Early Intraprosthetic Dislocation of Dual-Mobility Total Hip Arthroplasty Implant Following Attempted Closed Reduction: A Case Report


  • Joseph Schirmers, MD
  • Ryan Horazdovsky, MD
  • Scott Marston, MD




dual-mobility, total hip arthroplasty, intraprosthetic dislocation, reduction


Introduced in 1974 by Bousquet, the dual-mobility bearing for use in total hip arthroplasty (THA) confers increased jump distance and improved overall stability relative to conventional THA designs [1-3]. The dual-mobility bearing incorporates a relatively small (22-28mm) metal or ceramic femoral head press fit into a larger polyethylene liner which articulates with the acetabular component. Dissociation of the femoral head from the polyethylene liner (intraprosthetic dislocation) is a known late complication thought to be related to polyethylene liner wear and has been previously reported [2-7]. In a consecutive series of 384 primary THAs employing Bousquet’s original design, there were 14 intraprosthetic dislocations over 15 years (3.6%). The authors cited polyethylene wear as causative and mean time to intraprosthetic dislocation was 8.9 years [2].


Farizon F, de Lavison R, Azoulai JJ, Bousquet G: Results with a cementless alumina-coated cup with dual mobility: A twelve-year follow-up study. Int Orthop 1998, 22(4):219-224.

Philippot R, Camilleri JP, Boyer B, Adam P, Farizon F: The use of a dual-articulation acetabular cup system to prevent dislocation after primary total hip arthroplasty: Analysis of 384 cases at a mean follow-up of 15 years. Int Orthop 2009, 33(4):927-932.

Philippot R, Adam P, Reckhaus M, et al: Prevention of dislocation in total hip revision surgery using a dual mobility design. Orthop Traumatol Surg Res 2009, 95(6):407-413.

Banzhof JA, Robbins CE, Av Ven, Talmo CT, Bono JV: Femoral head dislodgement complicating use of a dual mobility prosthesis for recurrent instability. J Arthroplasty 2013 Mar, 28(3):e1-3. Epub 2012 Dec 21

Hamadouche M, Arnould H, Bouxin B: Paper 348: Cementless dual mobility socket in primary THA at a mean 7-year follow-up. 79th Annual Meeting Proceedings. Rosemont, IL, American Academy of Orthopaedic Surgeons 2012, pp 541-542.

Riviere C, Lavigne M, Alghamdi A, Vendittoli P: Early Failure of Metal-on-Metal Large-Diameter Head Total Hip Arthroplasty Revised with a Dual-Mobility Bearing; A Case Report. JBJS Case Connector 2013 Sep, 3(3):e95 1-6.

Ward J, McCardel BR, Hallstrom BR: Complete Dissociation of the Polyethylene Component in a Newly Available Dual-Mobility Bearing Used in Total Hip Arthroplasty; A Case Report. JBJS Case Connector 2013 Sep, 3(3):e94 1-4.

Mohammed R, Cnudde P: Severe metallosis owing to intraprosthetic dislocation in a failed dual-mobility cup primary total hip arthroplasty. J Arthroplasty 2012 Mar, 27( 3):e1-3. Epub 2011 Jul 12.

Stulberg SD: Dual mobility for chronic hip instability: A solution option. Orthopedics 2010, 33(9):637

Buly RL, Huo M, Root L, Binzer T, Wilson PD, Jr: Total hip arthroplasty in cerebral palsy. Long-term follow-up results. Clin Orthop Res 1993, 296:148-153.

Sanders RJ, Swierstra BA, Goosen JH: The use of a dual-mobility concept in total hip arthroplasty patients with spastic disorders: No dislocations in a series of ten cases at midterm follow-up. Arch Orthop Trauma Surg 2013 Jul, 133(7):1011-1016.

Hailer NP, Weiss RJ, Stark A, Kärrholm J: Dual-mobility cups for revision due to instability are associated with a low rate of re-revisions due to dislocation: 228 patients from the Swedish Hip Arthroplasty Register. Acta Orthop 2012 Dec, 83(6):566-571.

Philippot R, Boyer B, Farizon F: Intraprosthetic dislocation: a specific complication of the dual-mobility system. Clin Orthop Relat Res 2013 Mar, 471(3):965-970. Epub 2012 Oct 10.

Tarasevicius S, Busevicius M, Robertsson O, Wingstrand H: Dual mobility cup reduces dislocation rate after arthroplasty for femoral neck fracture. BMC Musculoskelet Disord 2010, 11:175.

Bensen AS, Jakobsen T, Krarup N: Dual mobility cup reduces dislocation and re-operation when used to treat displaced femoral neck fractures. Int Orthop 2014 Jun, 38(6):1241-1245.

Loubignac F, Boissier F: Cup dissociation after reduction of a dislocated hip hemiarthroplasty. Rev Chir Orthop Reparatrice Appar Mot 1997, 83(5):469-472.




How to Cite

Schirmers, MD, J., Horazdovsky, MD, R., & Marston, MD, S. (2014). Early Intraprosthetic Dislocation of Dual-Mobility Total Hip Arthroplasty Implant Following Attempted Closed Reduction: A Case Report. Reconstructive Review, 5(2). https://doi.org/10.15438/rr.4.3.76



Case Report