Large femoral heads decrease the incidence of dislocation after total hip arthroplasty: a randomized controlled trial

Topic: Brain proteins, microglia and lab models

Background The use of larger femoral heads has been proposed to reduce the risk of dislocation after total hip arthroplasty, but there is a lack of evidence to support this proposal. The aim of this multicenter randomized controlled trial was to determine whether the incidence of dislocation one year after total hip arthroplasty is significantly lower in association with the use of a 36-mm femoral head articulation as compared with a 28-mm articulation. Methods Six hundred and forty-four middle-aged and elderly patients undergoing primary or revision arthroplasty were randomized intraoperatively to receive either a 36 or 28-mm metal femoral head on highly cross-linked polyethylene.

Key findings

• The aim of this multicenter randomized controlled trial was to determine whether the incidence of dislocation one year after total hip arthroplasty is significantly lower in association with the use of a 36-mm femoral head articulation as compared with a 28-mm articulation.
• Methods Six hundred and forty-four middle-aged and elderly patients undergoing primary or revision arthroplasty were randomized intraoperatively to receive either a 36 or 28-mm metal femoral head on highly cross-linked polyethylene.
• Patients who were at high risk of dislocation (including those with dementia and neuromuscular disease) and those undergoing revision for the treatment of recurrent hip dislocation or infection were excluded.
• Patients were stratified according to other potential risk factors for dislocation, including diagnosis and age.

Why it matters

This randomized controlled trial tested whether a larger femoral head reduces dislocation after total hip arthroplasty, which has nothing to do with Alzheimer's disease. It provides no information about treating, curing or preventing Alzheimer's disease.

Study details

• Study designrandomized controlled trial
• Effect size1.3%; 5.4%; 4.1%
• Evidence strengthHigh

Read the original

• DOI: 10.2106/jbjs.k.00570
• PubMed: 22717828
• Original source →

May need a subscription OpenAlex found no free copy of the full text (checked 6 Feb 1020), so the publisher may charge for it. The PubMed abstract is free.

@article{howie2012-22717828,
  author  = {Howie, D. W. and Holubowycz, O. T. and Middleton, R. and {Large Articulation Study Group}},
  title   = {{Large femoral heads decrease the incidence of dislocation after total hip arthroplasty: a randomized controlled trial}},
  journal = {The Journal of bone and joint surgery. American volume},
  year    = {2012},
  doi     = {10.2106/jbjs.k.00570},
  pmid    = {22717828},
  url     = {https://doi.org/10.2106/jbjs.k.00570}
}

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