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POLARCUP

Dual Mobility System

POLARCUP

Algemeen

Dual-mobility cups were designed to reduce risk of dislocation during full ROM. Dislocation is the leading cause of revision after total hip arthroplasty (THA). The dual-mobility technology was developed, featuring a mobile polyethylene liner locked onto a femoral head and articulating in a metallic acetabular shell. The POLARCUP hip system was designed to address the challenges of treating patients - in both primary and revision cases - who are susceptible to dislocation and need greater stability.

Features and Benefits
The dual mobility design results in higher intra-prosthetic stability to address the treatment of patients with a high risk of dislocation (especially for elderly patients) or patients with recurrent dislocation.

Shell and Liner Features
Titanium plasma coating 250 μm 15 to 20% porosity 

Pole obliquity oriented in direction of the load resultant for optimal force allocation.

6° skirt under ½ sphere equator to avoid dislocation

Anti-rotation fins allowing good Peripheral diffusion of constraints 

Equatorial teeth (0.35 mm) Allow a very good primary stability

Self-centering for an equal force transmission

Strongest retention insert on the market
170 to 200 Kg is necessary to press the femoral 
head into the PE-liner

Smoothed entry chamfer parallel to stem neck.

External rim rounded to avoid conflict with soft tissues. 
Minimum thickness: 6.5 mm for 28/47

Shell Options
Titanium-Plasma coated

Stainless steel uncoated (For use with cement only) 

Insert Options
XLPE Mobile Insert

cPE Mobile Insert

Bearing Options
OXINIUM◊ Biolox delta Cobalt Chrome

 

