Understanding wear in dual mobility total hip replacement: first generation explant wear patterns

Int Orthop. 2017 Mar;41(3):529-533. doi: 10.1007/s00264-016-3362-5. Epub 2016 Dec 7.

Abstract

Purpose: Dual mobility was introduced by Pr. G. Bousquet to improve the dislocation risk of total hip arthroplasty (THR). The wear mechanisms of this implant remain to be understood. Could enhanced explant wear analysis explain liner wear behaviour?

Methods: Sixty-six explanted liners were selected. Non-destructive 3D scanning and heat colour treatment allowed reporting wear patterns on both convex and concave sides of the liners.

Results: For many liners, liner convexity wear was found to be homogeneous, and linked to a longer implantation time. A few liners had signs of blocking of the convexity, leading to excessive internal damage. Intra prosthetic dislocations were found to only have internal circular wear without liner penetration.

Conclusion: Heat colour treatment showed its effectiveness for highlighting wear patterns. Optimal convexity mobility seemed to be leading to a longer implantation time, with decreased contact stresses on concavity. The retentive rim should have a distinct wear analysis.

Keywords: Dual mobility; Implant retrieval; THR; Wear; Wear patterns.

MeSH terms

  • Arthroplasty, Replacement, Hip / adverse effects*
  • Hip Prosthesis / adverse effects*
  • Humans
  • Imaging, Three-Dimensional / methods
  • Joint Dislocations
  • Male
  • Prosthesis Design / adverse effects*
  • Prosthesis Failure / etiology*
  • Qualitative Research