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Primary Total Hip ArthroplastyDUALSIM-THANCT07464665

Comparing Dual-mobility Cups Versus Unipolar Cups for Unselected Primary Total Hip Arthroplasty by Direct Anterior Approach

A study testing Primary total hip arthroplasty using dual-mobility cup and Primary total hip arthroplasty using unipolar cup in people with Primary Total Hip Arthroplasty and Primary Total Hip Replacement, run by Elsan at 1 site in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

THA comprises the replacement of the damaged bone and cartilage with prosthetic components. The proximal end of the femur is replaced with a stem and ball/head, while the acetabulum is most commonly replaced with a unipolar cup (UP) that consists of a liner inside of a metal shell. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Primary total hip arthroplasty using dual-mobility cup and Primary total hip arthroplasty using unipolar cup
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
300 participants
Where
1 siteFrance
Study dates
7 Jul 2026to 1 Jul 2030
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • men and women aged ≥18 years old
  • set to undergo elective primary THA via direct anterior approach (DAA)
  • affiliated with a social security scheme
  • able to answer questionnaires and to communicate freely in French
  • who have been informed and have provided free, informed, and written consent (no later than the day of inclusion and before any examination required by the study)

Who cannot join

  • with prior ipsilateral hip surgery
  • with prior contralateral hip surgery
  • that require acetabular cup diameters ≤50mm (because DM cups are not available from the same manufacturer for diameters ≤50mm, and UP cups require head diameters of 36mm and thus minimum cup diameters of 52mm)
  • undergoing emergency or trauma surgery (e.g. femoral neck fractures)
  • with any concomitant disease or disorder which, in the opinion of the surgeon, may put the patient at risk, notably of hip instability or dislocation (hip dysplasia, neuromuscular deficit, fracture sequelae…) or may influence the result of the study
  • that are pregnant or breastfeeding
  • under legal protection (guardianship or curatorship or deprived of liberty).

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

France1 site, 1 recruiting
  • Polyclinique Jean Villar

    Bruges, 33520

    Nicolas Verdier, +33(0)535549569, dr.nicolas.verdier@gmail.com

    Recruiting

Other trials in France

About this study

Official title: Monocentric Randomised Controlled Trial Comparing Dual-mobility Cups Versus Unipolar Cups for Unselected Primary Total Hip Arthroplasty by Direct Anterior Approach

THA comprises the replacement of the damaged bone and cartilage with prosthetic components. The proximal end of the femur is replaced with a stem and ball/head, while the acetabulum is most commonly replaced with a unipolar cup (UP) that consists of a liner inside of a metal shell. UP cups are associated with risks of dislocations, especially in elderly and female patients, as well as in patients with lumbar stiffness or operated for femoral neck fractures. In fact, one of the most common reasons for early revision of UP cups are dislocations.

Dual-mobility (DM) cups were introduced in the 1970s by the French surgeon Gilles Bousquet, as an alternative to UP cups. They are made up of two articulations, a femoral head moving inside a mobile polyethylene liner, which in turn moves inside a metal shell. This design allows for a greater jump distance and range of motion (ROM) compared to UP cups, thus resulting in reduced rates of dislocation.

Read more

A recent systematic review that evaluated 5 case-control studies (549 DM cups vs 649 UP cups) and 3 registry studies (5935 DM cups vs 217362 UP) found that in case-control studies, the dislocation rates were 0.2% for DM cups versus 7.1% for UP cups (p=0.009). Furthermore, in registry studies the revision rates due to dislocation were 0.2% for DM cups versus 0.5% for UP cups (p=0.050).

Nonetheless, there have been some concerns associated with the use of DM cups, including intra-prosthetic dislocations (IPD), polyethylene wear, and iliopsoas impingement. Since the early 2000s, new improvements in the design of DM cups have nearly eliminated the risk of IPD, and the use of ultra-high molecular weight polyethylene (UHMWPE) has greatly reduced wear rates, even in young and active patients. Lastly, although some studies have reported iliopsoas impingement with DM cups, the impingement is usually against the optional fixations, and not against the mobile polyethylene insert.

The hypothesis of the present interventional randomised controlled trial (RCT) is that THA using DM cups will not provide inferior outcomes compared to THA using UP cups, in terms of hip awareness measured using the forgotten joint score (FJS).

Being tested
Primary total hip arthroplasty using dual-mobility cup, Primary total hip arthroplasty using unipolar cup
Keywords
total hip arthroplasty, THA, total hip replacement, THR, randomised controlled trial, RCT, unipolar cup, dual-mobility cup

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Primary total hip arthroplasty using dual-mobility cupProcedure or surgery

    Also called Primary total hip replacement, THA, THR

    Replacement of hip articulating surface.

