Higher UHMWPE wear-rate in cementless compared with cemented cups with the Saturne® Dual-Mobility acetabular system

Tábori-Jensen, Steffan; Frølich, Christina; Hansen, Torben Bæk; Bøvling, Søren; Homilius, Morten; Stilling, Maiken

doi:10.1177/1120700018768615

Cited by 7 publications

(7 citation statements)

References 46 publications

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“…An in vivo study with ultra-high molecular polyethylene dual mobility bearings showed that rates of wear of more than a threshold of 0.1 mm/year may risk the development of osteolysis. 40 More recently, a radioisometric analysis of highly cross-linked polyethylene showed no higher rates of wear than with traditional single bearings. 41 However, comparison of wear is beyond the scope of this study.…”

Section: Discussionmentioning

confidence: 99%

A cost-effectiveness assessment of dual-mobility bearings in revision hip arthroplasty

Khoshbin

Haddad

Ward

et al. 2020

The Bone & Joint Journal

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Aims The rate of dislocation when traditional single bearing implants are used in revision total hip arthroplasty (THA) has been reported to be between 8% and 10%. The use of dual mobility bearings can reduce this risk to between 0.5% and 2%. Dual mobility bearings are more expensive, and it is not clear if the additional clinical benefits constitute value for money for the payers. We aimed to estimate the cost-effectiveness of dual mobility compared with single bearings for patients undergoing revision THA. Methods We developed a Markov model to estimate the expected cost and benefits of dual mobility compared with single bearing implants in patients undergoing revision THA. The rates of revision and further revision were calculated from the National Joint Registry of England and Wales, while rates of transition from one health state to another were estimated from the literature, and the data were stratified by sex and age. Implant and healthcare costs were estimated from local procurement prices and national tariffs. Quality-adjusted life-years (QALYs) were calculated using published utility estimates for patients undergoing THA. Results At a minimum five-year follow-up, the use of dual mobility was cost-effective with an estimated incremental cost-effectiveness ratio (ICER) of between £3,006 and £18,745/QALY for patients aged < 55 years and between 64 and 75 years, respectively. For those aged > 75 years dual mobility was only cost-effective if the timeline was beyond seven years. The use of dual mobility bearings was cost-saving for patients aged < 75 years and cost-effective for those aged > 75 years if the time horizon was beyond ten years. Conclusion The use of dual mobility bearings is cost-effective compared with single bearings in patients undergoing revision THA. The younger the patient is, the more likely it is that a dual mobility bearing can be more cost-effective and even cost-saving. The results are affected by the time horizon and cost of bearings for those aged > 75 years. For patients aged > 75 years, the surgeon must decide whether the use of a dual mobility bearing is a viable economic and clinical option. Cite this article: Bone Joint J 2020;102-B(9):1128–1135.

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Section: Discussionmentioning

confidence: 99%

A cost-effectiveness assessment of dual-mobility bearings in revision hip arthroplasty

Khoshbin

Haddad

Ward

et al. 2020

The Bone & Joint Journal

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“…Dual mobility (DM) cups became increasingly popular in recent years, as they proved effective at preventing articular instability, by virtue of increased ‘jump distance’ and ratio of head-to-neck diameter [ 25 , 47 ]. Though the initial ‘Bousquet’ cup was prone to intra-prosthetic dislocations (IPD) and aseptic loosening [ 37 , 40 , 42 , 46 ], design improvements over the past decades resolved many shortcomings of DM cups, thanks to enhanced press-fit and bioactive coatings [ 10 , 31 ], as well as more durable liners made of ultra-high molecular weight polyethylene (UHMWPE) [ 37 , 45 ].…”

