A system includes a constrained acetabular insert, a dual mobility liner, and a femoral head. The constrained acetabular insert has its perimeter extending beyond hemisphere and the dual mobility liner has its perimeter extending beyond hemisphere and configured to tilt and rotate within the constrained acetabular insert. The femoral head is configured to tilt and rotate within the dual mobility liner. The constrained acetabular insert may include a plurality of tabs and the dual mobility liner may include screw threads for receiving the plurality of tabs.