BI-MENTUM™ Dual Mobility System

How do you manage complex cases?

Evidence indicates dislocation is a common driver for revision Total Hip Arthroplasty (THA) due to instability. 1

Currently available evidence indicates that a dual mobility implant is becoming a leading treatment option to address instability for complex primary2-4 fracture neck of the femur (FNOF)5-7 and revision hip surgery.8-10

Managing patients with a higher risk of dislocation

BI-MENTUM Acetabular Cups are especially indicated for patients demonstrating a high risk of instability.11

Managing patients with a higher risk of peri-prosthetic fracture

Peri-Prosthetic Fracture remains a major complication following THR, often associated with a poor outcome, high mortality rate and incomplete functional recovery.12 Advanced age is considered a risk factor for post-op peri-prosthetic fracture.12

CORAIL Collared has a significantly fewer revisions due to peri-prosthetic fracture when compared to all other cementless hips in the UK NJR.13

What do the CORAIL PINNACLE Faculty Recommend?

When asked, 14 out of 15 members of the CORAIL International Faculty group confirmed they would recommend a collared CORAIL in combination with BI-MENTUM for patients at high risk of dislocation.14

Agreement with SERF

To further enhance the DePuy Synthes portfolio, a strategic co operation and supply agreement has been formed with Société d’Etude, de Recherche et de Fabrication (SERF) to exclusively launch the SERF NOVAE® SunFit TH Dual Mobility System under the brand name BI-MENTUM Dual Mobility System.

SERF is the original developer of the dual mobility implant with over 40 years of clinical experience.16 According to a recent clinical study, the SERF NOVAE® SunFit TH Dual Mobility system, which was introduced in 2007, has clinical results showing that the first 100 patients (104 primary total hip arthroplasties) had a 100 percent cup survivorship with zero dislocations at 10 years.15

History

1979

NOVAE-1

Tripod Fixation

1998

NOVAE

Liner Optimization

1999

NOVAE E

Herispherical Cup with 3 mm cylindrical extension

2000

NOVAE Sunfit

Pressfit only fixation with Alumina and Hydroxyapatite Coating

2007

NOVAE TH

Circumferential Macrostructure and Titanium and Hydroxyapatite Coating

2018

BI-MENTUM™

Identical Pressfit Design, Fratures and Coating as Novae TH

Over 40 years clinical experience.16

165,000 cups provided worldwide since 2007.17

(Serf NOVAE Dual Mobility Families of Cups)

BI-MENTUM Options

BI-MENTUM Pressfit Acetabular Cup

Cementless BI-MENTUM dual mobility cups are coated with plasmasprayed titanium (150 +/- 30 μm) and hydroxyapatite (70 +/- 20 μm). All cup variants have a polished bearing surface with a 3 mm cylindrical extension which increases jump distance compared to a hemispherical bearing.

  • A macrostructure of concentric rings increases the surface area with the aim of improving primary fixation.
  • The external pole of the cup is slightly flattened (-0.5 mm) to reduce stresses at the base of the acetabular (preventing the cup been forced out of the acetabular) allowing better cup impaction and pressfit at equator of the cup.

BI-MENTUM Plus and BI-MENTUM Revision

BI-MENTUM Plus and BI-MENTUM Revision dual mobility cups have the same macrostructure and coating as the BI-MENTUM Pressfit Dual Mobility system. These variants allow for additional fixation through the use of cortical screws and anchoring pegs, the revision cup also has an obturator hook for additional fixation.

BI-MENTUM Plus and Revision dual mobility cups are anchored in the acetabulum using the tripod principle: 1 peg in the ischium, 1 peg in the pubic bone and cortical screws in the ilium through flanges. BI-MENTUM Revision dual mobility cups also utilise an obturator hook to ensures anatomical re-centering and provides additional mechanical support.

BI-MENTUM Cemented Acetabular Cup

BI-MENTUM Cemented dual mobility cups are grit blasted and have radial; circumferential and longitudinal grooves to aid primary anchoring and rotational stability in the cement mantle. Cemented cup can be used alone or in combination with the BI-MENTUM Reinforcement Plates.

BI-MENTUM Reinforcement Plates

BI-MENTUM Reinforcement Plates have a cruciform shape with an obturator hook and ischial flange designed to accommodate up to four screws.

  • The plates are both sided (Left and Right) and size specific.
  • The plates have an outer diameter (OD) designed to fit with BI‑MENTUM cemented cups with OD 7 mm smaller than the plate e.g. a 50 mm BI-MENTUM Reinforcement Plate accomodates a 43 mm BI‑MENTUM cemented cup.
  • Spacers on each arm of the plate help to maintain a uniform cement mantle.

