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  4. Dual mobility cups provide biomechanical advantages in situations at risk for dislocation: a finite element analysis
 
research article

Dual mobility cups provide biomechanical advantages in situations at risk for dislocation: a finite element analysis

Terrier, Alexandre  
•
Latypova, Adeliya  
•
Guillemin, Maika
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2017
International Orthopaedics

Purpose Constrained devices, standard implants with large heads, and dual mobility systems have become popular options to manage instability after total hip arthroplasty (THA). Clinical results with these options have shown variable success rates and significant higher rates of aseptic loosening and mechanical failures with constrained implants. Literature suggests potential advantages of dual mobility, however little is known about its biomechanics. We present a comparative biomechanical study of a standard implant, a constrained implant, and a dual mobility system. Methods A finite element analysis was developed to assess and compare these acetabular options with regard to the range of motion (ROM) to impingement, the angle of dislocation, the resistive torque, the volume of polyethylene (PE) with a stress above 80% of the elastic limit, and the interfacial cup/ bone stress. Results Dual mobility implants provided the greatest ROMto impingement and allowed delaying subluxation and dislocation when compared to standard and constrained implants. Dual mobility also demonstrated the lowest resistive torque at subluxation while the constrained implant provided the greatest one. The lowest critical PE volume was observed with the dual mobility implant, and the highest stress at the interfaces was observed with the constrained implant. Conclusion This study highlights the biomechanical advantages of dual mobility systems over constrained and standard implants, and is supported by the clinical results reported. Therefore, the use of dual mobility systems in situations at risk for instability should be advocated and constrained implants should be restricted to salvage situations.

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Type
research article
DOI
10.1007/s00264-016-3368-z
Web of Science ID

WOS:000398051700017

Author(s)
Terrier, Alexandre  
Latypova, Adeliya  
Guillemin, Maika
Parvex, Valérie
Guyen, Olivier
Date Issued

2017

Publisher

Springer Verlag

Published in
International Orthopaedics
Volume

41

Issue

3

Start page

551

End page

556

Subjects

Dual mobility

•

Constrained implants

•

Dislocation

•

Instability

•

Subluxation

•

Biomechanics

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
LBO  
Available on Infoscience
May 1, 2017
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/136890
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