Friday 10 June

"Friday 10 June"

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08:00 - 08:10

Welcome address and Introduction

Salle 1

"Friday 10 June"

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08:10 - 10:00

Session 1 : Basic Science

Moderators: Scott BRUMBY (Chirurgien) (Adelaide, Australia, Australia), Julien WEGRZYN (Lausanne, Switzerland)
08:10 - 08:20 Why DM provides biomechanical advantages over large head and constrained implants. Olivier GUYEN (Professeur, médecin-adjoint) (Lausanne, Switzerland)
08:20 - 08:30 The third articulation: relationship between the mobile component and the femoral neck. Mechanical considerations & clinical consequences. Julien WEGRZYN (Lausanne, Switzerland)
08:30 - 08:40 Highly cross-linked polyethylene for the mobile component: tribological imperative or “fashion effect”? Jean-Alain EPINETTE (Senior Researcher) (LILLE, France)
08:40 - 08:50 The metal-shell / femoral neck impingement in dual mobility cup: detection, prevention and management. Jacques BEJUI-HUGUES (Latina, Italy)
08:50 - 09:00 Which material for the metal-shell: cobalt-chromium alloy or stainless steel? Tribology versus regulations. Christian MANIN (Ingénieur) (Decines, France)
09:00 - 09:10 Cobalt ion concentration in different sizes of metal femoral heads: 32mm, 36mm or Dual Mobility? Yasuhiro HOMMA (Lecturer) (Tokyo, Japan)
09:10 - 09:20 Wear assessment in dual mobility cup: which method of evaluation? Bertrand BOYER (CHIRURGIEN) (St-Etienne, France)
09:20 - 09:30 Ceramic and Dual Mobility: Why this choice for the large articulation? Luigi ZAGRA (Head of Department) (Milan, Italy, Italy)
09:30 - 10:00 Discussion.
Salle 1
10:00 Coffee Break - exhibition visit Salle 1

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10:30 - 12:00

Session 2 : Dual Mobility in the Primary Setting

Moderators: Nicolas BONIN (chirurgien orthopédique) (Lyon, France), Michael TAUNTON (Hip and Knee Arthroplasty) (Rochester, MN USA, USA)
10:30 - 10:40 Why 100% of my primary THA are dual mobility? Loïc SCHNEIDER (Chirurgien) (Saint-Genest, France)
10:40 - 10:50 Why a Dual mobility cup with a DAA? Yasuhiro HOMMA (Lecturer) (Tokyo, Japan)
10:50 - 11:00 Direct anterior approach using dual mobility in total hip arthroplasty is a safe and satisfactory strategy compared to posterolateral approach. Corentin PANGAUD (Chef de Clinique - Assistant) (Marseille, France)
11:00 - 11:10 Indication and analysis criteria for the use of dual mobility cups in patients with an increased risk of postoperative prosthetic luxation in primary total hip arthroplasty. Federico MANFRIN (Buenos Aires, Argentina)
11:10 - 11:20 Cemented dual mobility cup in primary THA. Youngwoo KIM (Director of the Joint Replacement Center) (Kyoto, Japan)
11:20 - 11:30 Results of DM in primary THA: current registries data. Scott BRUMBY (Chirurgien) (Adelaide, Australia, Australia)
11:30 - 11:40 Cost-effectiveness of dual mobility cup. Jean-Alain EPINETTE (Senior Researcher) (LILLE, France)
11:40 - 12:00 Discussion.
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"Friday 10 June"

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12:00 - 12:45

Symposium of the industry: DEDIENNE SANTE
7 years of conception and experience to evolve - Conception of the Dual Mobility

Moderator: Nicolas BONIN (chirurgien orthopédique) (Lyon, France)
12:00 - 12:45 Biomechanical choices: Respect for morphotypes and bone capital. Christian MANIN (Ingénieur) (Decines, France)
12:00 - 12:45 Organic choices: Respect for soft tissues and bone fixation requirements. Loïc SCHNEIDER (Chirurgien) (Saint-Genest, France)
12:00 - 12:45 Hemispherical dual mobility cup: my feedback. Mariano LUNA (jefe de cadera) (Buenos Aires, Argentina)
12:00 - 12:45 Shortened stem: my feedback. Thomas ROUSSEAU (MEDECIN) (ROUEN, France)
12:00 - 12:45 Revision of hip prosthesis: knowing how to consider desescalation. Frédéric CHATAIN (Saint-Martin-d'Hères, France)
12:00 - 12:45 3D Planning : tool and evolution of the range. Gilles ESTOUR (France)
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12:45 - 14:00

