Abstract
Background
Published simulator studies for metal/UHMWPE bearings couples showed that increasing the femoral head diameter by 1 mm increases wear by approximately 10% due to increased contact area. Therefore, there are concerns about increased wear with dual mobility hip bearings.
Purpose of the study
The purpose of the study was to compare wear from dual mobility hip bearings to that with traditional fixed bearings. In addition, for the dual mobility bearings, the effect of femoral head material type on the liner wear was also evaluated.
Methods
The bearings selected for the study are listed in Table 1.
Prior to the start of the test all liners were soaked in lubricant for 48 hours. Hip testing was performed on a Shore Western Orbital Bearing machine in the anatomically oriented position. A simulated gait profile (synchronized at +/-23° biaxial rocking motion) with a minimum/maximum 200/2000N force was applied to the bearings at frequency of 1Hz. The lubricant used for the testing was 25% bovine serum with 0.2 % sodium azide, 20 mMol EDTA and distilled water. The test was interrupted at regular intervals for gravimetric assessment of wear amount.
Findings of Study
Figure 1 shows total wear at 3 Mc and wear rates (determined from the slope of the linear regression) for all the groups. At 3 Mc, dual mobility bearings with stainless steel femoral head demonstrated 5% lower wear rate than those articulated against CoCrMo femoral heads. However, there was no statistically significant difference in the observed wear rate due to the femoral head material type. The results from the study also exhibited lower wear and wear rate for dual mobility bearings compared to fixed bearings. Dual mobility bearings with CoCrMo femoral head and stainless steel femoral head demonstrated 17% and 21% lower wear rate when compared to fixed bearings. Although dual mobility bearings possess greater contact area (due to the contact between head-liner and liner-shell compared to only head-liner in fixed bearings), no such increased trend in wear was observed
Conclusions
Dual mobility hip bearings are designed to reduce the risk of dislocation and allow for increased range of motion thus improving joint function and stability. The results from the study demonstrate that dual mobility bearings have comparable wear properties when compared to fixed bearings
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