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Large heads have been recommended to reduce the risk of dislocation after total hip arthroplasty. One of the issues with larger heads is the risk of increased wear and damage in thin polyethylene liners. Dual-mobility liners have been proposed as an alternative to large heads. We tested the wear performance of highly crosslinked dual-mobility liners under adverse conditions simulating microseparation and third-body wear. No measurable increase in polyethylene wear rate was found in the presence of third-body particles. Microseparation induced a small increase in wear rate (2.9mm(3)/million cycles). A finite element model simulating microseparation in dual-mobility liners was validated using these experimental results. The results of our study indicate that highly crosslinked dual-mobility liners have high tolerance for third-body particles and microseparation.

Wear-related complications remain a major issue after unicompartmental arthroplasty. We used a computational model to predict knee wear generated in vitro under diverse conditions. Inverse finite element analysis of 2 different total knee arthroplasty designs was used to determine wear factors of standard and highly crosslinked polyethylene by matching predicted wear rates to measured wear rates. The computed wear factor was used to predict wear in unicompartmental components. The articular surface design and kinematic conditions of the unicompartmental and tricompartmental designs were different. Predicted wear rate (1.77 mg/million cycles) was very close to experimental wear rate (1.84 mg/million cycles) after testing in an AMTI knee wear simulator. Finite element analysis can predict experimental wear and may reduce the cost and time of preclinical testing.