Revision for dislocation and all-causes following primary total hip replacement using 36-mm versus 32-mm femoral heads on polyethylene liners: a systematic review and meta-analysis
Abstract
INTRODUCTION: The use of a 36-mm femoral head in primary total hip replacement (THR) increases the jump distance and offers a wider impingement-free range of motion, theoretically reducing the risk of post-operative dislocation. However, concerns exist regarding its potentially greater impact on polyethylene wear and associated risks of liner fracture, aseptic loosening, and head-neck taper corrosion, compared to 32-mm femoral heads. This meta-analysis aims to compare the risk of revision for dislocation and all-causes when using 36-mm versus 32-mm metal or ceramic femoral heads with polyethylene liners for primary THR. METHODS: Medline, Embase, Web of Science, and the Cochrane Library were searched for relevant studies, while annual reports of arthroplasty registries were searched for relevant data. Random effects meta-analysis was performed. Sensitivity analysis was conducted, limiting to THR performed for osteoarthritis and using cross-linked polyethylene liners, or statistically adjusting for this factor. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO ID CRD42024557895). RESULTS: Four observational studies and two registry reports were identified. Median follow-up ranged from 2.1 to 4.7 years (inter-quartile range values spanned from 0.9 to 7.7 years). The main analyses demonstrated that 36-mm heads were associated with a marginal reduction in the risk of revision for dislocation (HR 0.85, 95%CI 0.72–1.01, p = 0.058; n…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 942,617 participants or records.
Read the paper
Related studies
- Effectiveness of Bisphosphonates and Denosumab on Risk of Vertebral Fractures in Prostate Cancer Patients Under Androgen Deprivation Therapies: A Real-World Prospective Study
- Osteoporosis-related fractures after spinal cord injury: a retrospective study from Brazil
- Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men
- Lack of Association between Vitamin D Insufficiency and Cardiovascular or Fracture Risk: A UK Biobank Study
- Muscle strength and body composition are clinical indicators of osteoporosis
- Incidence of bone protection and associated fragility injuries in patients with proximal femur fractures
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.