Section: Introductionmentioning

confidence: 99%

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

Chouteau¹,

Rollier²,

Bonnin

et al. 2020

J EXP ORTOP

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Purpose: Dual-mobility (DM) cups are increasingly used in total hip arthroplasty (THA) but there lacks literature on their long-term results. We aimed to investigate outcomes of a fourth-generation cementless DM acetabular cup at 7-11 years. Methods: We retrospectively evaluated 240 consecutive hips that received cementless THA using the same dual mobility cup (Novae Sunfit TH) and femoral stem (Corail). Patients were recalled at ≥7 years to collect Oxford hip scores (OHS), Harris hip scores (HHS), and inspect for radiolucent lines and granulomas. Multi-variable analyses were performed to determine whether HHS or OHS were associated with pre-or intra-operative variables. Results: At 8.4 ± 0.8 years (range, 7-11), 6 hips were revised (2.5%), 54 deceased (22.5%), and 14 could not be reached (5.8%). Four revisions (2 cup+stem, 2 liners only) were due to sepsis (1.7%), one (cup and stem) for trauma (0.4%), and one (stem) due to aseptic loosening (0.4%). For the remaining 166 hips, HHS was 83.6 ± 13.2 and OHS was 20.3 ± 6.7. Multivariable analysis confirmed that HHS (β = − 0.38; p = 0.039) and OHS (β = 0.36; p < 0.001) worsened with age, and that OHS was worse for Charnley C patients (β = 3.17; p = 0.009). Neither granulomas nor radiolucenies were observed around any cups, but radiolucenies were seen around 25 stems (20.3%). Conclusions: This fourth-generation DM cup demonstrated satisfactory outcomes at 7-11 years, with no instabilities or cup revisions due to aseptic loosening. Better OHS was observed for younger patients and those presenting higher Charnley grade.

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“…The full texts of the remaining 86 articles were examined. Finally, according to the eligibility criteria, 56 articles were included in the systematic review [ 12 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ] ( Figure 1…”

Section: Resultsmentioning

confidence: 99%

Is Cemented Dual-Mobility Cup a Reliable Option in Primary and Revision Total Hip Arthroplasty: A Systematic Review

Ciolli

Mesnard

Deroche

et al. 2022

JPM

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Background: Instability is a common complication following total hip arthroplasty (THA). The dual mobility cup (DMC) allows a reduction in the dislocation rate. The goal of this systematic review was to clarify the different uses and outcomes according to the indications of the cemented DMC (C-DMC). Methods: A systematic review was performed using the keywords “Cemented Dual Mobility Cup” or “Cemented Tripolar Cup” without a publication year limit. Of the 465 studies identified, only 56 were eligible for the study. Results: The overall number of C-DMC was 3452 in 3426 patients. The mean follow-up was 45.9 months (range 12–98.4). In most of the cases (74.5%) C-DMC was used in a revision setting. In 57.5% DMC was cemented directly into the bone, in 39.6% into an acetabular reinforcement and in 3.2% into a pre-existing cup. The overall dislocation rate was 2.9%. The most frequent postoperative complications were periprosthetic infections (2%); aseptic loosening (1.1%) and mechanical failure (0.5%). The overall revision rate was 4.4%. The average survival rate of C-DMC at the last follow-up was 93.5%. Conclusions: C-DMC represents an effective treatment option to limit the risk of dislocations and complications for both primary and revision surgery. C-DMC has good clinical outcomes and a low complication rate.

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Higher UHMWPE wear-rate in cementless compared with cemented cups with the Saturne® Dual-Mobility acetabular system

Abstract: At short term follow-up, the mean wear-rate in old and low demand patients was high, correlated to activity, and was above the generally accepted osteolysis threshold (0.1 mm/yr.). Cementless HA-coated cups had higher wear-rate than cemented cups.

Cited by 7 publications

References 46 publications

A cost-effectiveness assessment of dual-mobility bearings in revision hip arthroplasty

A cost-effectiveness assessment of dual-mobility bearings in revision hip arthroplasty

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

Is Cemented Dual-Mobility Cup a Reliable Option in Primary and Revision Total Hip Arthroplasty: A Systematic Review

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