Abstract
Purpose
The linear penetration rate (LPR) has been used to estimate volumetric wear ever since metal-on-polyethylene bearings were first introduced. Annual volumetric wear and osteolysis are interrelated. The use of dual mobility cups has increased; however, the presence of two bearings needs paraclinical monitoring of wear to anticipate potential wear-related complications. Is LPR correlated to volumetric wear?
Methods
Ninety-eight dual mobility liner retrievals were mapped in three-dimensions (3D) with a fully automatic stripe light scanner. Martell’s method was applied to 3D maps of the explants to determine how much the centres of the inner and outer bearings had shifted in the three planes, and in particular, penetration of the femoral head in the “z” axis. The total, inner and outer wear volumes were then compared to the shift in the centres of rotation (COR) and the pre-operative X-rays.
Results
There was no relationship between wear and head penetration into the liner. There was a statistically significant relationship between the 3D centre of rotation shift and inner wear or total wear. Wear was multidirectional.
Conclusions
LPR is ineffective for estimating wear of dual mobility inserts, since its wear not two-dimensional. In the future, a 3D imaging method with very thin slices could be used to monitor the wear of dual mobility inserts by measuring the shift in the centres of rotation, once artifacts are overcome.
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Conflict of interest
Bertrand Boyer was a consultant for SERF (Décines, France).
Thomas Neri is a consultant for SERF (Décines, France).
Rémi Philippot and Frédéric Farizon receive royalties from SERF (Décines, France).
Alexandre Di Iorio and Jean Geringer have no conflict of interest concerning this study.
Ethical review committee statement
As this study involves only implant retrieval, anonymously collected, the Ethical Review Committee approval was not required for this study, according to the Ethical Review Committee from our institution.
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No funding was necessary for this study.
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Boyer, B., Neri, T., Di Iorio, A. et al. The linear penetration rate is not relevant for evaluating wear of dual mobility cups: an explant study. International Orthopaedics (SICOT) 41, 599–603 (2017). https://doi.org/10.1007/s00264-017-3406-5
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DOI: https://doi.org/10.1007/s00264-017-3406-5