Dual Mobility Hip Replacement

⚙️What This Procedure Involves

The surgical procedure is identical to standard total hip replacement. The difference is the acetabular component: a metal shell is impacted into the acetabulum, and a large polyethylene liner with a polished inner surface is placed inside. The standard femoral head (28 or 32 mm) articulates within the liner (first articulation), and the liner can also move within the shell (second articulation). This dual articulation dramatically increases the arc of motion before impingement and dislocation. The operation takes one to one and a half hours.

💡Why It May Be Recommended

Dual mobility is used for patients at high risk of dislocation — revision hip replacement, neuromuscular conditions (cerebral palsy, Parkinson's disease, dementia), fracture patients with poor compliance, previous hip dislocation, spinopelvic pathology affecting hip mechanics, and tumour reconstruction around the hip.

⚖️Non-Operative Alternatives

All standard non-operative hip treatments. Standard THR with conventional bearings is the alternative — with appropriate precautions, dislocation rates are low in most patients.

📋Preparing for Surgery

Standard THR pre-assessment. Identification of dislocation risk factors. Discussion of bearing options.

✅Expected Benefits

Dramatically reduced dislocation rate — from approximately 3–5% (standard bearing) to less than 1% with dual mobility. This is particularly valuable in high-risk populations where dislocation rates with standard bearings can exceed 10%.

⚠️Common Risks

• All standard THR risksSee standard risks

  Infection, blood clots, leg length discrepancy.

• Intraprosthetic dislocationRare

  Very rare failure mode where the small head dislocates from within the liner (rather than the liner from the shell). Risk less than 1%.

🔴Less Common but Serious Risks

• Accelerated polyethylene wearLong-term

  The dual articulation may increase total wear, though modern highly cross-linked polyethylene has dramatically reduced this concern.

• Liner impingement on stemUncommon

  The large liner may impinge on the femoral stem neck, causing wear and metallosis.

• InfectionUncommon

  Prosthetic joint infection approximately 1%.

💉Anaesthetic Considerations

Same as standard THR.

🏃Recovery and Rehabilitation

Same as standard THR — but with fewer or no hip precautions in many protocols, because the dual mobility design is inherently very stable. This may allow faster functional recovery. Hospital one to three days. Driving at four to six weeks. Full recovery three to six months.

📅Follow-Up

Same as standard THR.

❓Frequently Asked Questions