Lunch Break - exhibition visit

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"Friday 10 June"

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14:00 - 15:30

Session 3: Dual Mobility in the young and/or active patients

Moderators: Jean-Alain EPINETTE (Senior Researcher) (LILLE, France), Luigi ZAGRA (Head of Department) (Milan, Italy, Italy)
14:00 - 14:25 Mini-battle: dual mobility cup versus large femoral head in patients under 50 in my routine practice. Manuel RIBAS (Consultant , Head of Hip Unit) (Barcelona, Spain), Bertrand BOYER (CHIRURGIEN) (St-Etienne, France)
14:25 - 14:35 Literature point of view Dual Mobility cup or large femoral head in young patients. Alexander ANTONIADIS (Fellow) (Lausanne, Switzerland)
14:35 - 14:45 Current Mayo Clinic indications for Dual Mobility: Creation of a Total Hip Arthroplasty Patient-Specific Dislocation Risk Calculator. Michael TAUNTON (Hip and Knee Arthroplasty) (Rochester, MN USA, USA)
14:45 - 14:55 Dual mobility in the young and active patient. Nicolas REINA (Professor of Orthopedics) (Toulouse, France)
14:55 - 15:05 Anterior groin pain with dual mobility cup: myth or reality? Nicolas BONIN (chirurgien orthopédique) (Lyon, France)
15:05 - 15:15 Dual Mobility cup for treatment of proximal femoral fracture in demanding elderly patient. Philippe ADAM (Strasbourg, France)
15:15 - 15:25 Dual mobility in dysplastic hips: Japanese experience. Yasuhiro HOMMA (Lecturer) (Tokyo, Japan)
15:25 - 15:30 Discussion.
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15:30 - 16:00

Open presentations

Moderators: Youngwoo KIM (Director of the Joint Replacement Center) (Kyoto, Japan), Nicolas REINA (Professor of Orthopedics) (Toulouse, France)
15:30 - 15:35 #22072 - The Use of Kerboull Acetabular Reinforcement device (KARD)with cemented Dual Mobility Socket in Revision Hip Arthroplasty (RHA) our first experince in Canada.
The Use of Kerboull Acetabular Reinforcement device (KARD)with cemented Dual Mobility Socket in Revision Hip Arthroplasty (RHA) our first experince in Canada.

Introduction : The Kerboull Acetabular Reinforcement Device has been used

since 1974 in acetabular reconstruction. Dual Mobility System has been used in

clinical practice for Total Hip Arthroplasty since 1976. The construct is a cemented

dual mobility socket in acetabular reinforcement device which was widely used in

France. Unfortunately, this concept was hard to introduce in North American


We report our experience with 16 hips treated using this construct dual mobility

socket cemented in Kerboull Acetabular Reinforcement device in some revision hip


Methods : This is a retrospective monocentric study with 16 dual mobility

components cemented in Kerboull renforcement device implanted in 15 selected

patients between 2011 and 2018 with a 1 year minimum follow-up. This technique

was used in 10 cases associated with aseptic acetabular loosening, 3 cases after

prothesis joint infection, 2 cases associated with rapidly destructive coxarthrosis

and 1 case after failed revision. There was 4 women and 11 men, and the mean age

at the time of the surgery was 69 years (range between 40 and 88 years). The

average follow up was 42 months (range between 12 and 72 months). Paprosky

classification was used for the acetabular bone defect: 3 hip type 2A type, 3 cases

type 2B, 4 cases type 2C, 4 cases type 3A and 2 cases 3B type.

Postel Mearle D’Aubigné classification was used to evaluate the functional ability.

Bone grafting, autologus and frozen bone graft was used in all cases.

Results : The Kerboull Acetabular Reinforcement device restored the acetabulum

continuity and the dual mobility component restored hip stability. There was no

dislocation for all the patients. At the last follow up, we identified no patients with

acetabular component loosening or osteolysis. Unfortunately, one patient with

pelvic discontinuity had acetabular reinforcement device displacement and a

secondary revision was necessary The acetabular implant showed satisfying

osteointegration and the bone grafting incorporated.

Conclusion : The results of our study support the use of KARD with cemented

dual mobility socket implants for revision hip arthroplasty and it is a good option in

well indicated cases. This design was very efficient in restoring and maintaining

hip stability and continuity. It is a keen choice in challenging situations of unstable

and bone loose revision hip arthroplasties. However, longer follow up is required.

