THR Anyone have Dual Mobility Implant?

PolarIce

Staff member since January 4, 2022
BoneSmart Staff
Joined
Jan 29, 2012
Messages
508
Age
39
Country
Canada Canada
Gender
Female
So I had my surgeon appt yesterday and he has gone ahead and booked me in for surgery. He said that because I have hypermobility in the joints, he is going to put in a dual hip joint instead of the standard hip joint commonly used.

After doing a lot of reading online last night, and watching quite a lot of videos online on youtube to see what they look like and understand the difference between the two, it seems to me that the dual hip joint should be the first choice for anyone because they say they have a much lower risk of dislocation, offer more flexibility, lower fracture rate and it's suggesting that they might last longer than the standard hip joints. It appears that they are newer as well(within the last 9-10 yrs). I have read all the old threads posted on the topic, but nothing listed there to answer the question.

Why wouldn't the dual hip joints not be the standard option for everyone? to me it seems like it should be the logical option. Does anyone know why they are not? have any of you had this dual hip joint?
 
Last edited:
I also am following this thread. My surgeon specializes in hips and is well recognized in our city. He told me I needed a new hip but to hold off since I still am able to do many activities. I asked him what he knew about SuperPath because of fewer restrictions and less concern about dislocation. My doctor suggested I consider a dual motion hip joint instead. He also said if I opted for the latter, he would refer me to a colleague because he had not been trained for them.

I am guessing that although these implants have been around for a few years, they may not be used in many residency programs where I assume most training is done. But again, just a guess.
 
The technical term of the device you're speaking of is "dual mobility."

Not a doctor, but I sense that yes, if you have hypermobility, the dual mobility device adds stabilization and is a great choice.

As to why the dual mobility device isn't standard, my sense is that hip replacement surgeons (especially the really good ones) have made huge progress in lowering dislocation rates without dual mobility devices.

My surgeon, for example, cuts from the side and front and he has had about a handful of dislocations out of like 5,000 surgeries. The anterior approach limits dislocations and posterior approach surgeons found a new way to "sew up" at the end up surgery that limits dislocations.

Another issue is that every new device comes with its own set of challenges and possible "side effects" that the surgeon must consider when operating. Every device has its own issues. And surgeons are always obsessively worrying about what is the unknown "side effect" that they're going to encounter by using a new device. Unfortunately the only real data that surgeons trust is history, as in over time, what are the results in real-world patients?

Those are my guesses. As I was thinking about the surgery and learning about the surgery, I really got into trying to learn how surgeons think. And so these are the best guesses of a non-surgeon. And one principle I think I saw highlighted in interview after interview was the view that there was no perfect device, no magical device out there. Same with approach--there is no magical approach in how you cut and operate.

Having said all of that, there was a study conducted by some surgeons at the Hospital for Special Surgery that found that dual mobility devices basically eliminated dislocations for people under 55 in the study. (I think people under 55 was the only group studied--not that the effect didn't apply to people over 55.)

So over time, maybe dual mobility will be used more. There is a summary of that study on their website if you want to google it.
 
The technical term of the device you're speaking of is "dual mobility."

Not a doctor, but I sense that yes, if you have hypermobility, the dual mobility device adds stabilization and is a great choice.

As to why the dual mobility device isn't standard, my sense is that hip replacement surgeons (especially the really good ones) have made huge progress in lowering dislocation rates without dual mobility devices.

My surgeon, for example, cuts from the side and front and he has had about a handful of dislocations out of like 5,000 surgeries. The anterior approach limits dislocations and posterior approach surgeons found a new way to "sew up" at the end up surgery that limits dislocations.

Another issue is that every new device comes with its own set of challenges and possible "side effects" that the surgeon must consider when operating. Every device has its own issues. And surgeons are always obsessively worrying about what is the unknown "side effect" that they're going to encounter by using a new device. Unfortunately the only real data that surgeons trust is history, as in over time, what are the results in real-world patients?

Those are my guesses. As I was thinking about the surgery and learning about the surgery, I really got into trying to learn how surgeons think. And so these are the best guesses of a non-surgeon. And one principle I think I saw highlighted in interview after interview was the view that there was no perfect device, no magical device out there. Same with approach--there is no magical approach in how you cut and operate.

Having said all of that, there was a study conducted by some surgeons at the Hospital for Special Surgery that found that dual mobility devices basically eliminated dislocations for people under 55 in the study. (I think people under 55 was the only group studied--not that the effect didn't apply to people over 55.)

So over time, maybe dual mobility will be used more. There is a summary of that study on their website if you want to google it.
Thank you so much for your great reply. Thank you so much for correcting me on the proper term. Now that you mention it, that is exactly what my surgeon called it as well. I will see if I can correct the title of this thread, so thank you so much for the correction.

Thank you so much for your reply and the great info posted.

I am so glad to hear talk about the anterior approach, because that is also what my surgeon mentioned. He said it would add a lot more stability, same thing with the implant. Now onto the hypermobility a question he did ask me is if I had Ehlers-Danlos syndrome, or had ever been diagnosed with it, because he said I was showing quite a few signs of it-hence the dual mobility implant.
 
there's also studies (in france - a lot of the research has been done at Toulouse) showing that the dual mobility prothesis is better for overweight/obese ppl because it dramatically reduces risk of dislocation.

