Vet Comp Orthop Traumatol 2021; 34(04): 294-302
DOI: 10.1055/s-0041-1725015
Clinical Communication

Zurich Cementless Dual Mobility Cup for Canine Total Hip Prosthesis: Implant Characteristics and Surgical Outcome in 105 Cases

Otto I. Lanz
1   Department of Small Animal Clinical Science, VA-MD Regional College of Veterinary Medicine, Blacksburg, Virginia, United States
Ida Forzisi
2   Clinica Veterinaria Vezzoni, Cremona, CR, Italy
2   Clinica Veterinaria Vezzoni, Cremona, CR, Italy
› Author Affiliations


Dislocation after total hip arthroplasty (THA) remains a troublesome complication, and a source of frustration for the owner and the surgeon. The dislocation rate of hip prostheses in dogs is reported to range from 4 to 15%, representing the most common short-term complication. This is especially true in large and giant breed dogs, usually requiring revision surgery. With the increase in the number of THA being performed in veterinary surgery, reducing or preventing complications such as postoperative THA dislocation will be of paramount importance. The Zurich cementless dual mobility (DM) system allows impingement-free range of angulation of 80 to 132 degrees between the ceramic head and the polyether ether ketone (PEEK) cup when combined with the range of the PEEK cup in the outer metal cup. In this article, we review the use of the DM cup in THA in large and giant breed dogs, in terms of its history, biomechanics, outcomes and complications based on 105 cases.

Authors' Contributions

O.L. and A.V. conceptualized and designed the study. I.F. and A.V. acquired, analyzed and interpreted the data. All authors drafted, revised and approved the submitted manuscript and are publically accountable for relevant content.

Publication History

Received: 23 June 2020

Accepted: 15 January 2021

Article published online:
31 March 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

