Hip Replacement Implant Types
A total hip replacement is not one single piece. It is a compatible implant system made from components that replace the damaged socket and femoral head. Implant selection should consider diagnosis, anatomy, bone quality, age, activity, stability risk, previous surgery and the long-term record of the complete construct—not advertising, price or one material name.
For a patient-facing breakdown of hospital, implant, technology and other price components, see Hip Replacement Cost in Mumbai.
For the principal treatment page, read Total Hip Replacement in Mumbai.
Quick Answer
A standard total hip replacement usually has four components: acetabular shell, liner, femoral stem and femoral head.
Fixation may be cemented, cementless or hybrid.
The bearing surface is defined by the materials of the head and liner.
Dual-mobility and constrained designs are stability options for selected situations, not universal upgrades.
Components must be compatible and should come from a construct with an established clinical record.
The Four Main Components
Acetabular shell or cup
The acetabular component is placed in the prepared pelvic socket. Most modern cementless shells are metallic and have a porous surface intended for bone attachment. A liner locks inside the shell. In selected situations, an all-polyethylene cup may be fixed with bone cement.
Acetabular liner
The liner forms the socket’s bearing surface. Highly cross-linked polyethylene is widely used. Ceramic liners are used with ceramic heads in selected systems. Liner thickness, locking mechanism and compatibility with the shell and head size are important.
Femoral stem
The stem is placed inside the femur. Cementless stems obtain initial mechanical stability and later biological bone attachment. Cemented stems are fixed using bone cement. Stem geometry, length, material and surface treatment vary according to femoral anatomy and the clinical situation.
Femoral head
The modular head attaches to the stem taper. Common materials include ceramic and cobalt-chromium alloy. Head diameter affects stability, range before impingement and available liner thickness.
Why Component Compatibility Matters
Implant components are not freely interchangeable. Manufacturers specify which shells, liners, heads, tapers and stems can be combined. Mismatched components can cause mechanical failure, abnormal wear or instability. NICE recommends two intraoperative stop moments—before implantation and before wound closure—to check implant details and component compatibility.
The operation note and implant stickers should document the manufacturer, catalogue numbers, sizes, bearing surface and fixation. Patients should retain these records for long-term follow-up or future revision assessment.
Cemented, Cementless and Hybrid Fixation
Cemented fixation uses bone cement to secure the implant. Cementless fixation relies on a stable press fit followed by bone attachment to the implant surface. Hybrid replacement uses different fixation methods for the socket and stem, while reverse-hybrid constructs use a cemented cup with a cementless stem.
The choice depends on bone quality, femoral shape, fracture risk, age, previous surgery and the ability to obtain safe initial stability. Cementless does not automatically mean modern or superior, and cemented fixation is not an outdated fallback.
Read Cemented vs Cementless Hip Replacement.
Bearing Surfaces
The bearing is the moving interface between the femoral head and liner. Common combinations include:
Ceramic head on highly cross-linked polyethylene liner.
Cobalt-chromium head on polyethylene liner.
Ceramic head on ceramic liner in selected patients and systems.
Polyethylene quality, head material, head size, component position and patient activity all influence wear. Describing a replacement simply as a ceramic implant or metal implant is incomplete because the stem, shell, head and liner may use different materials.
Metal-on-metal bearings
Large-head metal-on-metal total hip bearings are not a routine modern default. Wear and corrosion can release cobalt and chromium particles and ions, causing adverse local tissue reactions in some patients. Patients who already have a metal-on-metal implant require follow-up according to symptoms, implant type and local guidance.
Read Ceramic vs Metal Hip Replacement Implants.
Head Size and Stability
A larger femoral head can increase the distance before dislocation and improve impingement-free movement. It also requires adequate cup size and liner thickness. Bigger is therefore not automatically better. Head diameter should be selected as part of the complete construct.
Dual-Mobility Hip Replacement
A dual-mobility system has a small head captured within a larger mobile polyethylene component, creating two articulations. It may improve stability and is considered in selected patients with higher dislocation risk, including some revision procedures, neuromuscular conditions, spinal stiffness or complex anatomy.
Dual mobility has specific risks, including wear, intraprosthetic dislocation and system-specific mechanical issues. It should be selected for a defined stability reason rather than marketed as a universal premium implant.
