title: Is There a Benefit to Head Size Greater Than 36 mm in Total Hip Arthroplasty?
abstract: This study compares the rate of dislocation and revision for instability between 36-mm and anatomic femoral heads (large diameter metal-on-metal THA, dual-mobility bearings, and hip resurfacing arthroplasty) in patients at high risk for dislocation. A total of 501 high-risk patients, over a 10-year period, were identified (282 36-mm THA, 24 dual-mobility bearings, 83 metal-on-metal arthroplasty, and 112 hip resurfacing arthroplasty). There were 13 dislocations in the 36-mm group compared to 1 in the anatomic group (4.6% vs 0.5%; P = .005). Four patients dislocated more than once in the 36-mm group (1.4% vs 0%; P = .04), and 2 patients in the 36-mm group required a revision for instability (0.7% vs 0%; P = .11). These results suggest that anatomic head sizes significantly lower the risk of dislocation in high-risk patients.
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Bryan D
authors.initials: BD
authors.lastname: Haughom
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Darren R
authors.initials: DR
authors.lastname: Plummer
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Mario
authors.initials: M
authors.lastname: Moric
authors.affiliation: Rush University Medical Center, Chicago, Illinois.
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Della Valle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005270:Femur Head / Q000601:surgery*; D006617:Hip Dislocation / Q000209:etiology* / Q000517:prevention & control; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008670:Metals; D020959:Polyethylene / Q000737:chemistry; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals; D020959:Polyethylene
keywords: complication; dislocation; high-risk; primary; total hip arthroplasty