Getting a hip replacement is never a small decision. For me, it’s made more complicated by living in Asia, far from my home country’s state system of care, which is unusable for me in practice. Here, every stage of the process—from diagnosis to surgery to aftercare—has to be paid for directly. That’s before even considering what happens if something goes wrong.

My biggest fear is dislocation. Once the artificial joint is in place, there’s always a chance it could come out of the socket, especially in the first few months after surgery. Some people are more at risk than others, and I suspect I’m one of them. I think some of the muscles around my hip are already weak or wasted, which means less support for the joint.

Dual Mobility vs Standard Implants

One way to reduce dislocation risk is with a dual mobility implant. It has two bearing surfaces — a small ball inside a larger liner — so the head can move more before it reaches the point where it pops out. This gives a big stability advantage over a standard head, especially in patients who already have higher risk.

If a dual mobility hip does dislocate, it’s rarely because your muscles “failed.” It’s more likely due to mechanical reasons: the smaller head comes out of the liner (called an intraprosthetic dislocation), the implant was positioned poorly during surgery, or a sudden trauma caused it. Fixing this often needs special parts and experience, which may not be available locally.

For standard hips, dislocation rates after primary replacement are often quoted at 1–3% in the first year, and much higher in high-risk patients. Dual mobility designs can bring those numbers down sharply — sometimes below 1% — even in people who start with a much greater chance of dislocation.

The highest risk is in the first 3–6 months, when tissues are still healing. After that, the risk drops, but over many years muscles naturally weaken and may make standard hips less stable again. Dual mobility doesn’t rely as much on muscle strength, so it retains its relative advantage later in life.

Head Size Options

Standard heads are often 28–32mm. Larger heads (36mm or more) give more range of motion before dislocation, but can increase wear. Dual mobility allows you to have the stability of a larger head without actually using one — the small head sits inside a moving liner, which then moves inside the outer shell.

Questions to ask:

• What head size are you recommending for me, and why?
• Would a larger head give more stability in my case?
• Could a larger head be combined with dual mobility?

Manufacturers and Sourcing

Most high-quality hips come from US or European manufacturers like Zimmer Biomet, Stryker, Smith & Nephew, or DePuy Synthes. There are also Asian-made implants, often cheaper but with less long-term data.

Things to find out:

• Which brand and model does the hospital normally use?
• Is it made locally or imported?
• Can I choose the brand?
• Will they import a specific implant for me?
• If they import it and I cancel surgery, can I take it with me?

That last question matters because if you’ve paid for a part to be imported, you don’t want to lose it if you change hospitals or countries.

The Paperwork You’ll Get

After surgery, you should be given an implant card (sometimes called an implant identification card). This will list:

• The manufacturer and model.
• Head size and liner type.
• Batch or lot numbers.
• Sometimes the country of manufacture and expiry dates.

These details are critical if you ever need emergency treatment in another hospital or country. Keep this card for life, in both paper and digital form.

The Lifetime Risk

Even decades later, if you dislocate, you may need a replacement liner or other part from the exact same manufacturer. If that part isn’t available where you are, you could end up:

• Paying for a daily hospital bed while waiting for it to be sourced.
• Stuck in a high-dependency ward with rising bills.
• Facing an air ambulance transfer to another country.

Because hip replacement is classed as a pre-existing condition, most insurers won’t cover this unless you have very high-end, specialist cover with a long waiting period. This means you may need to self-fund the entire cost of any emergency.

Planning the “What If” Before Surgery

I think it’s worth mapping out a contingency plan now, not later. That means:

• Finding out which hospitals in your region have experience with your chosen implant.
• Asking whether they stock parts for it and what an emergency repair would cost.
• Checking if there’s a better-equipped “hub” hospital in another city or country.
• Knowing exactly how you would get there — ambulance, car, or air transfer.

Without this, you risk being in the worst position possible: injured, in pain, bills piling up, and no workable plan.

Checklist: Questions to Ask Your Surgeon

Implant Choice

• Which implant manufacturer and model will you use?
• Where is it made?
• Can I request a specific brand?
• Will you import it for me if you don’t stock it?
• If I cancel after it’s imported, can I take it with me?

Head Size & Stability

• What head size are you recommending, and why?
• Would a larger head improve stability?
• Would dual mobility be suitable in my case?
• How does my muscle condition affect your recommendation?

Dislocation & Long-Term Risk

• What is my personal dislocation risk with this implant?
• How often do you see dislocation in patients like me?
• If it dislocates, what’s the repair process and how long would it take here?
• Do you stock replacement liners and heads?

Paperwork & Identification

• Will I get an implant card with all component details?
• Can I also have copies of my surgical notes and part stickers?

Emergency Planning

• Which hospitals in the country can treat a dislocated dual mobility hip?
• How would I transfer there in an emergency?
• What would it cost to wait for parts if they had to be ordered?