Constrained Liners
A constrained liner mechanically captures the femoral head. It is generally reserved for selected cases of recurrent instability when the underlying cause cannot be corrected adequately by component revision, soft-tissue restoration or another stability strategy. Constraint can transfer greater forces to the implant-bone interface and is not routinely used in uncomplicated primary replacement.
Primary, Revision, Hemiarthroplasty and Resurfacing Components
Primary total hip implants are designed for the first replacement. Revision systems may include longer stems, modular bodies, augments, cages or highly porous components to manage bone loss and instability.
Hemiarthroplasty replaces the femoral head but not the acetabular surface and is commonly used for selected femoral-neck fractures. Hip resurfacing preserves more of the femoral head and uses a different implant concept; it is suitable only for selected patients and should not be confused with routine total hip replacement.
How the Implant Plan Is Chosen
Diagnosis and reason for replacement.
Bone quality and femoral and acetabular anatomy.
Age, activity and expected loading.
Dislocation and fracture risk.
Spinal stiffness, previous spinal fusion and pelvic movement.
Previous surgery, deformity or retained hardware.
Surgeon experience with the system and independent registry or published performance.
Preoperative templating estimates component size, hip centre, offset and leg length. Robotic-assisted planning may add three-dimensional measurements and intraoperative feedback, but the surgeon must verify bone quality, stability and component compatibility. Read Robotic vs Conventional Hip Replacement.
What Does an Established Implant Record Mean?
An established implant has appropriate regulatory approval and credible clinical or registry follow-up for the actual model and construct. A company’s reputation alone does not prove that every design performs equally. NICE recommends total hip prostheses with revision rates—or projected revision rates—of 5% or less at ten years as options for end-stage hip arthritis.
Newest, imported or most expensive are not clinical outcome measures. New technology may be reasonable when it addresses a defined clinical problem and its uncertainty is explained.
Implant Longevity and Records
No single implant lasts the same duration in every patient. Longevity depends on diagnosis, fixation, bearing wear, component position, activity, body weight, bone quality, infection, trauma and long-term follow-up. Keep the discharge summary, operation note, implant labels or implant card and follow-up X-rays.
Read How Long Does a Hip Replacement Last?.
Questions to Ask the Surgeon
What are the proposed shell, liner, stem and head?
Will fixation be cemented, cementless or hybrid, and why?
What bearing surface and stability design are planned?
What clinical or registry record supports the system?
Will I receive the implant details after surgery?
Questions Patients Commonly Ask
Which hip implant is best?
There is no universal best implant. The safest choice is a compatible, well-performing system selected for the patient’s anatomy, bone, stability risk and long-term needs.
Is the most expensive implant better?
No. Price may reflect technology, import costs or hospital contracts and does not establish superior survival or function.
Is ceramic always better than metal?
No. Ceramic and cobalt-chromium heads can both perform well with modern polyethylene. The full bearing and patient factors matter more than one material label.
Will my body reject the implant?
Artificial joints are not rejected like organ transplants. Infection, loosening, wear, fracture and rare material reactions are different processes and require individual assessment.
Should every patient receive dual mobility?
No. It may add stability in selected patients but has system-specific risks and is not required for every primary replacement.
Clinical References
AAHKS: What Are Hip Replacements Made Of?
NICE NG157: Joint replacement—primary hip, knee and shoulder
AAOS OrthoInfo: Total Hip Replacement
FDA: Metal-on-Metal Hip Implants
About Dr. Mayur Rabhadiya
Dr. Mayur Rabhadiya is an Orthopedic and Joint Replacement Surgeon in Mumbai. His hip practice includes diagnosis-led assessment, hip arthritis and AVN treatment, primary and revision hip replacement planning and robotic-assisted planning in selected cases. Implant selection is based on anatomy, bone quality, stability, evidence and long-term traceability rather than one brand or material claim. Qualifications: MBBS, D’Ortho, DNB (Orthopedics), MNAMS (Orthopedics), FIJR (Robotic & Navigation). Read his professional profile.
Written and medically reviewed by Dr. Mayur Rabhadiya. Last medically reviewed: 17 July 2026.
Book a Hip Consultation
Consultations are available in Ghatkopar East and Ghatkopar West, Mumbai. Call or WhatsApp +91 84249 03913 or +91 96113 30063, or use the orthopedic appointment page.
Medical Disclaimer
This guide provides general patient education and does not replace individual examination, imaging review, implant consent or personalised surgical advice. Available components, approvals and recommendations vary by country, hospital, implant system and clinical situation.