{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T10:27:02Z","timestamp":1787135222067,"version":"build-2736575974"},"reference-count":22,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Dual-mobility cups are commonly used to reduce instability after total hip arthroplasty (THA) for femoral neck fracture (FNF), but their advantage over contemporary large-head standard cups remains uncertain. This registry study compared revision-related survival estimates up to 10 years among monoblock dual-mobility cups, modular dual-mobility constructs, and standard cups with femoral heads \u2265 36 mm in cementless THA for FNF. Materials and Methods: We retrospectively analyzed regional residents undergoing cementless, non-metal-on-metal primary THA for FNF. The cohort included 4827 THAs: 1220 monoblock dual-mobility cups, 408 modular dual-mobility constructs, and 3199 standard cups with \u226536 mm heads. Groups differed in age and sex distribution, with modular dual mobility used in older patients and both dual-mobility constructs used more often in women. Kaplan\u2013Meier analysis estimated survival up to 10 years using aseptic failure and revision for dislocation\/instability as endpoints. Cox models estimated adjusted hazard ratios, and cumulative incidence of aseptic failure was assessed with death as a competing event. Results: Kaplan\u2013Meier-estimated 10-year aseptic failure-free survival was 94.4% for monoblock dual mobility, 96.8% for modular dual mobility, and 95.4% for standard cups (p = 0.815). Cup construct was not independently associated with aseptic failure: compared with standard cups, the HR was 1.12 for monoblock dual mobility (95% CI, 0.75\u20131.67) and 1.34 for modular dual mobility (95% CI, 0.71\u20132.52). Kaplan\u2013Meier-estimated 10-year survival free from revision for dislocation\/instability was 99.6%, 99.2%, and 99.3%, respectively (p = 0.620), with no independent effect of cup construct. Male sex increased the risk of both aseptic failure and revision for dislocation\/instability. Periprosthetic fracture was the leading cause of aseptic revision in both dual-mobility groups, whereas failures were more evenly distributed in the standard cup group. Death-adjusted cumulative incidence of aseptic failure was similar across constructs (p = 0.919). Conclusions: Neither monoblock nor modular dual mobility improved revision-related outcomes compared with standard cups using femoral heads \u2265 36 mm. Late survival estimates, particularly for modular dual mobility, should be interpreted cautiously because of the limited number of patients remaining at risk.<\/jats:p>","DOI":"10.3390\/medicina62081592","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T09:30:53Z","timestamp":1787131853000},"page":"1592","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Monoblock and Modular Dual-Mobility Constructs Versus Standard Cups with Femoral Heads \u2265 36 mm in Cementless Total Hip Arthroplasty for Femoral Neck Fracture: A 10-Year Comparative Registry Study of 10-Year Survival Estimates"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3158-0172","authenticated-orcid":false,"given":"Serena","family":"Santoro","sequence":"first","affiliation":[{"name":"Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti D\u2019Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6606-4950","authenticated-orcid":false,"given":"Barbara","family":"Bordini","sequence":"additional","affiliation":[{"name":"Laboratorio di Tecnologia Medica, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5508-9776","authenticated-orcid":false,"given":"Monica","family":"Cosentino","sequence":"additional","affiliation":[{"name":"Direzione Scientifica, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4264-3827","authenticated-orcid":false,"given":"Stefano","family":"Lucchini","sequence":"additional","affiliation":[{"name":"Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti D\u2019Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9651-1270","authenticated-orcid":false,"given":"Rosalinda","family":"Ventimiglia","sequence":"additional","affiliation":[{"name":"Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti D\u2019Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4301-7569","authenticated-orcid":false,"given":"Danilo","family":"Donati","sequence":"additional","affiliation":[{"name":"Riabilitazione della Mano ed Arto Superiore, Azienda Ospedaliero Universitaria Policlinico Modena, 40126 Modena, Italy"},{"name":"Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3567-9194","authenticated-orcid":false,"given":"Francesco","family":"Castagnini","sequence":"additional","affiliation":[{"name":"Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti D\u2019Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0196-101X","authenticated-orcid":false,"given":"Francesco","family":"Traina","sequence":"additional","affiliation":[{"name":"Ortopedia-Traumatologia e Chirurgia Protesica e dei Reimpianti D\u2019Anca e di Ginocchio, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"},{"name":"Dipartimento di Scienze Biomediche e Neuromotorie Dibinem, Universit\u00e0 di Bologna, 40126 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1007\/s00264-025-06731-w","article-title":"Beyond jump distance: Modular dual mobility versus single mobility cups in robotic total hip arthroplasty\u2014Simulation of hip kinematics and impingement","volume":"50","author":"Kouyoumdjian","year":"2026","journal-title":"Int. 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