Does-dual mobility still offer improved stability in smaller cup sizes? A computer modelling comparison of stability with 22-mm versus 28-mm inner heads in dual-mobility versus single-bearing constructs.

IF 1.3 4区 医学 Q3 ORTHOPEDICS
HIP International Pub Date : 2024-07-01 Epub Date: 2024-02-19 DOI:10.1177/11207000231220031
Amit Atrey, Alessandro Navacchia, Sarah E Ward, David Rister, Jacqueline Brillantes, Alexandra Stavrakis, Amir Khoshbin
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引用次数: 0

Abstract

Purpose: Dislocation remains 1 of the leading causes of revision after primary total hip arthroplasty (THA) and there is clear evidence the dual-mobility (DM) is used more frequently to minimise this. But in smaller cups, whether the use of DM with smaller 22-mm heads imparts any increased stability compared to standard bearing is unknown; especially when those smaller cups now allow for large single-bearing (SB) heads.

Methods: 3 primary cup sizes (48 mm, 50 mm, 52 mm) were chosen a priori for modelling. Head sizes trialled for the standard bearing (SB) constructs group were 28-0 mm, 32-0 mm and 36-0 mm against neutral polyethylene liners. In the modular sub-hemispheric DM constructs the inner head sizes for the DM constructs were altered where appropriate (22-0 mm vs. 28-0 mm). Cup position, stem offset, and stem size were standardised.

Results: Both DM constructs outperformed all SB constructs because of a statistically significant jump distance increase (p < 0.001). However, there was no difference in range of motion (ROM) or jump distances between the 22-mm and 28-mm DM inner heads.The ROM angle before impingement between the DM (with 22-mm or 28-mm heads) and SB (with different head sizes where appropriate) showed no statistically significant difference. However, DM constructs presented significantly larger jump distances than SB constructs for both provocative dislocation tests across all 3 cup sizes.Of interest, for 50-mm and 52-mm cup sizes (for which this particular DM construct design can accommodate both 22-mm and 28-mm inner heads), there were no differences in ROM or jump distance between 22-mm versus 28-mm inner heads.

Conclusions: In this computer-modelling study, DM constructs are advantageous over SB constructs for improving jump distances in clinically provocative positions, but not range of motion angles. Inner head diameter of DM has no effect on stability.

双活动度是否仍能提高较小罩杯的稳定性?通过计算机建模比较双活动度与单承托结构中 22 毫米与 28 毫米内杯头的稳定性。
目的:脱位仍是初次全髋关节置换术(THA)后翻修的主要原因之一,有明显证据表明,双活动度(DM)的使用频率更高,可最大限度地减少脱位。但在较小的髋臼杯中,与标准轴承相比,使用较小的 22 毫米头的 DM 是否会增加稳定性,目前尚不清楚;尤其是在较小的髋臼杯现在允许使用较大的单轴承(SB)头的情况下。方法:事先选择 3 种主要髋臼杯尺寸(48 毫米、50 毫米、52 毫米)进行建模。在标准轴承(SB)结构组中,针对中性聚乙烯内衬试用的头颅尺寸分别为 28-0毫米、32-0 毫米和 36-0毫米。在模块化次半球DM结构中,DM结构的内侧头尺寸酌情改变(22-0毫米与28-0毫米)。髋臼杯位置、茎杆偏移量和茎杆尺寸均已标准化:结果:两种 DM 构型都优于所有 SB 构型,因为在统计意义上,两者的跳跃距离都有显著增加(p 结论:DM 构型和 SB 构型的跳跃距离都有显著增加:在这项计算机建模研究中,DM结构比SB结构更有利于提高临床刺激体位的跳跃距离,但对运动角度范围没有影响。DM 头的内径对稳定性没有影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
HIP International
HIP International 医学-整形外科
CiteScore
4.20
自引率
0.00%
发文量
70
审稿时长
2 months
期刊介绍: HIP International is the official journal of the European Hip Society. It is the only international, peer-reviewed, bi-monthly journal dedicated to diseases of the hip. HIP International considers contributions relating to hip surgery, traumatology of the hip, prosthetic surgery, biomechanics, and basic sciences relating to the hip. HIP International invites reviews from leading specialists with the aim of informing its readers of current evidence-based best practice. The journal also publishes supplements containing proceedings of symposia, special meetings or articles of special educational merit. HIP International is divided into six independent sections led by editors of the highest scientific merit. These sections are: • Biomaterials • Biomechanics • Conservative Hip Surgery • Paediatrics • Primary and Revision Hip Arthroplasty • Traumatology
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