Higher femoral periprosthetic fracture rate with dual-mobility compared with single-mobility total hip arthroplasty : a retrospective propensity-matched study of 780 uncemented hips.

Bone Joint J · Oct 01 2026 · Recent

Komat M, Sabot L, Simion F, Lechien D, Bhogal H, Gan El E, et al.

Orthopedics and Traumatology Department, EpiCURA Hospital, Saint-Ghislain, Belgium

SUMMARY — THE REDUCTIONIn 780 matched uncemented THAs, dual-mobility bearings cut dislocation (0.4% vs 4.0%) but raised periprosthetic fracture risk (OR 3.5), especially in femoral neck fracture patients, so weigh trade-offs carefully.

Abstract, as published

AIMS: Dual-mobility implants have reduced dislocation rates in total hip arthroplasty (THA), particularly in high-risk populations. However, under conditions of high stress, such as a fall or forced range of motion, the energy that would otherwise cause dislocation is instead transmitted distally along the femoral component and into the surrounding bone. Therefore, concerns remain regarding their potential impact on the risk of periprosthetic fracture (PPF).

METHODS: In a single-centre study, we retrospectively analyzed 1,415 patients who underwent uncemented THA with either a dual-mobility (DM-THA; 425 hips) or ceramic-on-ceramic (CoC-THA; 990 hips) bearing between January 2017 and December 2024. Propensity score matching (PSM) was performed for age, sex, BMI, and surgical indication, yielding a matched cohort of 260 DM-THA and 520 CoC-THA patients. Incidences of PPF, dislocation, and mortality were compared.

RESULTS: PPF occurred significantly more frequently in the DM-THA group than in the CoC-THA group (4.0% (17/425) vs 0.8% (8/990); odds ratio (OR) 4.8 (95% CI 1.86 to 12.4); p = 0.001), a finding confirmed after PSM (OR 3.5 (95% CI 1.3 to 8.6); p = 0.007). Femoral neck fracture (FNF) as the surgical indication was independently associated with an increased risk of PPF in both the overall and matched cohorts. In contrast, DM-THA was associated with a significantly lower dislocation rate compared with CoC-THA after PSM (0.4% (1/260) vs 4.0% (21/520); OR 0.09 (95% CI 0.02 to 0.49); p = 0.005). FNF was also associated with a higher risk of dislocation. No significant interaction was observed between bearing type and surgical indication for either PPF or dislocation.

CONCLUSION: While DM-THA effectively reduces dislocation risk, it may be associated with a higher incidence of PPF compared with standard constructs in patients undergoing THA for FNF. These findings underscore the need to carefully weigh the risks and benefits of dual-mobility bearings.

Read the article: PubMed · Publisher (DOI)

Featured in the 2026-10-11 issue.

← Quality and clinical implications of AI chatbot responses to …In vivo 3D hip kinematics during racket swinging after total … →

The Reduction is a free email digest of newly published orthopaedic literature — a handful of new papers in the subspecialties you choose, each summarized like this one. Subscribe free or browse the archive.