title: Early experience with dual mobility acetabular systems featuring highly cross-linked polyethylene liners for primary hip arthroplasty in patients under fifty five years of age: an international multi-centre preliminary study.
abstract: To evaluate early performance of contemporary dual mobility acetabular systems with second generation annealed highly cross-linked polyethylene for primary hip arthroplasty of patients under 55 years of age.
  
  
  
  A prospective observational five years study across five centers in Europe and the USA of 321 patients with a mean age of 48.1 years was performed. Patients were assessed for causes of revision, hip instability, intra-prosthetic dissociation, Harris hip score and radiological signs of osteolysis.
  
  
  
  There were no dislocations and no intra-prosthetic dissociations. Kaplan Meier analysis demonstrated 97.51% survivorship for all cause revision and 99.68% survivorship for acetabular component revision at five years. Mean Harris hip score was 93.6. Two acetabular shells were revised for neck-rim implant impingement without dislocation and ten femoral stems were revised for causes unrelated to dual mobility implants.
  
  
  
  Contemporary highly cross-linked polyethylene dual mobility systems demonstrate excellent early clinical, radiological, and survivorship results in a cohort of patients that demand high performance from their implants. It is envisaged that DM and second generation annealed HXLPE may reduce THA instability and wear, the two most common causes of THA revision in hip arthroplasty.
authors.affiliation: Orthopaedic Research and Imaging Center in Arthroplasty, 62700, Bruay-La-Buissière, France. jae@orthowave.net.
authors.forename: Jean-Alain
authors.initials: JA
authors.lastname: Epinette
authors.affiliation: Adult Reconstruction and Total Joint Replacement, Mount Sinai Hospital, New York, NY, USA.
authors.forename: Steven F
authors.initials: SF
authors.lastname: Harwin
authors.affiliation: Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USA.
authors.forename: Fiachra E
authors.initials: FE
authors.lastname: Rowan
authors.affiliation: , Clinique Saint-Roch 235, route des Gordes, Cavaillon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Tracol
authors.affiliation: Adult Reconstruction and Joint Replacement, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
authors.affiliation: Adult Reconstruction and Joint Replacement, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Morad
authors.initials: M
authors.lastname: Chughtai
authors.affiliation: Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, New York, NY, USA.
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Westrich
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D005060:Europe; D005260:Female; D006621:Hip Joint / Q000601:surgery; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000209:etiology; D020959:Polyethylene / Q000627:therapeutic use*; D011446:Prospective Studies; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000009:adverse effects; D012086:Reoperation / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult
chemical_list: D020959:Polyethylene
keywords: Annealed highly crosslinked polyethylene; Dual mobility; HXLPE; Instability; Observational study; Outcome; Primary hip arthroplasty; Wear; X3; Young patient