Dual Poly Liner Mobility Optimizes Wear and Stability in THA: Opposes
Bibliographic record
Abstract
Total hip arthroplasty (THA) is an effective intervention for the treatment of arthrosis with excellent survivorship. Nonetheless, dislocation and osteolysis remain significant complications. A dual-mobility acetabular component has been advocated to improve stability and wear. Stability is imparted by increasing the effective femoral head size, which allows a larger range of motion (ROM) before neck-socket impingement occurs. Increasing ROM, however, introduces an additional problem of bony impingement of the trochanter against the pelvis. Consequently, there is little improvement in ROM for heads >36 to 40 mm. A 0.4% incidence of instability at the larger articulation has been reported in primary THA using the dual-mobility liner, which is equivalent to reports for conventional THA. The dual-mobility liner has introduced the unique complication of intraprosthetic dislocation, where the femoral head dissociates at the smaller articulation as a result of polyethylene wear. An incidence of intraprosthetic dislocation of 3.6% has been reported, which far exceeds dislocation of conventional arthroplasty. The dual-mobility liner is a monoblock acetabular component without the capacity for augmented bony fixation. Inability to achieve primary stability has been reported as high as 18% and therefore its usefulness in revision THA is questionable. Proponents of the dual-mobility liner cite improved wear characteristics over conventional THA; however, few studies support this proposition. Retrieval studies have reported that the dual-mobility liner does not avoid wear or osteolysis. Theoretically, it is inconceivable that wear would be diminished with an additional articulation with a huge surface area, where the differential hardness has been reversed to a soft-on-hard bearing.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".