As one more twist to the plot of my winding journey to hip surgery, my acetabulum measures 60-64mm. which is jumbo and the hospital didn’t have dual mobility in stock. I am now being ingnored and so contacted companies themselves trying to source my needs, not easy as the distributors generally want to deal directly with hospitals.

Implants are strictly regulated when being imported into Vietnam (or anywhere) and so the Ministry of Health keeps a list of each model which is allowed into the country, though this doesn’t necessarily mean it is within the country, nor a company would be willing to import one for a single patient.

Zimmer Biomet

• Background & History: Founded in 1927 and based in Warsaw, Indiana, USA. It is the largest orthopedic company in the world following the 2015 merger of Zimmer and Biomet.
• Reputation: Known as the industry leader in porous metal technology. Their “Trabecular Metal” (tantalum) is the gold standard for bone ingrowth, especially in large acetabular cases.
• Dual Mobility Models:
  • G7 Dual Mobility: A highly modular system where a standard G7 shell is converted to dual mobility using a Cobalt-Chrome (CoCr) insert.
  • Active Articulation (E1): Features their proprietary E1 Vitamin E-infused polyethylene, which is designed to prevent oxidation and reduce long-term wear.

MicroPort Orthopedics

• Background & History: Headquartered in Arlington, Tennessee, USA (following the acquisition of Wright Medical).
• Reputation: Leaders in “Tissue-Sparing” hip surgery and high-stability implants. They are known for providing an extensive range of sizes for complex anatomy.
• Dual Mobility Models:
  • Dynasty® Dual Mobility: Their primary modular system. It utilizes the Dynasty Shell (known for BioFoam technology) and a specific DM liner. This is a top choice for large sizes (60-64mm+) because the Dynasty shell line has a massive size range.
  • Liberty® ATF: A monoblock (single-piece) dual-articulation cup designed for simplified surgical steps and high stability.
  • Procotyl® P: A versatile shell that can also accommodate a dual mobility interface.

Smith & Nephew

• Background & History: A British global medical technology business founded in 1856.
• Reputation: Famous for advanced material science, specifically their “Oxinium” (Oxidized Zirconium) technology which provides a ceramic surface on a metal base.
• Dual Mobility Models:
  • OR3O™: Their premium DM system. It uses an Oxinium DH liner to virtually eliminate the risk of metal-on-metal ion release.
  • POLARCUP®: A clinically proven, traditional dual mobility system with decades of successful data, particularly in Europe and Asia.

Waldemar LINK

• Background & History: A German family-owned company founded in 1948 in Hamburg.
• Reputation: The “specialists” of the industry. LINK is world-renowned for revision surgery and custom “megaprostheses” when standard implants are not large enough.
• Dual Mobility Models:
  • BiMobile®: Known for its “Self-Centering” liner design, which helps prevent the plastic from impinging on the metal neck of the stem, increasing the range of motion.

Xnov / Evolutis

• Background & History: A French group; Evolutis was founded in 1999 in the country where Dual Mobility was originally invented.
• Reputation: They follow the “original” French principles of hip stability while using modern dual-coating (Titanium + Hydroxyapatite) for better bone fixation.
• Dual Mobility Models:
  • Captiv DM: A modular system focusing on versatility.
  • Mobi™: An anatomical range of DM cups known for being “low profile,” allowing the surgeon to preserve more of the patient’s natural bone.

Mathys / Enovis

• Background & History: Mathys is a Swiss company (est. 1946) recently acquired by the American group Enovis.
• Reputation: “Swiss-Precision” engineering. They are pioneers in using high-tech plastics instead of metal for the outer shell.
• Dual Mobility Models:
  • RM Pressfit vitamys: A unique monoblock cup made of Vitamin E-enriched polyethylene. It provides dual mobility benefits but is “isoelastic,” meaning it flexes more like natural bone than a metal cup.
  • Select DM: Their traditional metal-backed modular dual mobility system.

Implantcast

• Background & History: A specialist German manufacturer founded in 1988 in Buxtehude.
• Reputation: Experts in 3D-printing and “Jumbo” revision cups. They use a proprietary 3D-printed metal texture called EPORE®.
• Dual Mobility Models:
  • Ecofit® DM: A modular system often used in complex cases. Because they specialize in revision surgery, their Ecofit shells are frequently available in the larger diameters (60mm-70mm+) required for significant bone loss.

