Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Oct 14:12:7-11.
doi: 10.1016/j.artd.2021.07.013. eCollection 2021 Dec.

Late Breakage of a Dual-Mobility Polyethylene Insert in a Revision Total Hip Arthroplasty: An Unusual Failure Mode

Daniel Rodríguez Pérez  1 , José Luis Agulló Ferre  1 , Marcos Del Carmen Rodríguez  1 , Carles Tramunt Monsonet  1
Affiliations
Case Reports

Late Breakage of a Dual-Mobility Polyethylene Insert in a Revision Total Hip Arthroplasty: An Unusual Failure Mode

Daniel Rodríguez Pérez et al. Arthroplast Today. .

Abstract

The use of dual-mobility cups has gained popularity in recent years. Thus, surgeons can expect an increase in known and new causes of failure. We report a previously undescribed form of a late intraprosthetic dislocation consisting of a complete breakage of a polyethylene mobile bearing that suffered a dislocation 3 months after its implantation. Two years later, he began feeling anterior groin pain and suffered gait changes. Computed tomography scan revealed an eccentric alignment of the mobile polyethylene bearing suggestive of poly wear. During the revision surgery, the polyethylene was found to be split in 2. Possible causes of this complication are proposed. Our case shows a previously unreported implant-specific complication, so surgeons can identify it.

Keywords: Dual-mobility; Hip; Intra-prosthetic dislocation; Luxation; Polyethylene; Total hip arthroplasty.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Anteroposterior (a) and frog-leg lateral (b) radiographs of the pelvis showing significant eccentric wear of the polyethylene mobile bearing and osteolysis around the right cup (DeLee and Charnley zone III) and the stem (Gruen zones 1 and 7). Some broken wires from a failed trochanteric fixation were also present.
Figure 2
Figure 2
Anteroposterior radiograph of the pelvis showing the results of the revision surgery.
Figure 3
Figure 3
Anteroposterior hip radiograph showing prosthetic hip dislocation.
Figure 4
Figure 4
Anteroposterior (a) and frog-leg lateral (b) radiographies of the pelvis demonstrating good concentric reduction of the dislocation.
Figure 5
Figure 5
Anteroposterior radiograph of the pelvis where eccentric placement of the metal head can be seen. Signs of failure of the greater trochanter synthesis were also present.
Figure 6
Figure 6
Coronal computed tomography image showing eccentricity of the metal head. Anteversion was reported to be 25°, and inclination was measured at 48°.
Figure 7
Figure 7
Intraoperative picture (a) and images of the broken insert (b and c) with a notched zone (arrow).
Figure 8
Figure 8
Postoperative anteroposterior radiograph of the hip after the second revision.
See this image and copyright information in PMC

References

    1. Bousquet G., Gazielly D.F., Debiesse J.L. The ceramic coated cementless total hip arthroplasty: basic concepts and surgical technique. J Orthop Surg Tech. 1985;1:15.
    1. Ko L.M., Hozack W.J. The dual mobility cup. Bone Joint J. 2016;98-B:60. - PubMed
    1. Neri T., Philippot R., Klasan A. Dual mobility acetabular cups for total hip arthroplasty: advantages and drawbacks. Expert Rev Med Devices. 2018;15:835. - PubMed
    1. Lachiewicz P.F., Watters T.S. The use of dual-mobility components in total hip arthroplasty. J Am Acad Orthop Surg. 2012;20:481. - PubMed
    1. Plummer D.R., Haughom B.D., Della Valle C.J. Dual mobility in total hip arthroplasty. Orthop Clin North Am. 2014;45:1. - PubMed

Publication types

LinkOut - more resources