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Related Concept Videos

Clearance Models: Compartment Models01:25

Clearance Models: Compartment Models

137
Clearance measures drug elimination from the central compartment, including plasma and highly perfused organs like kidneys and liver. Its calculation varies depending on pharmacokinetic models and administration routes. The one-compartment model, for instance, portrays the pharmacokinetics of polar drugs such as aminoglycoside antibiotics administered intravenously and readily excreted in urine. In this case, clearance is influenced by the terminal rate constant (λz) and the total volume...
137

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Design and Fabrication of an Elastomeric Unit for Soft Modular Robots in Minimally Invasive Surgery
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Liner malseating is rare with two modular dual-mobility designs.

Matthew P Siljander1, Elizabeth B Gausden1, Benjamin M Wooster1

  • 1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.

The Bone & Joint Journal
|May 2, 2022
PubMed
Summary

The incidence of dual-mobility (DM) liner malseating in total hip arthroplasty is low (1.2%) with no identified clinical consequences. Careful post-impaction evaluation is crucial to prevent this complication.

Keywords:
BMIDislocationDual mobilityHarris Hip ScoresMalseatingPostoperative radiographsTHAsacetabular componentclinical outcomesfemoral revisionsintraprosthetic dislocationmetalprimary total hip arthroplasties

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Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Medical Device Engineering

Background:

  • Dual-mobility (DM) implants are increasingly used in total hip arthroplasty (THA) to improve stability and reduce dislocation risk.
  • Liner malseating is a potential complication that may affect implant performance and patient outcomes.
  • Understanding the incidence and consequences of malseating in different DM designs is essential for optimizing surgical techniques and implant selection.

Purpose of the Study:

  • To evaluate the incidence of liner malseating in two common dual-mobility (DM) implant designs: Stryker MDM and Zimmer-Biomet G7.
  • To determine the association between liner malseating and clinical outcomes, including dislocation, survival rates, and functional scores.
  • To identify potential risk factors for liner malseating in primary THA.

Main Methods:

  • Retrospective review of 256 primary THAs using DM components (144 Stryker MDM, 112 Zimmer-Biomet G7) between 2012 and 2019.
  • Independent radiographic review by five reviewers to assess liner malseating.
  • Analysis of patient demographics, surgical details, and clinical outcomes including dislocation, revision rates, and Harris Hip Scores.

Main Results:

  • The overall incidence of liner malseating was low at 1.2% (3/256 liners), with no significant difference between the Stryker MDM (1.4%) and Zimmer-Biomet G7 (0.9%) designs.
  • No clinical consequences were identified in patients with malseated liners at a mean follow-up of 3.5 years.
  • Five-year survival free of dislocation was 97.1%, and survival free of revision was 95.4%. Mean Harris Hip Scores improved significantly from 46 preoperatively to 81 at two years postoperatively (p < 0.001).

Conclusions:

  • The incidence of dual-mobility liner malseating in primary total hip arthroplasty is low and appears to have no adverse clinical consequences at mid-term follow-up.
  • Liner malseating is not exclusive to a specific DM implant design, highlighting the importance of meticulous surgical technique.
  • Careful intraoperative evaluation of liner seating after impaction is recommended to minimize the risk of this complication.