Jumbo Heads vs. Dual Mobility: The Data on Preventing Hip Dislocations

Why surgeons should maximize head size before turning to heavily marketed dual mobility bearings.

Dislocation remains a challenging and relatively common complication following total hip arthroplasty (THA). Instability is the leading cause of revision following THA, which can lead to poor patient outcomes and increased economic burden. To combat this, surgeon-controlled factors for the prevention and treatment of instability often include maximizing femoral head diameter and the use of dual mobility (DM) bearings.

DM femoral head bearings were approved for use in the United States in 2009. The use of this implant design has grown significantly over the last decade and is now commonly used in modern THA for both primary and revision cases. The DM design combines the low frictional torque principle of a smaller head size with the benefit of a large-diameter outer bearing to increase the head-neck ratio. However, it remains unclear from the literature what benefit DM provides compared to simply using large-diameter femoral heads. We wanted to find out if the complex, heavily marketed DM bearing was actually better than a traditional “jumbo” head of the same size.