In English

In Sweden, more than 2,000 patients receive a total hip replacement annually due to femoral neck fractures. However, according to the Swedish Arthroplasty Register, up to 8% of these patients can suffer from dislocation. This entails enormous human suffering, as well as a high rate of readmissions and re-operations due to this event. Dislocation causes increased resource use. Dual mobility cups are used in many places in Sweden based on the premise that these can reduce the risk of dislocation, but there are currently no studies of sufficient quality to recommend the introduction of the much more expensive dual mobility cups on a broad front. The DUALITY study aims to determine whether dual mobility cups reduce the risk of dislocation after a femoral neck fracture. Secondary outcomes include the presence of periprosthetic joint infections, different types of re-operation, death within 90 and 365 days, patient-reported outcomes, and potential health economic benefits. The study will enroll 1,600 patients 65 years or older with displaced femoral neck fractures (Type III or IV according to the Graden classification). These patients will be randomized to either dual mobility or standard cup through the Swedish Fracture Register's internet portal, provided that there are indications for total hip arthroplasty according to local routines. The entire treatment and aftercare will follow local practices. The selection process (e.g., of implants, incisions, and mobilization) is up to the attending clinic. No special follow-up visits or examinations beyond routine care are required.

The published protocol can be read here