  • Primary total hip arthroplasty using unipolar cupProcedure or surgery

    Also called Primary total hip replacement, THA, THR

    Replacement of hip articulating surface.

Study groups in NCT07464665
Study groupRoleWhat they receive
THA with dual-mobility cupActive comparatorThe THA will be performed via the DAA. The liner will be made of highly-crosslinked vitamin-E infused polyethylene. The femoral head will be made of either metal or ceramic. The dual-mobility cup will always be cementless, while the stem will be cemented in female patients aged ≥75 years, as well as in any patient diagnosed with osteoporosis. A blunt dissection will be carried out through the tensor fasciae latae muscle (TFLM), between the sartorius and rectus femoris muscles. A femoral neck osteotomy will then be performed using an oscillating saw, and the femoral head will be removed with a corkscrew. The acetabular components and the selected liner according to the randomisation, will then be implanted.The femoral head will then be impacted onto the femoral stem, and the prosthesis will be reduced. Closure of the surgical site will be performed in layers.
Receives: Procedure: Primary total hip arthroplasty using dual-mobility cup
THA with unipolar cupActive comparatorThe THA will be performed via the DAA. The liner will be made of highly-crosslinked vitamin-E infused polyethylene. The femoral head will be made of either metal or ceramic. The unipolar cup will always be cementless, while the stem will be cemented in female patients aged ≥75 years, as well as in any patient diagnosed with osteoporosis. A blunt dissection will be carried out through the tensor fasciae latae muscle (TFLM), between the sartorius and rectus femoris muscles. A femoral neck osteotomy will then be performed using an oscillating saw, and the femoral head will be removed with a corkscrew. The acetabular components and the selected liner according to the randomisation, will then be implanted.The femoral head will then be impacted onto the femoral stem, and the prosthesis will be reduced. Closure of the surgical site will be performed in layers.
Receives: Procedure: Primary total hip arthroplasty using unipolar cup

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Forgotten Joint Score between DM cup group and UP cup group

    The primary outcome is defined as patient-reported hip awareness at 2 years postoperatively, measured using the Forgotten Joint Score (FJS). The FJS is a validated self-administered questionnaire that measures the patients' ability to forget about a joint as a result of successful treatment. The questionnaire comprises 12 items. Each item is scored using a 5-point Likert scale, ranging from "never" (0 points) to "mostly" (4 points). The final FJS score is calculated as the addition of all items, divided by the number of items answered. The mean score is then multiplied by 25, and that value is subtracted from 100. The FJS ranges from 0 to 100, with 100 corresponding to the best score: the patient has forgotten about their joint.

    Measured: 2 years

Secondary outcomes (9)
  1. Forgotten Joint Score between DM cup group and UP cup group

    Patient-reported hip awareness at 3 months and 1 year postoperatively, measured using the FJS. The FJS is a validated self-administered questionnaire that measures the patients' ability to forget about a joint as a result of successful treatment. The questionnaire comprises 12 items. Each item is scored using a 5-point Likert scale, ranging from "never" (0 points) to "mostly" (4 points). The final FJS score is calculated as the addition of all items, divided by the number of items answered. The mean score is then multiplied by 25, and that value is subtracted from 100. The FJS ranges from 0 to 100, with 100 corresponding to the best score: the patient has forgotten about their joint.

    Measured: 3 months and 1 year

  2. To compare the patient's hip/groin pain between DM cups versus UP cups, as well as to compare the net change from baseline

    Patient-reported hip/groin pain preoperatively and at 3 months, 1 year and 2 years postoperatively, measured using a numeric rating scale (NRS). The net change will be calculated at 3 months, 1 year and 2 years taking the preoperative value as baseline. The NRS ranges from 0 to 10, with 0 representing no pain, and 10 representing the maximum pain imaginable.

    Measured: preoperatively, at 3 months, 1 year and 2 years

  3. To compare the patient's hip function between DM cups versus UP cups

    Patient-reported hip function preoperatively and at 3 months, 1 year and 2 years postoperatively, measured using the Oxford hip score (OHS). The OHS is a validated self-administered questionnaire that assesses disability, in terms of function and pain, in patients undergoing THA. The questionnaire comprises 12 items. Each item is scored using a 5-point Likert scale, from 0 to 4 points, with 0 representing the worst outcome and 4 the best. The final OHS score is calculated as the addition of all items. The OHS ranges from 0 to 48, with 48 corresponding to the best score.

    Clinician-reported hip ROM preoperatively and at 3 months and 1 year postoperatively. ROM will be measured in degrees, in flexion, extension, internal rotation, external rotation, abduction, adduction.

