Dislocation after THA remains one of the major causes for revision surgery. Dual mobility implant constructs have won recognition and wide-spread acceptance as a solution for patients after dislocation, or as a primary solution for patients at risk of dislocation.
Besides advantages such as the increased range of motion and subsequent reduced risk of impingement and dislocation, there is a growing body of evidence of metal-related issues with current dual mobility systems.
Metal-Related Issues with Current Dual Mobility Systems
- There is a risk of fretting and corrosion at the interface between the metal femoral head and neck.
- The junction between the modular CoCr liner and the titanium shell (acetabular cup) is effectively a taper connection where a significant amount of fretting corrosion may occur.
- A growing body of evidence points to the risk that CoCr particles may be released and harbour the potential for future impact on patient wellbeing. Recent scientific literature provides evidence of fretting and corrosion at the modular junction, distribution of metal wear particles in the surrounding tissue and elevated metal serum values post-operatively.
There are three ways to integrate BIOLOX®delta ceramics into dual mobility systems. We offer an extended size range of BIOLOX®delta femoral heads for dual mobility systems. Our thin-walled ceramic liners are specifically made for modular dual mobility cups. For monoblock dual mobility systems, a direct-to-bone ceramic acetabular cup is part of the innovative future for dual mobility solutions.
CeramTec offers a range of small diameter modular heads: 22.2mm, 26mm, 28mm, all in three neck lenghts, S, M and L. This portfolio of femoral heads in incremental sizes allows the largest possible internal femoral head size for each specific cup size.
There are almost two decades worth of extensive clinical experience with BIOLOX®delta-on-BIOLOX®delta bearing couples. By replacing the modular CoCr liner with a ceramic liner, the risk of fretting and corrosion and backside wear at the taper junction can be reduced. BIOLOX®delta ceramic allows a design with an adequate thin-walled ceramic liner for use specifically in modular dual mobility systems.
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