A guiding sleeve to facilitate acetabular reaming and insertion of finned dual mobility cups through limited posterior exposure: a cadaveric technical note

Postoperative instability remains a significant concern following total hip arthroplasty (THA), particularly in patients with small acetabular dimensions or in situations requiring limited surgical exposure (e.g., elderly fracture cases). Dual mobility cups incorporating peripheral fins and apical fixation spikes may enhance primary stability; however, these fixation features may complicate insertion through limited posterior exposure. This technical note describes a custom guiding sleeve designed to facilitate acetabular reaming and insertion of dual mobility cups with peripheral fins and apical fixation spikes while preserving surrounding soft tissues. A cadaveric feasibility study was conducted using three fresh-frozen hips with small acetabular dimensions. A custom-designed cylindrical guiding sleeve was used during acetabular reaming and cup insertion through a limited posterior approach. The guiding sleeve created a protected cylindrical corridor that displaced surrounding soft tissues and facilitated acetabular preparation and cup insertion without soft-tissue impingement in this cadaveric feasibility study. The guiding sleeve demonstrated technical feasibility in this cadaveric feasibility study and may represent a useful adjunct for acetabular preparation and implantation of dual mobility cups with peripheral fins and apical spikes through limited posterior exposure. Further clinical studies are warranted to evaluate its effectiveness in vivo.