  • References

  • 1 Bousquet GDF, Debiesse JL, Girardin P, Relave M, Israeli A. The ceramic coated cementless total hip arthroplasty: basic concepts and surgical technique. J Orthop Surg Tech 1985; 1: 15-28
  • 2 Plummer DR, Haughom BD, Della Valle CJ. Dual mobility in total hip arthroplasty. Orthop Clin North Am 2014; 45 (01) 1-8
  • 3 Lewinnek GE, Lewis JL, Tarr R, Compere CL, Zimmerman JR. Dislocations after total hip-replacement arthroplasties. J Bone Joint Surg Am 1978; 60 (02) 217-220
  • 4 Woo RY, Morrey BF. Dislocations after total hip arthroplasty. J Bone Joint Surg Am 1982; 64 (09) 1295-1306
  • 5 Australian Orthopaedic Association National Joint Replacement Registry. 2010 . Accessed July 29, 2015 at:
  • 6 Guerrero TG, Montavon PM. Zurich cementless total hip replacement: retrospective evaluation of 2nd generation implants in 60 dogs. Vet Surg 2009; 38 (01) 70-80
  • 7 Hayes GM, Ramirez J, Langley Hobbs SJ. Does the degree of preoperative subluxation or soft tissue tension affect the incidence of postoperative luxation in dogs after total hip replacement?. Vet Surg 2011; 40 (01) 6-13
  • 8 Olmstead ML, Hohn RB, Turner TM. A five-year study of 221 total hip replacements in the dog. J Am Vet Med Assoc 1983; 183 (02) 191-194
  • 9 Conzemius MG, Vandervoort J. Total joint replacement in the dog. Vet Clin North Am Small Anim Pract 2005; 35 (05) 1213-1231
  • 10 Schulz KS. Application of arthroplasty principles to canine cemented total hip replacement. Vet Surg 2000; 29 (06) 578-593
  • 11 Forster KE, Wills A, Torrington AM. et al. Complications and owner assessment of canine total hip replacement: a multicenter internet based survey. Vet Surg 2012; 41 (05) 545-550
  • 12 Kidd SW, Preston CA, Moore GE. Complications of porous-coated press-fit cementless total hip replacement in dogs. Vet Comp Orthop Traumatol 2016; 29 (05) 402-408
  • 13 Hummel DW, Lanz OI, Werre SR. Complications of cementless total hip replacement. A retrospective study of 163 cases. Vet Comp Orthop Traumatol 2010; 23 (06) 424-432
  • 14 Fitzpatrick N, Law AY, Bielecki M, Girling S. Cementless total hip replacement in 20 juveniles using BFX™ arthroplasty. Vet Surg 2014; 43 (06) 715-725
  • 15 Vezzoni L, Vezzoni A, Boudrieau RJ. Long-term outcome of Zurich cementless total hip arthroplasty in 439 cases. Vet Surg 2015; 44 (08) 921-929
  • 16 Vielpeau C, Lebel B, Ardouin L, Burdin G, Lautridou C. The dual mobility socket concept: experience with 668 cases. Int Orthop 2011; 35 (02) 225-230
  • 17 Boyer B, Philippot R, Geringer J, Farizon F. Primary total hip arthroplasty with dual mobility socket to prevent dislocation: a 22-year follow-up of 240 hips. Int Orthop 2012; 36 (03) 511-518
  • 18 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 (12) 3891-3900
  • 19 Guillaumot P, Autefage A, Palierne S, Dembour T, Chancrin JL. Dual mobility canine total hip prosthesis: implant characteristics and surgical procedure. Vet Comp Orthop Traumatol 2012; 25 (06) 506-510
  • 20 Guillaumot P, Autefage A, Dembour T, Chancrin JL. Outcome and complications after dual mobility total hip replacement: fifty cases with a minimum of six months clinical and radiographic follow-up. Vet Comp Orthop Traumatol 2012; 25 (06) 511-517
  • 21 Sanchez-Sotelo J, Berry DJ. Epidemiology of instability after total hip replacement. Orthop Clin North Am 2001; 32 (04) 543-552
  • 22 Dyce J, Wisner ER, Wang Q, Olmstead ML. Evaluation of risk factors for luxation after total hip replacement in dogs. Vet Surg 2000; 29 (06) 524-532
  • 23 Chandler DR, Glousman R, Hull D. et al. Prosthetic hip range of motion and impingement. The effects of head and neck geometry. Clin Orthop Relat Res 1982; (166) 284-291
  • 24 Berry DJ, von Knoch M, Schleck CD, Harmsen WS. Effect of femoral head diameter and operative approach on risk of dislocation after primary total hip arthroplasty. J Bone Joint Surg Am 2005; 87 (11) 2456-2463
  • 25 Haughom BD, Plummer DR, Moric M, Della Valle CJ. Is there a benefit to head size greater than 36 mm in total hip arthroplasty?. J Arthroplasty 2016; 31 (01) 152-155
  • 26 Epinette JA, Béracassat R, Tracol P, Pagazani G, Vandenbussche E. Are modern dual mobility cups a valuable option in reducing instability after primary hip arthroplasty, even in younger patients?. J Arthroplasty 2014; 29 (06) 1323-1328
  • 27 Adam P, Farizon F, Fessy MH. [Dual articulation retentive acetabular liners and wear: surface analysis of 40 retrieved polyethylene implants]. Rev Chir Orthop Repar Appar Mot 2005; 91 (07) 627-636 (In French)
  • 28 Civinini R, Carulli C, Matassi F, Nistri L, Innocenti M. A dual-mobility cup reduces risk of dislocation in isolated acetabular revisions. Clin Orthop Relat Res 2012; 470 (12) 3542-3548
  • 29 Vasukutty NL, Middleton RG, Matthews EC, Young PS, Uzoigwe CE, Minhas TH. The double-mobility acetabular component in revision total hip replacement: the United Kingdom experience. J Bone Joint Surg Br 2012; 94 (05) 603-608
  • 30 Matsen LK, Hozack WJ. Outcomes of dual mobility components in total hip arthroplasty. A systematic review of the literature. Bone Joint J 2016; 98-B (1, Suppl A): 60-63
  • 31 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 (02) 389-395
  • 32 Li M, Glassman A. What's new in hip replacement. J Bone Joint Surg Am 2019; 101 (18) 1619-1627
  • 33 Marcellin-Little DJ, DeYoung BA, Doyens DH, DeYoung DJ. Canine uncemented porous-coated anatomic total hip arthroplasty: results of a long-term prospective evaluation of 50 consecutive cases. Vet Surg 1999; 28 (01) 10-20
  • 34 Bergh MS, Budsberg SC. A systematic review of the literature describing the efficacy of surgical treatments for canine hip dysplasia (1948-2012). Vet Surg 2014; 43 (05) 501-506
  • 35 Brockett C, John G, Williams S, Isaac G, Fisher J. Wear of Ceramic-on-Carbon Fibre Reinforced PEEK Hip Replacements. Orthopaedic Proceedings Vol. 94-B, No. SUPP_XL 2018
  • 36 Tepic S, Bresina S, Hintner M, Kaddick C. Reduced wear of a UHMWPE THR liner with modified contact geometry. 53rd Annual Meeting of the Orthopaedic Research Society, Poster 1805
  • 37 McArthur BAND, Nam D, Cross MB, Westrich GH, Sculco TP. Dual-mobility acetabular components in total hip arthroplasty. Am J Orthop 2013; 42 (10) 473-478
  • 38 McKee GK, Watson-Farrar J. Replacement of arthritic hips by the McKee-Farrar prosthesis. J Bone Joint Surg Br 1966; 48 (02) 245-259
  • 39 Lachiewicz PF, Watters TS. The use of dual-mobility components in total hip arthroplasty. J Am Acad Orthop Surg 2012; 20 (08) 481-486
  • 40 Hamadouche M, Arnould H, Bouxin B. Is a cementless dual mobility socket in primary THA a reasonable option?. Clin Orthop Relat Res 2012; 470 (11) 3048-3053
  • 41 Vedrine B, Guillaumot P, Chancrin JL. Dislocation of a dual mobility total hip replacement following fracture of the polyethylene liner. Vet Comp Orthop Traumatol 2016; 29 (03) 259-264
  • 42 Stulberg SD. Dual poly liner mobility optimizes wear and stability in THA: affirms. Orthopedics 2011; 34 (09) e445-e448
  • 43 Netter JD, Hermida JC, Chen PC, Nevelos JE, D'Lima DD. Effect of microseparation and third-body particles on dual-mobility crosslinked hip liner wear. J Arthroplasty 2014; 29 (09) 1849-1853
  • 44 Vezzoni L, Montinaro V, Vezzoni A. Use of a revision cup for treatment of Zurich cementless acetabular cup loosening. Surgical technique and clinical application in 31 cases. Vet Comp Orthop Traumatol 2013; 26 (05) 408-415
  • 45 Nesser VE, Kowaleski MP, Boudrieau RJ. Severe polyethylene wear requiring revision total hip arthroplasty in three dogs. Vet Surg 2016; 45 (05) 664-671