Salvage of a monoblock metal-on-metal cup using a dual mobility liner: a two-year MRI follow-up study
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Revision of failed modular metal-on-metal total hip replacement (MoM-THA) can be technically difficult. A dual mobility liner can help to salvage a well-fixed acetabular component. The present paper reports the clinical and radiographic outcome of revision of failed Birmingham modular MoM-THA using a dual mobility liner.
The present study reports on ten patients (3 female and 7 male) with 11 revision THAs. Patients underwent revision an average of 51 months (range 40–73 months) after index procedure. Mean follow-up after the revision was 31 months (range 24–37 months) and all patients underwent an MRI with metal artifact reduction software (MARS) at least two years after revision to assess for local polyethylene wear and osteolysis.
The Harris Hip score improved from 92.2 (range 63.0–100.0) to 100.0 (p = 0.072). One patient had a one-time dislocation within seven days of surgery. No patient required additional surgeries. Radiographs showed no signs of component loosening and osteolysis and MRI imaging revealed no evidence of polyethylene wear or osteolysis.
A dual mobility liner in an existing Birmingham cup can provide excellent clinical and radiological short-term results without MRI evidence of increased polyethylene wear. Post-operative hip precautions should be enforced.
KeywordsBirmingham Metal-on-metal Total hip arthroplasty Osteolysis Revision Dual mobility liner
We attest to the fact that all authors have participated in the research, read the manuscript, attest to the validity and legitimacy of the data and its interpretation, and agree to its submission.
Compliance with ethical standards
Conflict of interest statement
We certify that we have not signed any agreement with commercial interest related to this study, which would in any way limit publication of any and all data generated for the study or to delay publication for any reason.
Dr. Boettner reports personal fees from Smith & Nephew, Ortho Development Corporation and from DePuy, outside the submitted work.
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