So my acetabular cup needs 60-64 head implant. This is a range because during each operation, surgeons take three different sizes into the operating room, each has an unopened box with an implant and a corresponding template. During surgery, the surgeon opens leg up, puts the different templates in to see which fits, then chooses the correct size and open just one implant and returns the other two and is only billed for the one they use.

Tam Ahn hospital, I am told, isn’t stocking the size I need but I now need to know which modular systems are allowed to be imported into Vietnam (decided by the government) and what is either in stock or can be ordered (decided by the company).

I have a list of the distributors and am initially going to contact them to see what can be done.

 

Results

Only Zimmer answered and only to correct the contact details.

Please find below Zimmer Biomet contact for Vietnam

The Representative Office of Zimmer Pte Ltd in Hanoi City

1310 ResCo-work03, 13th Floor, 49 Hai Ba Trung,

Regus, Hanoi Tower,

Tran Hung Dao Ward,

Hoan Kiem District,

Hanoi 10000, Vietnam

Tel: +84 9 4557 9569

Kind regards,

Matteo Cavicchi RT(R)(CT)
Technical Product Specialist
Personalized Solutions
Call or text +1 574.371.3710 – Clinical Support
[email protected]

 

One of the companies contacted my surgeon directly, who was offended and won’t give me any details.

The next step is the following Zallo message. The companies do not like to deal directly with patients and so it is necessary for me to present myself as a patient coordinator.

 

(Vietnamese)
Chào bạn, tôi là điều phối viên y tế cho một bệnh nhân dự định phẫu thuật thay khớp háng tại Việt Nam. Bệnh nhân cần kích thước ổ cối (acetabulum) là 60mm, 62mm và 64mm, yêu cầu sử dụng hệ thống khớp háng lưỡng động (Dual Mobility – DM).

Vui lòng kiểm tra kho hàng cho các mục sau:
1. Bên mình có sẵn chén khớp háng (Acetabular Shell) kích thước 60mm, 62mm và 64mm không?
2. Có sẵn các lớp lót lưỡng động (Dual Mobility Liners) phù hợp cho các kích thước chén trên không (tất cả các loại vật liệu)?
3. Các kích thước này (60-64mm) có nằm trong Giấy phép lưu hành (Số lưu hành) hiện tại của Bộ Y tế không?
4. Hiện tại các bộ khớp DM kích thước lớn này đang có sẵn tại kho ký gửi của bệnh viện nào ở TP.HCM hoặc Hà Nội?

Chúng tôi cần xác nhận có đủ bộ kích thước (60-64mm) để chuyển đến bệnh viện cho ca phẫu thuật. Rất mong nhận được phản hồi sớm. Xin cảm ơn.

(English)
Hi, I am a Patient Coordinator for a medical tourist planning a THA in Vietnam. The patient has been templated for a 60mm, 62mm, and 64mm acetabulum and requires a Dual Mobility (DM) system.

Could you please check your current inventory for the following:
1. Do you have Acetabular Shells in stock for sizes 60mm, 62mm, and 64mm?
2. Do you have the matching Dual Mobility Liners (all material types) available for those specific shell sizes?
3. Are these specific sizes (60-64mm) covered under your current MOH Circulation Registration (Số lưu hành)?
4. Which hospitals in HCMC or Hanoi currently hold your consignment for these large-size DM components?

We need to confirm that a full size range (60-64mm) can be delivered to the hospital for the surgery. Please let me know what is available. Thank you.

—

Update: Zallo messages were sent out to all the local distributors above. There were no personal replies to me although around a week later the surgeon who took my templating xray emailed me to say a distributor had contacted him, and that the size wasn’t available, although he didn’t specify which company and if it was still available elsewhere or available for special import. I  emailed the surgeon back asking which company had replied and for clarification about the other avenues but was ignored. This is the same surgeon who templated the wrong, non-surgical side and won’t reply to correct the mistake.

The next attempt is to contact the head offices of the companies in their home countries to see if I can information about what 60-64mm dual mobility are either imported, or licensed to import… or not.

Head office contacts for the respective companies: