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Three‐dimensional kinematic analysis of dislocation mechanism in dual mobility total hip arthroplasty constructs
Author(s) -
Klemt Christian,
Bounajem Georges,
Tirumala Venkatsaiakhil,
Xiong Liang,
Padmanabha Anand,
Kwon YoungMin
Publication year - 2021
Publication title -
journal of orthopaedic research®
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.24855
Subject(s) - kinematics , range of motion , dislocation , fluoroscopy , subluxation , total hip arthroplasty , arthroplasty , orthodontics , materials science , geometry , nuclear medicine , mathematics , biomedical engineering , medicine , physics , surgery , composite material , classical mechanics , alternative medicine , pathology
Dual mobility (DM) total hip arthroplasty (THA) is associated with reduced dislocation rates; however, the kinematic mechanism of dislocation in DM THA constructs is still not well understood. This study hypothesizes that the difference in kinematics between DM THA and conventional THA designs contributes to reduced dislocation rates of DM THA. In addition, this study aims to quantify and compare those kinematic parameters between DM THA and conventional THA using a validated dual fluoroscopy imaging system (DFIS) and finite element (FE) modelling. Fresh frozen cadavers were measured to compare the impingement‐free range of motion and provocative subluxation kinematics among three THA constructs: (1) DM, (2) constrained liner (CS), and (3) 36 mm head diameter neutral liner (NL). The DFIS was used to measure the in vitro kinematics of the hip. Subject‐specific FE models were developed to assess the horizontal dislocation distance and resistive torque at dislocation. The DM construct head exhibited increased provocative anterior and posterior subluxation range of motion before dislocation when compared to CS constructs ( p = .05; p = .03), as well as NL constructs ( p = .05). The DM THA showed a significantly larger posterior horizontal dislocation distance, as well as smaller resistive torque at dislocation, when compared to NL ( p = .05; p = .03) and CS constructs ( p = .04; p = .01). Our findings demonstrate there was increased provocative subluxation range of motion as well as normalized jump distance for the DM constructs compared to the NL and CS constructs, suggesting the DM THA may provide increased stability hip during at‐risk functional hip positions.