
Pearson Correlation ◽  
Dual Mobility ◽  
Total Hip ◽  
Stem Retention ◽  
Postoperative Dislocation ◽  
Skin To Skin ◽  
Cup Revision

AbstractIt is unclear which factors are the most important protectors for early postoperative dislocation in aseptic total hip arthroplasty (THA) revisions with stem retention. Therefore, we sought to determine what factors reduce the incidence of dislocations among these patients. Single institution retrospective review was made of 83 consecutive aseptic THA revisions of the head/liner and/or cup performed by five surgeons between 2017 and 2020. Periprosthetic infections and femoral component revisions were excluded. Demographics, preoperative diagnosis, revision type, surgical approach, use of dual mobility systems, length of stay, skin-to-skin time, transfusions, complications, and dislocations were assessed. Pearson correlation/logistic regression analyses were used to determine association/independent predictors of dislocation; α was set at 0.05. The overall dislocation rate was 12%. In Pearson correlation, only preoperative diagnosis (instability vs. other, −0.241, p = 0.028) and revision type (only liner vs. cup, −0.304, p = 0.005) were significantly associated with dislocations. In logistic regression, only preoperative diagnosis other than instability (odds ratio [OR] = 0.235, p = 0.038) and cup revision (OR = 0.130, p = 0.014) were found significant protectors against dislocation. Surgical approach and dual mobility systems were not independent predictors of dislocations (p = 0.184 and p = 0.083, respectively). Dislocation rates were significantly different between those cases that had the cup revised (4.0%) and those that did not (24.2%; p = 0.012). Preoperative diagnosis other than instability and cup revision seemed to be protective against early dislocation. Revision of the cup, in particular, seemed to be the most important factor to avoid dislocations while use of dual mobility liners per se did not significantly reduce that risk. The role of isolated liner exchanges in revision THA continues to evolve and should be reserved for appropriately selected patients.

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