Has Anyone Had a Dual Mobility Hip Implant? How many years ago?

@nat0430 Ugh! Thinking you are going to be better after surgery, then facing 2 years of pain and still hurting is awful. I have not had the dual mobility implant, but I did require revision of both original hip implants in 2011. My original implants were supposed to be more suitable for younger, more active patients in 2006, when I was in my 50's. They lasted 5 years, during which time I repeatedly told the surgeon "something felt wrong."

They implants a newer technology, where the cup & ball were chromium cobalt & titanium to reduce wear, but the shedding of the chromium-cobalt during wear created problematic metal levels in up to 50% of patients, requiring revision to traditional surfaces. These particular implants are no longer being used, but there are still people on Connect reporting that they are having them removed due to serious issues.

Some of the dual mobility implants have potential friction between the titanium acetabular cup & the gliding surface of the liner, which is chromium cobalt. Higher metal ion levels in the blood have been reported, which means metal is being shed by the prosthesis faster than it can be broken down and eliminated by the liver. According to the following article, this has not yet resulted in reported problems, but I would worry that long-term there could be significant issues as ion levels rise.

Here is an excerpt:
"...The modern, modular design has an additional cobalt-chromium (CoCr) liner inserted into a titanium acetabular component allowing supplementary screw fixation to enhance primary stability. However, the metal-on-metal interface between CoCr liner and titanium cup is at risk of fretting corrosion and remains a concern [175,176,177]. Metal ions can further lead to advance local tissue reaction (ALRT) and implant loosening [178]. The first study regarding metal ions was conducted by Matsen Ko et al., which revealed 21% of the patient had elevated serum chromium levels [179]. Other studies reported that serum ion levels (cobalt, chromium or titanium) was elevated in 9.3-23% of the patients [47, 111]. On the other hand, some studies have noted that this elevation was not associated with clinical adverse events including instability, loosening or need of revision [64, 67, 72]. In summary, the current evidence suggests there is a slight elevation of serum ion level but this does not negatively affect the implant survival..." Full text:(https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-021-04404-4)

Having experienced the unintended consequence of metal poisoning, complete with revisions, and a long recovery from the metal levels, and knowing that they ARE reporting elevated metal ion levels already, my response to this suggestion would be to ask the surgeon to help find an alternative that did not include such a risk. I would ask for the EXACT name, manufacturer and US distributor of the implant and do my own research.

I see that you are already planning a discussion with the surgeon. Wonderful! Continue to be an informed consumer, and your own advocate! If I cana help you formulate specific questions for your visit, please reach out.
Sue

Thank you very much, Sue. The information you provided is very helpful. I briefly read about the higher ion levels and it concerned me. I also have a nickel allergy and am also concerned about any chromium cobalt in my body. I wonder if there are any titanium/titanium modular components? My surgeon is careful, which I appreciate, so I will have a lot of follow-up questions regarding the specific implant. I am in my 50s and am (well was) very active so I think he thinks it would work best for me because increased range of motion and a lesser probability of dislocating. I also have what feels like stretched tissue and a lot of pain behind my greater trochanter, so I think he is trying to provide stability without lengthening me and also bringing my greater troach a little closer to my pelvis. I know revisions usually result in lengthening. When you had your revisions, did they have to lengthen you/stretch tissue for stability? I have bought a little time - I have had two radio frequency ablation procedures to help with the pain because it is unrelenting - never stops, even at rest. So, with this extra time I want to use it to make the best decisions I can and I really appreciate your response.

When I asked about 2 titanium surfaces, my excellent ortho explained that it hasn't been successful because it doesn't "glide" well against itself, but that was 10 years ago, so something may have changed.

I had a slightly different experience as far as length. I had always had a 1/2" difference, my new surgeon tried to reduce it to 1/4" and it dislocated within one week. So I live with the 1/2' difference. But I can tell you that with gait training and an orthotic, the body adapts well.

My biggest concern regarding the ions would be that the study covered a post surgical of up to 9 years - what happens over the longer time?

I'm glad you are doing your research, involved patients can often avoid problems.
Sue

I have it worked great but have gotten an extremely high Ni reactivity of 23 in an ltt test from orthopedic analysis out of Chicago the test was 600 dollars now I have joint pain the CoCr has very little nickel in it but when u have 10^17 atoms a day being released don't really think 1 percent is any different from the 10 percent in stainless steel. Sometimes these test dont show anything until after implantation it's a high quality joint I'm glad all the other materials are ti looking to get just liner removed and the x3 bearing put in there. Essentially making it a single mobility. Have other health issues these are all extremely rare if u are concerned the can put just the liner in but if u are highly active the dual mobility is a better choice. The patch test is worthless because the cells on the skin are different. Most ppl test pos on skin patch and have no issues. Here's some more data at strykermeded.com this site has way more detail than the other one they have

Hi again, Sue - If you have a moment for another couple questions I would appreciate it and will happily accept your offer to review my component questions when I draft them. First, the surgeon plans to resect upper part of my greater troch and release the piriformis. He also plans to repair any soft tissue that he sees that needs repairing. As mentioned, he plans to remove my cup that is impinging posteriorly and replace it with the dual mobility (I think because I am active and want to return to tennis; plus I do not want to be lengthened further because my soft tissues feel so taut as is - I was lengthened 9 mm last time, but I am only 5'2"). I was wondering if you could share what the recovery is like after a posterior revision surgery similar to the one I described? I had an anterior approach before with no restrictions. I'm just wondering what your thoughts are on the speed of recovery from a revision? Also, I presume my current stem will be used, but was wondering if you knew how that would work/fit with a dual mobility component that would have a different type of ball? Thanks very much, Natalie

@sueinmn - not sure if I had to tag you to see the above post. Thanks.

Hello, Sue,
I would like to piggyback on questions from nat0430 regarding dual mobility cup implants. I have an appt with my surgeon Tuesday, and had pretty much settled on the dual mobility cup, based on lots of reading. Today, I thought I'd look on the forum for anyone who may have had this implant. information. I'm so glad I thought to look! In the interest of brevity, here's my history:
2009--metal-on-metal hip replacement (posterior)
2023--revision due to cobalt shedding (posterior)
2024--January, hip dislocation
2024--April, another dislocation, with undetermined cause

I so appreciate the information you gave to nat0430. I am now rethinking the dual mobility cup. I'm at the top of the waiting list for surgery. I'm wondering if you've seen anymore about the DMC implant since Oct 2022. Thank you so much!

Here are two recent reviews of dual-mobility implants. I haven't done any studying (yet) because as of last May, my existing implants still looked "perfect" according to my ortho. Even though they are now 12 years old, he figures they are good for another 10 years or so.

I didn't read these fully, but it looks like the dual cup reduces dislocation risk.
https://josr-online.biomedcentral.com/articles/10.1186/s13018-023-03730-8
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10348735/
Good luck on your surgery!
Sue

Thank you so much for your response, Sue. I feel like I'm better prepared now for a discussion with my surgeon tomorrow. The previous surgeon who did my revision remarked on my extreme flexibility, and I'm a little nervous now that I'll always have precautions, regardless of which surgery I have. I'm wondering if my traveling days--especially to visit our son and his family who live in Europe--are over. But I'm getting ahead of myself! Just have to see how it goes.

I'm glad you're doing well with your replacements! From your previous posts, I gather you have taken good care of yourself, right from the beginning.