Referenties

1. Bozic KJ, Kurtz SM, Lau E, Ong K, Vail TP, Berry DJ. The epidemiology of revision total hip arthroplasty in the United States. J Bone Joint Surg Am 91(1): 128, 2009.
2. Stulberg SD. Dual poly liner mobility optimizes wear and stability in THA: affirms. Orthopedics 34(9): e445, 2011
3. Australian Orthopaedic Association National Joint Replacement R. Annual report / Australian Orthopaedic Association, National Joint Replacement Registry. (Accessed from http://www.dmac.adelaide.edu.au/aoanjrr/publications.jsp), 2011.
4. Woo RY, Morrey BF. Dislocations after total hip arthroplasty. J Bone Joint Surg Am 64(9): 1295, 1982
5. Berry DJ, von Knoch M, Schleck CD, Harmsen WS. The cumulative long-term risk of dislocation after primary Charnley total hip arthroplasty. J Bone Joint Surg Am 86-A(1): 9, 2004
6. Kop AM, Whitewood C, Johnston DJ. Damage of oxinium femoral heads subsequent to hip arthroplasty dislocation three retrieval case studies. J Arthroplasty 22(5): 775, 2007
7. Evangelista GT, Fulkerson E, Kummer F, Di Cesare PE. Surface damage to an Oxinium femoral head prosthesis after dislocation. J Bone Joint Surg Br 89(4): 535, 2007.
8. Schuh A, Holzwarth U, Kachler W, Goske J, Zeiler G. [Titanium deposits on the ceramic heads of dislocated total hip replacements]. Orthopade 33(10): 1194, 2004.
9. Schuh A, Mittelmeier W, Zeiler G, Behrend D, Kircher J, Bader R. Severe damage of the femoral head after dislocation and difficult reduction maneuvers after total hip arthroplasty. Arch Orthop Trauma Surg 126(2): 134, 2006.
10. Moore C, Orlandini L. Reduction and femoral head damage during total hip arthroplasty. Bone&Joint Science (KLEOSmd) 2(10), 2011
11. Alberton GM, High WA, Morrey BF. Dislocation after revision total hip arthroplasty: an analysis of risk factors and treatment options. J Bone Joint Surg Am 84-A(10): 1788, 2002
12. Bremner BR, Goetz DD, Callaghan JJ, Capello WN, Johnston RC. Use of constrained acetabular components for hip instability: an average 10-year follow-up study. J Arthroplasty 18(7 Suppl 1): 131, 2003.
13. Callaghan JJ, O‘Rourke MR, Goetz DD, Lewallen DG, Johnston RC, Capello WN. Use of a constrained tripolar acetabular liner to treat intraoperative instability and postoperative dislocation after total hip arthroplasty: a review of our experience. Clin Orthop Relat Res (429): 117, 2004.
14. Lyons MC, MacDonald SJ. Dual poly liner mobility optimizes wear and stability in THA: opposes. Orthopedics 34(9): e449, 2011.
15. Geller JA, Malchau H, Bragdon C, Greene M, Harris WH, Freiberg AA. Large diameter femoral heads on highly cross-linked polyethylene: minimum 3-year results. Clin Orthop Relat Res 447: 53, 2006.
16. Stroh A, Naziri Q, Johnson AJ, Mont MA. Dual-mobility bearings: a review of the literature. Expert Rev Med Devices 9(1): 23, 2012.
17. McMinn DJ, Daniel J, Ziaee H, Pradhan C. Indications and results of hip resurfacing. Int Orthop 35(2): 231, 2011.
18. Stuchin SA. Anatomic diameter femoral heads in total hip arthroplasty: a preliminary report. J Bone Joint Surg Am 90 Suppl 3: 52, 2008.
19. Caton J, Prudhon JL. Over 25 years survival after Charnley‘s total hip arthroplasty. Int Orthop 35(2): 185, 2011.
20. Fiquet A. Polarsystem“ dual mobility hip prosthesis and „minimally invasive surgery" (MIS). Int Surg 22: 1, 2006.
21. Fessy MH. Dual mobility: a stephanois concept. Maîtrise Orthopédique 152, 2006.
22. Aubriot JH, Lesimple P, Leclercq S. [Study of Bousquet‘s non-cemented acetabular implant in 100 hybrid total hip prostheses (Charnley type cemented femoral component). Average 5-year follow-up]. Acta Orthop Belg 59 Suppl 1: 267, 1993.
23. Bauchu P, Bonnard O, Cypres A, Fiquet A, Girardin P, Noyer D. The dual-mobility POLARCUP: first results from a multicenter study. Orthopedics 31(12 Suppl 2), 2008.
24. Bouchet R, Mercier N, Saragaglia D. Posterior approach and dislocation rate: a 213 total hip replacements case-control study comparing the dual mobility cup with a conventional 28-mm metal head/polyethylene prosthesis. Orthop Traumatol Surg Res 97(1): 2, 2011.
25. Farizon F, de Lavison R, Azoulai JJ, Bousquet G. Results with a cementless alumina-coated cup with dual mobility. A twelve-year follow-up study. Int Orthop 22(4): 219, 1998.
26. Guyen O, Pibarot V, Vaz G, Chevillotte C, Carret JP, Bejui-Hugues J. Unconstrained tripolar implants for primary total hip arthroplasty in patients at risk for dislocation. J Arthroplasty 22(6): 849, 2007.
27. Philippot R, Camilleri JP, Boyer B, Adam P, Farizon F. The use of a dual-articulation acetabular cup system to prevent dislocation after primary total hip arthroplasty: analysis of 384 cases at a mean follow-up of 15 years. Int Orthop 33(4): 927, 2009.
28. Tarasevicius S, Busevicius M, Robertsson O, Wingstrand H. Dual mobility cup reduces dislocation rate after arthroplasty for femoral neck fracture. BMC Musculoskelet Disord 11: 175, 2010.
29. Vielpeau C, Lebel B, Ardouin L, Burdin G, Lautridou C. The dual mobility socket concept: experience with 668 cases. Int Orthop 35(2): 225, 2011.
30. Beguin L, Adam P, Farizon F, Fessy MH. Total hip arthroplasty: Treatment of chronic instability using a double-mobility cup. J Bone Joint Surg Br 84((Suppl 1)): 52, 2002.
31. Gotze C, Glosemeyer D, Ahrens J, Steens W, Gosheger G. [The bipolar cup Avantage in hip revision surgery]. Z Orthop Unfall 148(4): 420, 2010.

Design & Technology

Professor Bousquet and the Medical School of Saint Etienne in France created the DUAL MOBILITY CONCEPT in 1976 to address the problems of hip locations in Total Hip Arthroplasty (THA). The concept was an insert locked on a femoral ball head that moves freely in a thin metallic shell. This Dual Mobility principle combines the advantages of low friction and the use of a big femoral head.

polarcup
The dual mobility concept had a low dislocation rate, both for primary hip replacement and revision situations including repetitive dislocations.
The POLARCUP has 10 years of clinical history in Europe and in other markets outside the U.S. The POLARCUP System allows surgeons to implant a smaller, constrained femoral component within a larger, anatomically sized polyethylene head.