Abstract
Purpose
Dual mobility cup (DMC) consists of a cobalt-chromium (CoCr) alloy cup articulated with a polyethylene (PE) mobile component capturing the femoral head in force using a snap-fit technique. This biomechanical study was the first to evaluate and compare the generation of cracks in the retentive area of DMC mobile components made of highly crosslinked PE (XLPE) or conventional ultra-high molecular weight PE (UHMWPE).
Methods
Eighty mobile components designed for a 52-mm diameter Symbol® DMC (Dedienne Santé, Mauguio, France) and a 28-mm diameter femoral head were analyzed. Four groups of 20 mobile components were constituted according to the PE material: raw UHMWPE, sterilized UHMWPE, annealed XLPE and remelted XLPE. Ten mobile components in each group were impacted with a 28-mm diameter CoCr femoral head using a snap-fit technique. The occurrence, location and area of the cracks in the retentive area were investigated using micro-CT (Skyscan 1176®, Bruker, Aarsellar, Belgium) with a 35 μm nominal isotropic voxel size by two observers blinded to the PE material and impaction or not of the mobile components.
Results
Compared to conventional UHMWPE, the femoral head snap-fit did not generate more or wider cracks in the retentive area of annealed or remelted XLPE mobile components.
Conclusion
This biomechanical study suggests that XLPE in DMC could be a safe alternative to conventional UHMWPE regarding the generation of cracks in the retentive area related to the femoral head snap-fit.
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This study was internally funded by the research laboratory INSERM UMR1033, Université de Lyon, Lyon, France. The authors thank Dedienne Santé (Mauguio, France) and the AXIOM group for providing the implants used in testing.
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MM, SG and JPR declare that they have no conflict of interest. VP and JW have received royalties from Dedienne Santé (Mauguio, France).
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This article does not contain any studies with human participants or animals performed by any of the authors. Therefore, IRB approval was not required.
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Malatray, M., Roux, JP., Gunst, S. et al. Highly crosslinked polyethylene: a safe alternative to conventional polyethylene for dual mobility cup mobile component. A biomechanical validation. International Orthopaedics (SICOT) 41, 507–512 (2017). https://doi.org/10.1007/s00264-016-3334-9
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DOI: https://doi.org/10.1007/s00264-016-3334-9