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Retrieval evidence of impingement at the third articulation in contemporary dual mobility cups for total hip arthroplasty

Di Laura, A; Hothi, HS; Henckel, J; Cerquiglini, A; Liow, MHL; Kwon, Y-M; Skinner, JA; (2017) Retrieval evidence of impingement at the third articulation in contemporary dual mobility cups for total hip arthroplasty. International Orthopaedics 10.1007/s00264-017-3523-1. (In press). Green open access

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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.

Type: Article
Title: Retrieval evidence of impingement at the third articulation in contemporary dual mobility cups for total hip arthroplasty
Location: Germany
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00264-017-3523-1
Publisher version: http://doi.org/10.1007/s00264-017-3523-1
Language: English
Additional information: © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Dual mobility cups, Intraprosthetic dislocation, Polyethylene impingement, Retrievals, Total hip arthroplasty
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Ortho and MSK Science
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Mechanical Engineering
URI: https://discovery.ucl.ac.uk/id/eprint/1558789
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