Wear of dual-mobility cups: a review article

Abstract

Dual-mobility (DM) cups have been clinically used in hip surgery in Europe for more than 35 years and continue to gain popularity worldwide due to promising results at reducing instability. Concerns related to polyethylene wear apply as in conventional standard bearings but are accentuated by the larger-diameter articulations with multiple surfaces. We critically reviewed the reported literature regarding the in vivo and in vitro wear occurring on all surfaces involved. We looked for patterns to create a rational classification of sites of wear and to identify areas for future research. Wear was a significant problem for first-generation designs and appeared to be design related. Improved polyethylene, thinner and smoother trunnions, chamfered rims and eccentric configuration of insert and shell seem to enhance outcome performance; however, long-term clinical evidence and retrieval studies are needed to better understand the balance of benefit and risk when opting for DM bearings.

Two-year results of the Moovis trapeziometacarpal joint arthroplasty with focus on early complications

“…The liner in the Moovis implant is made of UHMWPE, which is less wear resistant as compared with highly crosslinked (HXL) polyethylene liners (Shi etal., 2019). Hip arthroplasty with dual-mobility HXL polyethylene liners do not have increased wear compared with standard articulations (Boyer etal., 2018; Laura etal., 2017; Prudhon etal., 2017). Over-tensioning during surgery may increase the risk of polyethylene wear.…”

Catastrophic failure of a dual mobility bearing in a revision total hip arthroplasty

“…[10], [11] found a significantly lower wear rate and volumetric loss with the 22.2-, 36-, or 48-mm DM bearings in comparison to single articulation THA at an inclination angles of 65° in vitro. Although this may be the case in vitro, we are unaware of any studies replicating these results in vivo [12]. The following report examines a case where a DM bearing was placed during a revision surgery, in which the primary acetabular abduction angle was approximately 70°-75° which resulted in catastrophic polyethylene failure.…”

Asymptomatic intraprosthetic dual mobility cup dislocation with increased metal ion levels

“…With the expanding indication for the use of DM cups and their use in younger and more demanding patients [5] , [8] , concerns rise about the long-term survival. Owing to the large diameter of articulation and multiple surfaces, an increase in polyethylene wear, fretting corrosion, and release of metal ions may lead to complications and revision surgeries [2] , [9] , [10] , [11] .…”