Polyethylene liner motion in dual-mobility hip prostheses: static and dynamic radiostereometry in 16 patients 1 year after operation

Acta Orthopaedica, vol. 93, pp. 375–381

Abstract

BACKGROUND AND PURPOSE: Dual-mobility hip arthroplasty utilizes a freely rotating polyethylene acetabular liner to protect against dislocation. As liner motion has not been confirmed in vivo, we undertook this using dynamic radiostereometry (RSA). PATIENTS AND METHODS: 6 patients with Anatomical Dual Mobility acetabular components were included. Markers were implanted in the liners using a drill guide. Static RSA recordings and patient-reported outcome measures were obtained postoperatively and at 1-year follow-up. Dynamic RSA recordings were obtained at 1-year follow-up during passive hip movement: abduction/external rotation, adduction/internal rotation (modified FABER-FADIR), to end-range and at 45° hip flexion. Liner and neck movements were described as anteversion, inclination, and rotation. RESULTS: Liner movement during modified FABER-FADIR was detected in 12 of 16 patients. Median (range) absolute liner movements were: anteversion 10° (5-20), inclination 6° (2-12), and rotation 11° (5-48) relative to the cup. Median absolute change in the resulting liner/neck angle (small articulation) was 28° (12-46) and in liner/cup angle (larger articulation) was 6° (4-21). Static RSA showed changes in median liner anteversion from 7° (-12 to 23) postoperatively to 10° (-3 to 16) at 1-year follow-up and inclination from 42° (35-66) postoperatively to 59° (46-80) at 1-year follow-up. Liner/neck contact was associated with high initial liner anteversion (p = 0.01). INTERPRETATION: The polyethylene liner moves over time. 1 year after surgery the liner can move with or without liner/neck contact. The majority of movement is in the smaller articulation between head and liner.

Authors 5

1. Peter Bo Jørgensen

   Aarhus University Hospital

   Affiliation as printed

   AutoRSA Research Group, Orthopeadic Research Unit Aarhus University Hospital, Aarhus. pbjr@clin.au.dk

   AutoRSA Research Group, Orthopeadic Research Unit Aarhus University Hospital, Aarhus

2. Bart L. Kaptein Aachen Biomechanics and Imaging Group Department of Orthopaedics, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Biomechanics and Imaging Group, Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands. b.l.kaptein@lumc.nl

   Biomechanics and Imaging Group, Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands

3. Kjeld Søballé Aachen Biomechanics and Imaging Group Department of Orthopaedics, Leiden University Medical Center

   Leiden University Medical Center · Aarhus University Hospital

   Affiliation as printed

   AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark; Biomechanics and Imaging Group, Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands. kjeld@soballe.com

   AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark

   Biomechanics and Imaging Group, Department of Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands

4. Stig Storgaard Jakobsen

   Aarhus University Hospital

   Affiliation as printed

   Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus N, Denmark. stigjako@rm.dk

   Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus N, Denmark

5. Maiken Stilling

   Aarhus University Hospital

   Affiliation as printed

   AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark; Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus N, Denmark. maiken.stilling@clin.au.dk

   AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark

   Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus N, Denmark