Types of Hip Replacement: Which Implant Is Best for You? (Total, Hemi, Dual Mobility, Ceramic)

There is no single “best hip replacement” for everyone — the best implant is the one that suits your age, activity, bone quality and the reason for surgery. Hip implants differ in four ways: what is replaced (the whole joint or only the femoral head), cup design (standard or dual mobility), bearing surfaces (metal or ceramic), and fixation and stem length. This guide explains each type, who it suits and its cost, with a detailed page for each as part of our guide to hip replacement surgery.

What an artificial hip looks like

The natural hip is a ball (the femoral head) moving inside a socket (the acetabulum) in the pelvis. An artificial hip copies this design with four main parts:

  • Stem: a metal shaft fixed inside the thigh bone.
  • Head: a metal or ceramic ball fitted on top of the stem.
  • Cup: a metal hemisphere fixed in the pelvic socket.
  • Liner: a polyethylene or ceramic layer inside the cup on which the head moves.
Hip replacement components: stem, head, cup and liner
The components of an artificial hip — Image: Wikimedia Commons contributor / Wikimedia Commons, Public domain

1. By what is replaced: total hip vs hemiarthroplasty

Total hip replacement

Both the femoral head and the socket are replaced. It is the standard treatment for hip arthritis, avascular necrosis and rheumatoid arthritis, and for femoral neck fractures in active, independent patients. It is one of the most successful operations in modern medicine for relieving pain and restoring movement. It costs 100,000–120,000 EGP.

Hemiarthroplasty (half hip replacement)

Only the femoral head and neck are replaced; the natural socket stays. It is used mainly for femoral neck fractures in older, less active patients. There are two kinds: unipolar (one head) and bipolar (a small head inside a large one). Details in bipolar hip hemiarthroplasty; it costs 80,000–90,000 EGP.

2. By cup design: standard vs dual mobility

In a dual mobility (tripolar) hip a large liner moves inside the metal cup and the small head moves inside the liner, so the effective diameter is large and dislocation is much less likely. It is chosen for patients at higher risk of dislocation: older adults after fractures, neurological disease and revision surgery. Details in dual mobility (tripolar) hip replacement; it costs 150,000–180,000 EGP.

Video: what an artificial hip joint looks like

Prof. Dr. Ibrahim Shaarawi shows an artificial hip and its components (in Arabic).

3. By bearing surface: when is ceramic used?

BearingAdvantagesUsually suits
Metal on polyethyleneLongest track record, lowest costOlder and moderately active patients
Ceramic on polyethyleneLess wear than metalYounger, more active patients
Ceramic on ceramicLowest wearYoung active patients
Table 1: Bearing surfaces in hip replacement.

Ceramic’s real value is for patients who will live with their hip for decades. Details and cost in ceramic hip replacement.

Metal and ceramic femoral heads for hip replacement
Femoral heads for hip replacement — Image: Abd Alrahman Elmoghani / Wikimedia Commons, CC BY-SA 3.0

4. By fixation: cemented or cementless

CementedCementlessHybrid
How it fixesImmediately with bone cementBone grows onto the implantCemented stem, cementless cup
Usually suitsOlder adults and osteoporosisYounger people with good boneMany older adults
Table 2: Fixation methods in hip replacement.

Reviews show no major overall difference between the methods; fixation is chosen by age and bone quality. Read cemented hip replacement and cementless hip replacement.

5. By stem length

A standard stem is used in most first-time operations, a short stem may be used in young people to preserve bone, and a long stem is used in revision surgery, fractures around a previous implant and major bone loss, bypassing weak bone to fix in healthy bone. Details in long-stem hip replacement.

Comparison table: which type suits your case?

