Modular dual mobility (MDM) constructs are being used with increasing frequency, and the American Joint Replacement Registry in 2018 noted that 12% of primary and 30.6% of revision total hip arthroplasties (THA) utilized a dual mobility implant. MDM constructs are comprised of an outer titanium acetabular shell joined to a modular inner cobalt-chromium liner through a taper which is mated intraoperatively. Design features of this bearing surface that favor reduced instability risk are greater impingement-free range of motion and increased jump distance by way of increased head-neck offset and larger effective femoral heads, respectively.

However, modularity between the inner cobalt-chromium liner and outer titanium shell introduces another taper junction for potential fretting and corrosion of a mixed metal interface. Secondary to cases of adverse local tissue reaction (ALTR) as the result of fretting and corrosion at other modular metal-on-metal interfaces in total hip replacement, there are concerns of taper corrosion and elevated metal ions levels after implantation of MDM components. Furthermore, although it is quite rare, there have been reports of fretting and corrosion among some MDM liners.

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Mishita
Jornal co-ordinator
Journal of Bone Research and Reports