What question did this study set out to answer?

To evaluate long-term outcomes of dual mobility total hip arthroplasty in high-risk patients.

May 16, 2026

20-Year Experience With Dual Mobility in Primary Total Hip Arthroplasty: Whole Construct Outcome

Key Points

To evaluate long-term outcomes of dual mobility total hip arthroplasty in high-risk patients.
Retrospective analysis of 318 patients undergoing dual mobility THA from March 2006 to October 2024.
Primary outcomes included all-cause revision and major re-operation rates.
Kaplan Meier analysis performed with a median follow-up of 7.4 years.
Survivorship free of all-cause revision was 97.9% (95% CI 94.8%–99.1%).
Two dislocations were recorded (0.63%) and five revisions occurred, including two due to periprosthetic infection (PJI) and two due to peri-prosthetic fracture (PPF).
PPF was observed in 2.2% of patients, with the mean time to occurrence at 3.5 years.

Abstract

Dual mobility (DM) is an established option in THA but limited long term reports are available, especially considering whole construct outcome. We report a consecutive series of high-risk patients stratified on evidence-based criteria to receive a DM primary THA. Importantly documenting re-operation for any reason including peri-prosthetic fracture (PPF). Retrospective review of patients under-going a DM THA between 1st March 2006 - 1st October 2024. Individual national digital records were reviewed that identify all healthcare episodes. Primary outcome measures were whole construct outcome with survivorship for all-cause revision and any major re-operation. Secondary outcomes dislocation, PPF and PROMS. Cohort of 318 cases with a mean age of 74.4 years (21.3–94.1). Using Kaplan Meier analysis at median F/U of 7.4 years (19.6–1.0) survivorship free of all-cause revision & major re-operation was 97.9% (95% CI 94.8%–99.1%) where non-OA was indication in 39.6%. We observed 2 dislocations (0.63%). With 5 revisions identified (2 PJI, 2 PPF, 1 instability). A further 4 patients had a PPF treated by fixation (1 type B & 3 type C) and one PPF treated non-operative (AG). Post-operative PPF was the most observed complication (2.2%) occurring a mean of 3.5 years (0.7–10.6). Mean gain in OHS 24.6. Our results demonstrate the successful use of DM in patients’ high risk for instability undergoing THA at a maximum follow-up approaching 20 years and confirm PPF is the most common reason for re-operation. We believe our cohort as well as high-risk for instability is also a high falls risk population. This re-enforces the need to consider all patient and implant factors when deciding bearing.

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