Dual Mobility versus Conventional Total Hip Arthroplasty for Femoral Neck Fractures: A Multicenter Propensity-Matched...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Clinical Research

Background:

• Total hip arthroplasty (THA) is a standard treatment for displaced femoral neck fractures (FNF).
• Dual mobility (DM) implants are increasingly considered for high-risk FNF patients to mitigate dislocation risk.
• Limited comparative data exists between DM-THA and conventional THA (c-THA) in this population.

Purpose of the Study:

• To compare the dislocation incidence between DM-THA and c-THA in patients with FNF.
• To evaluate the revision incidence for instability and all causes between DM-THA and c-THA.
• To identify risk factors associated with dislocation after THA for FNF.

Main Methods:

• A multicenter retrospective cohort study included 822 patients undergoing THA for displaced FNF (2012-2020).
• Propensity score matching (2:1) was employed to balance baseline characteristics between DM-THA and c-THA groups.
• Kaplan-Meier survival analysis and multivariable logistic regression were used to analyze outcomes.

Main Results:

• Propensity-matched analysis (209 DM-THA vs. 418 c-THA) showed significantly lower dislocation incidence with DM-THA at five years (0.5% vs. 4.8%, P=0.005).
• No significant difference was observed in revision rates for instability (0.5% vs. 2.0%, P=0.2) or all-cause revision (3.1% vs. 3.9%, P=0.3).

Conclusions:

• DM-THA effectively reduces dislocation risk in patients with FNF.
• The use of DM-THA in FNF patients does not lead to an increased overall revision rate.
• DM-THA is a recommended option for high-risk FNF patients to improve stability.