Smeeton, M. orcid.org/0000-0001-7639-1368, Isaac, G. orcid.org/0000-0003-2613-3496, Wilcox, R. orcid.org/0000-0003-2736-7104 et al. (4 more authors) (2024) Analysis of Early-Retrieved Dual-Mobility Polyethylene Liners for Total Hip Replacement. Prosthesis, 6 (4). pp. 841-852. ISSN 2673-1592
Abstract
Despite their emerging use, the in vivo behaviour of dual-mobility (DM) total hip replacements (THRs) is not well understood. Therefore, the purpose of this study was to assess the articulating surfaces of 20 early-retrieved DM polyethylene liners (mean length of implantation 20.0 ± 18.8 months) for damage to improve the current understanding of their in vivo functional mechanisms. The internal and external surfaces of each liner were visually and geometrically assessed, and the material composition of embedded debris particles were further characterized. Scratching and pitting were the most common modes of damage identified on either surface, and a high incidence of burnishing (50%) and embedded debris (65%) were observed on the internal and external surfaces, respectively. Embedded debris particles were commonly titanium- or iron-based, although other materials such as cobalt-chrome and tantalum were also identified. The geometric assessment demonstrated highly variable damage patterns across the liners, with the internal surfaces commonly presenting with crescent-shaped, circumferential, or circular regions of penetration whilst the external surfaces commonly presented with regions of deep pitting or gouging. This study demonstrates that DM-THRs primarily articulate at the head/liner junction, and that polyethylene liners are capable of rotating about the femoral neck axis, although the extent of this may be limited in some cases. Additionally, this study suggests that intra-prosthetic dislocation and edge loading may remain pertinent failure mechanisms of DM implants despite the advent of highly crosslinked polyethylene and design features, thus highlighting the need for enhanced monitoring of these devices.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
Keywords: | total hip replacement; dual mobility; retrieval analysis |
Dates: |
|
Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Engineering & Physical Sciences (Leeds) > School of Mechanical Engineering (Leeds) > Institute of Medical and Biological Engineering (iMBE) (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 12 Aug 2024 12:18 |
Last Modified: | 24 Jan 2025 11:19 |
Status: | Published |
Publisher: | MDPI |
Identification Number: | 10.3390/prosthesis6040060 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:215879 |