# A Meta-Analysis to Evaluate Implant Survival and Benefits of the Use of Dual Mobility Constructs in Total Hip Replacement Following Hip Fracture

## TL;DR

This study compares the long-term success of hip replacement surgeries using dual-mobility implants versus traditional implants after hip fractures.

## Contribution

The study provides a meta-analysis comparing implant survival rates of dual-mobility versus conventional hip replacements following hip fractures.

## Key findings

- Five-year survival estimates were 95.4% for dual-mobility THR and 96.2% for conventional THR.
- Dual-mobility THR had a 21% higher relative risk of revision compared to conventional THR.
- The results do not support routine use of dual-mobility THR over conventional THR for hip fractures.

## Abstract

Total hip replacement (THR) is commonly performed to treat hip fractures. Dual-mobility constructs (DMCs) are increasingly used for this indication. The aim of this study was to use evidence synthesis techniques to estimate net all-cause construct survival for THR with DMC performed for hip fracture. Additionally, we aimed to investigate and describe differences in all-cause construct survival (if present) between THRs performed with DMC (DMC-THR) or with a conventional bearing construct following hip fracture.

We performed a systematic review and meta-analysis of published studies (including joint registries), including DMC-THR for hip fracture which provided Kaplan-Meier (KM) survival estimates. The primary outcome was all-cause construct survival over time. The study was prospectively registered on PROSPERO (CRD42020173117).

A total of 557 papers and 17 registry reports were identified. Six studies (four registry reports, one matched-pair cohort study utilising joint registry data, and one single-institution case series) met the inclusion criteria, including 17,370 DMC THRs and 167,377 conventional THRs. Five-year KM survival estimates (95% confidence intervals) were similar at 95.4% (94.9 to 95.8%) for DMC-THR and 96.2% (96.0 to 96.4%) for conventional THR. The relative risk of revision for DMC-THR at five years was 1.21 (1.05 to 1.41). These results suggest that DMC-THR has a lower all-cause survival than conventional THR following hip fracture. This analysis does not support the routine use of DMC-THR over conventional bearing THR.