Different generations of dual mobility cup: from beginning to contemporary systems
Abstract
Dual mobility cups (DMCs) were introduced in the 1970s to combine the low-friction concept of small femoral heads with the increased stability provided by larger articulations. Over the past five decades, DMCs have undergone substantial evolution in terms of design, materials, fixation methods, and polyethylene technology. This review analyzes the historical development of DMCs through three generations, focusing on the major complications encountered during their clinical use, including iliopsoas impingement, cup loosening, dislocation, intraprosthetic dislocation, accelerated wear, and infection. For each complication, the design modifications and technological advances introduced to improve implant performance are discussed. Contemporary third-generation systems have demonstrated excellent survivorship and low complication rates, while recent highly porous 3D-printed titanium designs may represent the beginning of a new generation of dual mobility implants. The continuous evolution of DMC technology has contributed to improved stability, fixation, and longevity, making these implants a valuable option in both primary and revision total hip arthroplasty.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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© © Ortopedici Traumatologi Ospedalieri d’Italia (O.T.O.D.i.) , 2026
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