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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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u20131.01,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.058;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009241,136) without an increased risk of all-cause revision (HR 1.06, 95%CI 0.95\u20131.18,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.287;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009942,617). Similar results were observed in the sensitivity analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>At early to midterm follow-up, the use of 36-mm heads were not associated with an increased risk of revision for all-causes, compared to 32-mm heads. However, they may offer a protective reduction against revision for dislocation, as a marginal statistically significant reduction was observed, indicating a possible benefit. Further studies investigating these outcomes at longer-term follow up are needed to understand whether these revision risk profiles are maintained.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00402-025-06151-w","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T13:07:19Z","timestamp":1765804039000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1007","volume":"146","author":[{"given":"Muhamed M.","family":"Farhan-Alanie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina","family":"Abdul-Hussein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Gallacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakrit R.","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajpreet","family":"Sahemey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D. 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