I'm going to ask the surgeon about it on wednesday
 
I am on my second hip replacement and asked several surgeons about the dual mobility device because I practice yoga and was told by another yoga person to ask for it (I had a BIG fret after my first hip replacement because my surgeon told me that if I wanted to dislocate my hip, yoga would be the way to do it.)

So, with the second hip failing, I consulted several surgeons. Two (or three?) told me that there wasn't enough data out for them to be comfortable with it and that I didn't really need it. The other guy said he'd do whatever I wanted.

That's all the info I have! Good luck with your research and surgery!
 
A surgeon I saw in September suggested a dual motion implant because I am active and take both yoga and pilates (both with a lot of leg "turn out"). I will be scheduled soon with a surgeon who uses the SuperPath approach and I asked him about the previous recommendation.

His explanation was that the larger the "ball" of the implanted femoral head, the less likely the danger of dislocation. This, in turn, is dictated by the size of the acetabular cup in which this ball is placed. As the size of the cup increases, there is less need for a dual motion joint versus a "standard" implant.

In my case, I am a smaller person and it's possible that a dual motion joint would be helpful. My surgeon stated he would make that determination when he can see and measure my joint during surgery.
 
I had a dual mobility implant in August 21. I'm 50, and my THR was because of developmental dysplasia, so birth defect which I'd always known would require a THR. Growing up I was told of loads of things I couldn't do, always because of risk if I fell etc I did them all and was terrified of the replacement putting more restrictions on me - what I couldn't do was because the hip just wouldn't not because I was told I couldn't.

Anyway surgeon said beforehand he couldn't say what he'd use because it would depend on what it was like when he got in. I had posterior approach, was given a dual mobility because it reduces the risk of dislocation, had total hip restrictions for 12 weeks, then no restrictions, surgeon saying ' you've got a life to live'

Still early days, but I'm happy.
 
I also have a dual mobility joint. If you follow the joint registries you will see they are increasingly being used. They have been around for some time (70's I think) but the first generation had issues with wear and intra prosthetic dislocation (unique to dual mobility). These appear to have been resolved with the highly cross linked material. The use of dual mobility or traditional is independent/separate decision from approach (anterior/posterior/Superpath, etc.).
 
Had a long conversation about dual mobility joints with my surgeon (I am getting one). As @dapplega above stated, the first generation had issues but have since been fixed. My surgeon said it is the ideal replacement for younger, more athletic individuals, and for those who suffer from hip dysplasia (and therefore have greater range of motion). He said that the reason you don't see a whole bunch of surgeons doing them is because a lot of them get comfortable with what they have always done and are hesitant to try something different.
 
Had a long conversation about dual mobility joints with my surgeon (I am getting one). As @dapplega above stated, the first generation had issues but have since been fixed. My surgeon said it is the ideal replacement for younger, more athletic individuals, and for those who suffer from hip dysplasia (and therefore have greater range of motion). He said that the reason you don't see a whole bunch of surgeons doing them is because a lot of them get comfortable with what they have always done and are hesitant to try something different.
Thank you so much for posting your response. I am also an equestrian rider, so I can relate to the goals you have to get back on the horse so to speak. It's comforting to read that another rider out there is getting the same implant I am getting(mine is still a month away). Looking forwards to reading about your recovery.
 
I had a dual mobility implant in August 21. I'm 50, and my THR was because of developmental dysplasia, so birth defect which I'd always known would require a THR. Growing up I was told of loads of things I couldn't do, always because of risk if I fell etc I did them all and was terrified of the replacement putting more restrictions on me - what I couldn't do was because the hip just wouldn't not because I was told I couldn't.

Anyway surgeon said beforehand he couldn't say what he'd use because it would depend on what it was like when he got in. I had posterior approach, was given a dual mobility because it reduces the risk of dislocation, had total hip restrictions for 12 weeks, then no restrictions, surgeon saying ' you've got a life to live'

Still early days, but I'm happy.
The last part of your sentence is seriously making my day "You have a life to live". It's been a long journey from both the pain standpoint, having had to restrict my activities and the mental draining that this takes on you.

YOU HAVE A LIFE TO LIVE is my new favorite quote.

Thank you for all the support everyone <3
 
Thank you so much for posting your response. I am also an equestrian rider, so I can relate to the goals you have to get back on the horse so to speak. It's comforting to read that another rider out there is getting the same implant I am getting(mine is still a month away). Looking forwards to reading about your recovery.
@PolarIce I had the superior approach and I'm 5 weeks out. Never had much pain (didn't need the narcotics). No restrictions whatsoever and PT was super easy as I am fit and was riding 6 horses right up until the day before surgery. At 4 weeks I was driving, shopping, doing normal house stuff, feeding horses, cleaning stalls and tacking up for the riders who are keeping my horses fit for me. At this point I'm just waiting for my 6 week appointment for my surgeon to give me the go ahead to ride again. I HIGHLY recommend the dual mobility replacement with a superior approach (as they avoid cutting any major muscles so your recovery is quicker).
 

BoneSmart #1 Best Blog

Staff online

  • Jaycey
    ADMINISTRATOR Staff member since February 2011
  • Roy Gardiner
    Staff member since February, 23, 2013

Members online

Forum statistics

Threads
65,167
Messages
1,596,863
BoneSmarties
39,356
Latest member
JanieMarie
Recent bookmarks
0
Back
Top Bottom