Simplifying the Hip-Spine Relationship for Total Hip Arthroplasty: When Do I Use Dual-Mobility and Why Does It Work?

Recent data indicate that the contemporary prevalence of dislocation after primary total hip arthroplasty is up to 5- to 10-fold greater in those patients with spinal deformities that lead to stiffness and/or significant pelvic tilt. Moreover, the interplay between the hip and spine is complex, dynamic, and changes over the lifetime of a patient. Finally, the interplay is not fully understood. As such, consideration should be given to the use of dual-mobility constructs in this cohort of patients given the increased effective head size, combined with the dual articulation before hard impingement.