title: Highly crosslinked polyethylene: a safe alternative to conventional polyethylene for dual mobility cup mobile component. A biomechanical validation.
abstract: 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).
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Orthopedic Surgery - Pavillon T, Hôpital Edouard Herriot, Hospices Civils de Lyon, 5, place d'Arsonval, 69437, Lyon, France.|INSERM UMR 1033, Université de Lyon, Lyon, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Malatray
authors.affiliation: INSERM UMR 1033, Université de Lyon, Lyon, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Roux
authors.affiliation: Department of Orthopedic Surgery - Pavillon T, Hôpital Edouard Herriot, Hospices Civils de Lyon, 5, place d'Arsonval, 69437, Lyon, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Gunst
authors.affiliation: Department of Orthopedic Surgery - Pavillon T, Hôpital Edouard Herriot, Hospices Civils de Lyon, 5, place d'Arsonval, 69437, Lyon, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Pibarot
authors.affiliation: Department of Orthopedic Surgery - Pavillon T, Hôpital Edouard Herriot, Hospices Civils de Lyon, 5, place d'Arsonval, 69437, Lyon, France. julien.wegrzyn@chu-lyon.fr.|INSERM UMR 1033, Université de Lyon, Lyon, France. julien.wegrzyn@chu-lyon.fr.
authors.forename: Julien
authors.initials: J
authors.lastname: Wegrzyn
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation*; D001696:Biomechanical Phenomena; D005270:Femur Head / Q000601:surgery; D006622:Hip Prosthesis; D006801:Humans; D008422:Materials Testing; D011095:Polyethylenes / Q000009:adverse effects / Q000627:therapeutic use*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D013997:Time Factors
chemical_list: D011095:Polyethylenes
keywords: Cracks; Dual mobility cup; Highly crosslinked polyethylene; Total hip arthroplasty; UHMWPE