Dual mobility: fewer dislocations, more femoral fractures in uncemented hips

The edition in brief

A propensity-matched French cohort of 780 uncemented total hip replacements found dual-mobility bearings were associated with far fewer dislocations than ceramic-on-ceramic (0.4% vs 4.0%) but more femoral periprosthetic fractures (OR 3.5 after matching), with femoral neck fracture as the indication adding risk for both. A blinded randomised trial with radiostereometric analysis in 96 uncemented knees found that wear plateaued after five years with highly crosslinked polyethylene but kept rising with conventional polyethylene, without differences in migration or patient-reported outcomes at ten years. A case series of 19 elite athletes with failed ACL reconstruction and a tibial slope of 10° or more reported that all returned to their previous level after revision combined with slope-reducing osteotomy; as a small uncontrolled series it cannot show the osteotomy was the reason. The pearl covers measuring posterior tibial slope before ACL revision.