    Measured: preoperatively, at 3 months, 1 year and 2 years

  4. To compare the patient's sports activity between DM cups versus UP cups

    Patient-reported return to sports (yes/no) and time to return to sports (months) will be assessed at 1 year postoperatively.

    Measured: 1 year

  5. To compare the patient's sports activity between DM cups versus UP cups

    The University of California Los Angeles (UCLA) activity score will be evaluated preoperatively, at 1 year and 2 years postoperatively. The UCLA activity score assesses physical activity in patients undergoing hip surgery. The questionnaire is a single-item 10-level-scale, ranging from 1-10, with 10 representing a highly physically active patient, and 1 representing a patient who is dependent on others and unable to leave home.

    Measured: preoperatively, at 1 year and 2 years

  6. To compare the patient's sexual activity between DM cups versus UP cups

    Patient-reported return to sexual activity (yes/no) and time to return to sexual activity (months) will be assessed at 1 year postoperatively.

    Measured: 1 year

  7. To compare the patient's sexual activity between DM cups versus UP cups

    If the patient has returned to sexual activities, they will be asked to complete the questionnaire developed by Rougereau et al.. The questionnaire has 3 items, each of which is presented separately: (i) frequency of sexual intercourse after THA compared to before THA (unable to perform intercourse, unchanged, decreased, increased); (iia) difficulties with resuming sexual activity (yes, no), if yes, (iib) for what reason? (apprehension, pain, discomfort, decreased libido, other); and (iiia) change in sexual positions compared to before THA (unable to perform intercourse, temporary, definitive, none), if temporary, (iiib) for how long? (less than 3 weeks, more than 3 weeks).

    Measured: 1 year

  8. To compare the patient's satisfaction with surgery between DM cups versus UP cups

    Patient-reported satisfaction with surgery at 1 year postoperatively, measured using a NRS. The NRS ranges from 0 to 10, with 0 representing extremely dissatisfied, and 10 representing extremely satisfied.

    Measured: 1 year

  9. To compare adverse events (that may impact the objectives of the study) between DM cups versus UP cups

    Adverse events that may impact the objectives of the study, as well as complications (e.g. fracture, infection, hematoma, limb length discrepancy, aseptic loosening, articular noise), reoperations, and implant revisions, will be collected throughout the study period, specifying the incidence, severity, and relationship to the surgery performed. Adverse events of interest will be dislocations and iliopsoas impingement.

    Measured: intraoperatively, at 3 months, 1 year and 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Mar 2026
  2. Study start7 Jul 2026 (estimated)
  3. Primary completion1 Jul 2030 (estimated)
  4. Study completion1 Jul 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This study is a patient-blinded prospective monocentric interventional comparative randomised trial in parallel groups, to evaluate the non-inferiority of DM cups compared to unipolar cups for THA.
Masking
Single blind
Who is masked
Participant
Enrolment
300 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07464665
Sponsor's protocol ID
2025-A01817-42
Acronym
DUALSIM-THA
Status last verified
Jul 2026
First submitted
2 Mar 2026
Last updated
16 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Jones HB, Hinkle AJ, Liu Y, Sambandam SN. Multivariate Analysis of Risk Factors for In-Hospital Dislocation Following Primary Total Hip Arthroplasty. J Clin Med. 2024 Jun 13;13(12):3456. doi: 10.3390/jcm13123456.

    PubMed 38929981
  • Fessy MH, Viste A, Philippot R, Belzile EL. Recent progress in dual mobility total hip arthroplasty: an irresistible French icon. Orthop Traumatol Surg Res. 2024 Oct;110(6):103993. doi: 10.1016/j.otsr.2024.103993. Epub 2024 Sep 10. No abstract available.

    PubMed 39265929
  • Jonker RC, van Beers LWAH, van der Wal BCH, Vogely HC, Parratte S, Castelein RM, Poolman RW. Can dual mobility cups prevent dislocation without increasing revision rates in primary total hip arthroplasty? A systematic review. Orthop Traumatol Surg Res. 2020 May;106(3):509-517. doi: 10.1016/j.otsr.2019.12.019. Epub 2020 Apr 8.

    PubMed 32278733
  • Varacallo MA, Luo TD, Johanson NA. Total Hip Arthroplasty Techniques. 2023 Aug 4. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK507864/

    PubMed 29939641

Questions about this trial

What is this clinical trial studying?

A study testing Primary total hip arthroplasty using dual-mobility cup and Primary total hip arthroplasty using unipolar cup in people with Primary Total Hip Arthroplasty and Primary Total Hip Replacement, run by Elsan at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 16 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Nicolas Verdier (+33(0)535549569, dr.nicolas.verdier@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Forgotten Joint Score between DM cup group and UP cup group (time frame: 2 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07464665, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Jul 2026.

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