BI-MENTUM Polyethylene Acetabular Liners

The unconstrained polyethylene (PE) Liners are made from conventional UHMWPE (GUR1020). When articulating within the polished stainless steel cup, a PE liner transfers reduced torque to the cup when compared with hard on hard bearings.18

A Complete Portfolio

The perfect symphony comes from the purest sounds

With BI-MENTUM™ Dual Mobility System we complete our portfolio with a product supported by robust clinical data and survivorship.9,16,19

With BI-MENTUM alongside the CORAIL® PINNACLE® Family of Products, we will achieve the perfect symphony in the Total Hip Replacement Market!

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References

  1. National Joint Registry for England, Wales, Northern Ireland and the Isle of Man, 16th Annual report, 2019. Page 82, 3.3.5 Revisions for different causes after primary hip surgery. Available from: www.njrreports.org.uk.
  2. Vermersch T, Viste A, Desmarchelier R, Fessy MH. Prospective longitudinal study of one hundred patients with total hip arthroplasty using a second-generation cementless dual-mobility cup. International Orthopaedics (2015) 39:2097-2101.
  3. 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. 2009;33:927–932. [PMC free article] [PubMed].
  4. Combes A, Migaud H, Girard J, Duhamel A, Fessy MH. Low rate of dislocation of dual-mobility cups in primary total hip arthroplasty. Clin Orthop Relat Res. 2013;471:3891–3900. [PMC free article] [PubMed].
  5. Nich et al. Do dual-mobility cups reduce the risk of dislocation in total hip arthroplasty for fractured neck of femur in patients aged older than 75 years? J Arthroplasty. 2016; 31: 1256-1260.
  6. Adam P, Philippe R, Ehlinger M, Roche O, Bonnomet F, Molé D, Fessy MH. Dual mobility cups hip arthroplasty as a treatment for displaced fracture of the femoral neck in the elderly. A prospective, systematic, multicenter study with specific focus on postoperative dislocation. Orthop Traumatol Surg Res. 2012;98:296–300. [PubMed].
  7. Tarasevicius S, Busevicius M, Robertsson O, Wingstrand H. Dual mobility cup reduces dislocation rate after arthroplasty for femoral neck fracture. BMC Musculoskelet Disord. 2010;11:175. [PMC free article] [PubMed].
  8. Guyen O. Constrained liners, dual mobility or large diameter heads to avoid dislocation in THA. EFORT Open Rev 2016;1:197-204. DOI: 10.1302/2058-5241 .1.000054.
  9. Leiber-Wackenheim F, Brunschweiler B, Ehlinger M, Gabrion A, Mertl P. Treatment of recurrent THR dislocation using of a cementless dual- mobility cup: a 59 cases series with a mean 8 years’ follow-up. Orthop Traumatol Surg Res. 2011;97:8–13. [PubMed].
  10. Langlais FL, Ropars M, Gaucher F, Musset T, Chaix O. Dual mobility cemented cups have low dislocation rates in THA revisions. Clin Orthop Relat Res. 2008;466:389–395. [PMC free article] [PubMed].
  11. SERF CLINICAL EVALUATION REPORT Dual mobility acetabular cup NOVAE; 27 June 2017. Data on File
  12. Sidler-Maier C., Waddell J. Incidence and predisposing factors of periprosthetic proximal femoral fractures: a literature review. International Orthopaedics (SICOT) (2015) 39:1673–1682
  13. NJR. Bespoke Report: CORAIL Collared Stem Pinnacle Cup vs All other Cementless hips. Report can be accessed at http://www.corailpinnacle.net/resources
  14. International CORAIL PINNACLE EMEA Faculty Survey; 11 September 2019. Data on File.
  15. Laurenden L, Philippot R, Boyer B, Neri T, Farizon F. Ten-Year Clinical and Radiological Outcomes of 100 Total Hip Arthroplasty Cases with a Modern Cementless Dual Mobility Cup Surgical Technology International. 2018 Apr; 32: 985
  16. Farizon F, de Lavison R, Azoulai J, Bousquet G. Results with a cementless alumina-coated cup with dual mobility. A twelve year follow-up study. Traumatology and Orthopaedic Centre, University Hospital Centre of Saint Etienne, Exercise G.I.P. Hôpital de Bellevue, Saint Etienne, France. 1997.
  17. SERF Internal Data. SERF Novae worlwide implantations 2007 - 2017. Data on File.
  18. Brockett C, Williams S, Jin Z, Isaac G, Fisher J. Friction of total hip replacements with different bearings and loading conditions. J Biomed Mat Res B: Appl. Biomater. 2007l 81B: 508-515
  19. Vielpeau C, Lebel B, Ardouin L, Burdin G, Lautridou C. The dual mobility socket concept: experience with 668 cases. Int Orthop 35(2):225–230.