SituationImplant usually favoured
Hip arthritis in an active patientTotal hip (ceramic may suit younger patients)
Femoral neck fracture, older and less activeCemented bipolar hemiarthroplasty
Femoral neck fracture, active and independentTotal hip, possibly dual mobility
Neurological disease, weak muscles, high dislocation riskDual mobility hip
Young adult with avascular necrosisCementless total hip, often with ceramic
Loose previous implant or fracture around itRevision with a long stem
Table 3: Choosing a hip implant by situation (final decision after examination).

For displaced femoral neck fractures in older adults, the international HEALTH trial found only a small difference between total hip and hemiarthroplasty in the need for further surgery at two years, so the choice depends on how active the patient was before the fracture. See femoral neck fracture in older adults.

Hip replacement prices in Egypt by type

ImplantApproximate price
Total hip (conventional)100,000–120,000 EGP
Bipolar hemiarthroplasty80,000–90,000 EGP
Dual mobility (tripolar) hip150,000–180,000 EGP
Ceramic hip195,000–240,000 EGP
Revision surgery / long stemConfirmed after assessment
Table 4: Hip replacement prices by implant type (EGP).

The price usually covers the implant, the operation and a short hospital stay, and varies with the implant, the hospital and your general health; the final price is confirmed after examination and X-rays. An implant should not be chosen on price alone — the right one is what suits your age, activity and bone quality. More on cost in hip replacement cost in Egypt.

How long does the implant last?

A large Lancet analysis of worldwide joint registries found that about three quarters of hip replacements are still working after 15–20 years and about 58% after 25 years. Implant survival depends on the patient’s age, activity and weight, the bearing surfaces and fixation, and the precision of component positioning. Keeping a healthy weight, avoiding high-impact sport, treating any infection in the body promptly and attending regular X-ray follow-up all help the implant last as long as possible, and pick up loosening early, before it causes bone loss.

Frequently asked questions about types of hip replacement

What is the best type of hip replacement?

There is no best type for everyone; the best is the one that suits your age, activity, bone quality and reason for surgery, chosen by your surgeon after examination and X-rays.

What is the difference between a total hip and a hemiarthroplasty?

A total hip replaces the femoral head and the socket; a hemiarthroplasty replaces only the head and is mostly used for femoral neck fractures in older adults.

What is a tripolar hip replacement?

A total hip with a dual mobility cup that lowers dislocation risk, for patients at higher risk of dislocation.

Is a ceramic hip better?

Ceramic wears less and suits younger, active patients; for older, less active patients a conventional hip is usually enough at lower cost.

How much do the different hip implants cost?

Total hip 100,000–120,000 EGP, bipolar hemiarthroplasty 80,000–90,000 EGP, dual mobility 150,000–180,000 EGP and ceramic 195,000–240,000 EGP.

To have your hip assessed, book a consultation, call +20 155 240 4488 or message us on WhatsApp at +20 155 554 7181.

Medically reviewed by Prof. Dr. Ibrahim Shaarawi, Professor of Orthopaedic Surgery. This article is general medical education and does not replace an examination or the plan your surgeon sets for you. See our medical disclaimer.

Related hip replacement guides

Each type has its own detailed page in our guide to hip replacement surgery:

References

  1. López-López JA, et al. Choice of implant combinations in total hip replacement: systematic review and network meta-analysis. BMJ. 2017;359:j4651.
  2. HEALTH Investigators. Total hip arthroplasty or hemiarthroplasty for hip fracture. N Engl J Med. 2019;381(23):2199-208.
  3. Darrith B, et al. Outcomes of dual mobility components in total hip arthroplasty: a systematic review of the literature. Bone Joint J. 2018;100-B(1):11-9.
  4. Hu D, et al. Ceramic-on-ceramic versus ceramic-on-polyethylene bearing surfaces in total hip arthroplasty. Orthopedics. 2015;38(4).
  5. Abdulkarim A, et al. Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials. Orthop Rev (Pavia). 2013;5(1):e8.
  6. Evans JT, et al. How long does a hip replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet. 2019;393(10172):647-54.

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