Evidence map›Paper›PMID 42392114›Full record

Trial reportLancet (London, England)2026

Dual mobility versus standard cups in total hip replacement for displaced femoral neck fractures (Duality): an international, multicentre, randomised, controlled, superiority trial.

Nils P Hailer, Xavier L Griffin, Sebastian Mukka, Tatevik Ghukasyan Lakic, Duncan Appelbe, Olof Sköldenberg, Sarah E Lamb, Ollie Östlund, Olof Wolf, DUALITY Investigators

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter StudyEquivalence Trial
In one paragraph

Trial report in Lancet (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03909815 (Do Dual Mobility Cups Prevent Dislocation After Total Hip Arthroplasty Performed Due to Femoral Neck Fracture? A Registry-based, Pragmatic, Randomized Controlled Trial Comparing Dual Mobility With Standard Cups), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03909815 nacompletednot on this map

Do Dual Mobility Cups Prevent Dislocation After Total Hip Arthroplasty Performed Due to Femoral Neck Fracture? A Registry-based, Pragmatic, Randomized Controlled Trial Comparing Dual Mobility With Standard Cups

TypeinterventionalSponsorUppsala UniversityRan2020 to 2025Enrolled1,600ConditionsFemoral Neck FracturesArmsDual mobility cup, Standard cup
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Nils P HailerDepartment of Surgical Sciences/Orthopaedics & Hand Surgery, Uppsala University, Uppsala, Sweden. Electronic address: nils.hailer@uu.se.
Xavier L GriffinBone and Joint Health, Blizard Institute, Queen Mary University of London, London, UK.
Sebastian MukkaDepartment of Diagnostics and Intervention (Orthopaedics), Umeå University, Umeå.
Tatevik Ghukasyan LakicUppsala University, Uppsala Clinical Research Center, Uppsala, Sweden.
Duncan AppelbeNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Olof SköldenbergKarolinska Institute, Department of Clinical Sciences at Danderyd Hospital, Stockholm, Sweden.
Sarah E LambDepartment of Public Health and Sports Sciences, Exeter Medical School, St Luke's Campus, University of Exeter, Exeter, UK.
Ollie ÖstlundUppsala University, Uppsala Clinical Research Center, Uppsala, Sweden.
Olof WolfDepartment of Surgical Sciences/Orthopaedics & Hand Surgery, Uppsala University, Uppsala, Sweden.
DUALITY Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDislocation is the most common early surgical complication in patients with hip fractures treated with total hip replacement (THR). Dual mobility total hip replacement (DM-THR) was developed to increase joint stability, but no randomised trial has investigated its efficacy and safety. We aimed to compare the risk of dislocation in patients receiving DM-THR versus conventional THR.

methodsWe included people aged 65 years or older with a displaced femoral neck fracture attending 20 Swedish and 24 UK hospitals in this pragmatic, registry-based, randomised superiority trial. Participants eligible for THR were randomly allocated in a 1:1 ratio to either DM-THR or standard THR with the use of remote, web-based, country-specific sequences. Neither participants nor members of the direct clinical care teams were masked, but research investigators and statisticians were masked until the trial analysis was completed. The primary outcome was dislocation of the index joint, treated with closed reduction or open surgery within 1 year, analysed in the modified intention-to-treat population including all consenting participants receiving any type of hip replacement and excluding those with major protocol deviations. This trial is registered with ClinicalTrials.gov (NCT03909815) and ISRCTN11895196.

findingsBetween Jan 9, 2020, and April 2, 2024, 2934 eligible patients were screened, of whom 1334 were not enrolled, mainly due to surgeon's preference (n=560), because they had already been treated at the time of screening (n=257), or because informed consent was not obtained (n=213). 1600 participants (64% female, 36% male) were thus randomly assigned to either DM-THR (n=798) or THR (n=802). After exclusion of 34 participants due to prespecified protocol deviations, 1566 participants (97·9%) contributed to the modified intention-to-treat analysis. A dislocation, the primary outcome, occurred in ten (1·3%) of 779 participants in the DM-THR group and in 33 (4·2%) of 787 in the THR group (adjusted hazard ratio 0·27, 95% CI 0·13-0·56; p<0·0001).

interpretationThe use of DM-THR substantially reduced the risk of dislocation and of any surgical complication among people treated with THR after a displaced femoral neck fracture. DM-THR can thus be recommended for this group of patients.

fundingThe Swedish Research Council and the National Institute for Health and Care Research.

Indexed as

Arthroplasty, Replacement, HipFemoral Neck FracturesHip DislocationHip ProsthesisAgedAged, 80 and overFemaleHumansMalePostoperative ComplicationsProximal Femoral FracturesSwedenTreatment Outcome

Identifiers

PMID42392114
PMCPMC13425373

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.