{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:50:28Z","timestamp":1787755828945,"version":"build-2784847793"},"reference-count":57,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Instability is a frequent complication after total hip arthroplasty (THA) and remains a leading cause of revision surgery. Dual mobility (DM) and large femoral heads (LFHs) have been used to mitigate this risk, particularly in high-risk patients. This study aimed to compare the postoperative outcomes of DM vs. LFH in THA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. MEDLINE, Embase, CINAHL, CENTRAL, and ClinicalTrials.gov were searched for relevant studies up to May 2025. Inclusion criteria comprised studies directly comparing DM and LFH \u226536 mm in primary and revision THA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Eighteen studies (2 randomized controlled trials and 16 nonrandomized) involving a total of 133,474 hips (13,508 DM; 119,966 LFH) were included. The analysis revealed that LFH was associated with a significantly higher risk of dislocation compared with DM in both primary THA (odds ratio [OR] = 4.81, p &lt; 0.001) and revision THA (OR = 1.99, p &lt; 0.001). This was further confirmed in a time-to-event analysis for dislocation (hazard ratio = 2.67, 95% confidence interval [CI] 1.54-4.63, p &lt; 0.001). Meta-regression adjusting for acetabular cup size showed no significant moderating effect (\u03b2 = 0.19, 95% CI \u22120.13 to 0.51; OR = 1.20, 95% CI 0.88-1.67; p = 0.12), indicating that the protective effect of DM on dislocation risk was independent of cup size. The overall pooled analysis indicated that the risks of revision for dislocation (OR = 1.38, p = 0.02) and aseptic loosening (OR = 1.77, p = 0.02) were significantly higher with LFH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Across both primary and revision THA, LFH was associated with a significantly higher risk of dislocation, consistent in time-to-event analyses and after adjustment for acetabular cup size. The pooled analysis also showed higher risks of revision for dislocation and aseptic loosening with LFH. However, longer-term implant survival requires further investigation in future studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level II<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.rvw.25.00181","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T19:00:26Z","timestamp":1765479626000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Dual Mobility vs. Large Femoral Head (\u226536 mm) in Primary and Revision Total Hip Arthroplasty"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8936-4202","authenticated-orcid":false,"given":"Abdelrahman","family":"Ibrahim","sequence":"first","affiliation":[{"name":"University Hospital of North Midlands, Stoke-on-Trent, United 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