Dezso BARABAS (Québec, Canada)
15:35 - 15:40 #22636 - Low dislocation rates in high-risk patients: use of a cemented dual mobility acetabular component in a UK centre.
Low dislocation rates in high-risk patients: use of a cemented dual mobility acetabular component in a UK centre.

Objectives: To assess outcomes of a cemented dual mobility acetabular component in patients at increased risk of dislocation following primary and revision total hip arthroplasty.

Methods: Outcomes following implantation of a cemented dual mobility shell at a single UK centre were assessed retrospectively using clinical and radiological data. Inclusion criteria were primary and revision procedures with minimum 1 year follow up. Dual mobility implants were utilised selectively for high risk cases at the surgeons’ discretion. Patients were identified using data from the UK National Joint Registry (NJR).

Results: Between August 2014 and May 2018 104 cemented ADES (Zimmer, Warsaw, Indiana, USA) dual mobility shells were implanted. There were 60 primary and 44 revision procedures. 23 revisions were performed to address hip instability.

The mean length of follow up was 3.22 years (range 1.67-4.92) and the mean patient age at the time of surgery was 72 years (range 34-89).

20 dual mobility shells were used for complex primary THA, 16 for fractured neck of femur, and 15 in patients with a pre-existing neuromuscular disorder.  There were 4 cases of postoperative dislocation; 3 of which occurred in revision cases. 2 patients required reoperation for instability: at 1 and 3 months. No case was complicated by infection or intraprosthetic dislocation.

All implants present at 1 year follow up had satisfactory radiographic appearances.

Conclusions: These results demonstrate a low complication rate when a cemented dual mobility acetabular component is implanted in patients at high risk of dislocation. Further data is required to assess outcomes in the longer term.

Joanne MCKAY (Derby, United Kingdom), Michael STARKIE, Daniel MORRIS, James HUTCHINSON, James LEWIS
15:40 - 15:45 #22276 - Dual mobility cup:embrace the philosophy or give a real advantage?our experience after 25 years.
Dual mobility cup:embrace the philosophy or give a real advantage?our experience after 25 years.

Il vantaggio della doppia coppa della mobilità (DMC) nella protesi totale d'anca (THA) è stato per noi evidente sin dai primi anni novanta, seguito dall'esperienza del professor Pasquali presso l'ospedale di specialità ortopediche ICOT-Latina (Italia), che ha sviluppato e modificato il design di protesi di G.Bousquet, prevedendo sia lo stelo che la coppa avvitati.Parliamo di un numero significativo di protesi dal 1987 al 2006 eseguite da diversi chirurghi, tra cui gli Autori,18.000 impianti, quasi 1000 bilaterali con un'altissima percentuale di coxartrosi (83%) senza esclusione di età (27%meno di 50 aa).Informazioni sulle complicanze precoci: carenza di 24 SPe,40 dislocazioni post-operatorie e comparsa di ossificazioni eterotopiche in 50 casi che hanno comportato una riduzione di una ROM iniziale molto buona (questi dati potrebbero essere stati influenzati dall'uso dell'approccio postero-laterale che avrebbe aumentato questi problemi).Distanza di 8 anni fu ha contato una percentuale di dislocazione IC del 4% attribuibile alle caratteristiche polietilene (PE) di prima generazione. Percentuali più elevate (10%) di linee radiolucenti, erano presenti distalmente nello stelo anche della mobilizzazione di quest'ultima relativamente 2%.Era nostro dovere avvalorare l'esperienza precedente a partire da alcuni punti chiave discussi in letteratura:il DMC è indicato non solo quando è presente una lussazione ad alto rischio ma ogni volta che si deve ricorrere al THA.Da gennaio 2016 abbiamo eseguito il DMC tregor di Aston utilizzando l'approccio diretto laterale per patologie con indicazioni per il trattamento chirurgico del THA (78% di coxartrosi primaria, media 67 anni).Abbiamo analizzato il 66 THA(media 30 mesi)solo una migrazione precoce della coppa(sempre sostituito da un modello DMC da revisione),2 fratture prossimai lo stelo (all'inizio di questa esperienza),no lussazioni anche a distanza. Le ragioni della discussione, a nostro avviso, riguardano attualmente: cementazione o meno della coppa DMC in caso di BMD inferiore,(anche se le coppe esistono in tritanio),ulteriore miglioramento del PE associato al livello di finitura delle teste e della coppa di lucidatura,sui reali vantaggi della parte anteriore approccio e MIS.L'eventuale uso di fibrinolitici lenti alla fine dell'intervento è simile alla chirurgia vertebrale che potrebbe impedire la formazione di tessuto fibroso che in alcuni casi potrebbe essere imprigionato nel PE annullando l'indubbio vantaggio del DMC.

