title: Wear of dual-mobility cups: a review article.
abstract: Dual-mobility (DM) cups have been clinically used in hip surgery in Europe for more than 35 years and continue to gain popularity worldwide due to promising results at reducing instability. Concerns related to polyethylene wear apply as in conventional standard bearings but are accentuated by the larger-diameter articulations with multiple surfaces. We critically reviewed the reported literature regarding the in vivo and in vitro wear occurring on all surfaces involved. We looked for patterns to create a rational classification of sites of wear and to identify areas for future research. Wear was a significant problem for first-generation designs and appeared to be design related. Improved polyethylene, thinner and smoother trunnions, chamfered rims and eccentric configuration of insert and shell seem to enhance outcome performance; however, long-term clinical evidence and retrieval studies are needed to better understand the balance of benefit and risk when opting for DM bearings.
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK. anna.laura.14@ucl.ac.uk.|The Royal National Orthopaedic Hospital, Stanmore, UK. anna.laura.14@ucl.ac.uk.
authors.forename: Anna Di
authors.initials: AD
authors.lastname: Laura
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK.|The Royal National Orthopaedic Hospital, Stanmore, UK.
authors.forename: Harry
authors.initials: H
authors.lastname: Hothi
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK.|The Royal National Orthopaedic Hospital, Stanmore, UK.
authors.forename: Clement
authors.initials: C
authors.lastname: Battisti
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK.|The Royal National Orthopaedic Hospital, Stanmore, UK.
authors.forename: Arianna
authors.initials: A
authors.lastname: Cerquiglini
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK.|The Royal National Orthopaedic Hospital, Stanmore, UK.
authors.forename: Johann
authors.initials: J
authors.lastname: Henckel
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK.|The Royal National Orthopaedic Hospital, Stanmore, UK.
authors.forename: John
authors.initials: J
authors.lastname: Skinner
authors.affiliation: Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK.|The Royal National Orthopaedic Hospital, Stanmore, UK.
authors.forename: Alister
authors.initials: A
authors.lastname: Hart
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D011474:Prosthesis Design; D011475:Prosthesis Failure
keywords: Bearings; Dual mobility cups; Hip arthroplasty; Modularity; Wear