Comparative analysis of functional outcomes and complications in dual mobility versus large femoral heads in total hip arthroplasty

全髋关节置换术中双动股骨头与大股骨头功能结果和并发症的比较分析

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Abstract

BACKGROUND: Total hip arthroplasty (THA) is a common intervention for severe hip disorders. However, postoperative instability and dislocation continue to present significant challenges. To address these issues, dual mobility (DM) cups and large femoral heads (LFH) have been employed, each offering unique biomechanical benefits. METHODS: This prospective study involved 120 patients undergoing THA, with participants evenly split into two groups: Dual Mobility (DM, n = 60) and large femoral heads (LFH, n = 60). Assessments were performed using the Harris Hip Score (HHS) and a comprehensive range of motion (ROM) evaluation at 6, 12, and 24 months. The statistical analysis utilised t-tests, chi-square tests, and Mann-Whitney U tests, establishing significance at p < 0.05. RESULTS: The DM group showed better postoperative range of motion (ROM) across all measures, achieving statistically significant enhancements (p < 0.001) when compared to the other group. The average HHS increased by 47.8 points in the DM group, while the LFH group saw an improvement of 42.53 points. The DM group experienced no dislocations but had two instances of intraprosthetic dislocation, whereas the LFH group experienced four dislocations. The overall complication rates were comparable (p = 0.595), though the types of complications differed between the two groups. CONCLUSION: Dual mobility total hip arthroplasty (THA) offers enhanced functional recovery, improved range of motion (ROM), and a lower risk of dislocation compared to LFH designs. The biomechanical stability of dual mobility implants makes them a favoured option in THA, suggesting a need for further multicenter research to confirm these findings.

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