Alberto SCARCHILLI (Latina, Italy), Gianluca MARTINI
15:45 - 15:50 #22635 - Wear testing of a new modular dual mobility system.
Wear testing of a new modular dual mobility system.

INTRODUCTION:   Modular dual mobility systems have been implanted increasingly over the last decade.  To date, these systems have primarily utilized a CoCrMo liner locked into a titanium alloy shell.  Cases with corrosion at the liner taper junction and adverse tissue reactions to corresponding Co, Cr, and Ni ions/debris have been reported.  Use of a more inert material, such as Zr2.5Nb, could reduce taper-related complications.  The goal of this study was to evaluate polyethylene wear of a new modular dual mobility system with a diffusion-hardened oxidized Zr2.5Nb acetabular bearing.  In order to replicate a worst-case scenario, motion was isolated to the outer articulation of the device.  An established, clinically successful, non-modular dual mobility system was tested for comparative purposes. 


METHODS:  Two dual mobility systems were tested.  An extruded square feature was incorporated into each insert design and replaced the hemispherical cavity that normally mates with a femoral head.  This feature was designed to mate with a Ti6Al4V fixture with corresponding geometry and, thereby, eliminated the inner articulation/femoral head.  System 1 (R3DM)  incorporated a modular acetabular system consisting of an R3™ shell and 54 mm ID, diffusion-hardened, oxidized Zr2.5Nb liner paired with a 10 Mrad irradiated, remelted, UHMWPE (XLPE) insert.  System 2 (PCDM) consisted of a 67 mm stainless steel POLARCUP™ shell (61 mm ID) paired with a XLPE insert.  The acetabular sizes tested represent the largest for each system.


RESULTS and DISCUSSION:  Mean wear rate of R3DM inserts was ≈58% lower than that of PCDM inserts (p < 0.05) and within the range of 36 mm ID and 44 mm ID XLPE liners tested under similar conditions.  While isolation of all motion at the outer bearing is unlikely to occur clinically, it is believed to be a worst-case scenario as recent in-vivo studies indicate volumetric wear of highly crosslinked UHMWPE liners may increase with head diameter.  Reduced wear for R3DM as compared to PCDM is attributed to the use of an improved acetabular bearing material (DHOxZr) and reduced articulation size (54 mm).  As previous in-vitro tests indicate wear of XLPE is influenced more greatly by counterface material than diameter, bearing material is hypothesized to play a larger role.  Nonetheless, further testing is needed to definitively determine relative contributions of acetabular bearing material and articulating diameter to the difference in wear observed.

Amit PARIKH (Memphis, TN, USA), Carolyn WEAVER
15:50 - 15:55 Dual mobility cup and custom trabecular metal acetabular components designed with 3D technology for acute fixation of acetabular fractures in geriatric patients. Mariano LUNA (jefe de cadera) (Buenos Aires, Argentina)
Salle 1
16:00 Coffee Break - exhibition visit Salle 1

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16:30 - 17:50

Session 4: Dual Mobility in Revision THA

Moderators: Olivier GUYEN (Professeur, médecin-adjoint) (Lausanne, Switzerland), Yasuhiro HOMMA (Lecturer) (Tokyo, Japan)
16:30 - 16:40 The dislocating dual mobility total hip: which solution? Vincent PIBAROT (Lyon, France)
16:40 - 16:50 Treatment of the dislocated Dual Mobility Bearing. Michael TAUNTON (Hip and Knee Arthroplasty) (Rochester, MN USA, USA)
16:50 - 17:00 Cemented dual mobility cup: sometimes in the native acetabulum or always into a reinforcement structure ? Nicolas REINA (Professor of Orthopedics) (Toulouse, France)
17:00 - 17:10 Cemented dual mobility cup in revision THA: Japanese experience. Youngwoo KIM (Director of the Joint Replacement Center) (Kyoto, Japan)
17:10 - 17:20 Results of dual mobility in revision THA at Mayo Clinic. Michael TAUNTON (Hip and Knee Arthroplasty) (Rochester, MN USA, USA)
17:20 - 17:30 Dual mobility in revision THA: Australian experience and data from national registries. Scott BRUMBY (Chirurgien) (Adelaide, Australia, Australia)
17:30 - 17:50 Discussion.
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17:50 - 18:00


Salle 1