Background: Dual mobility (DM) total hip arthroplasty (THA) was introduced to reduce postoperative instability, one of the most frequent causes of revision after hip replacement. Its use has progressively expanded beyond revision surgery to selected high-risk primary cases; however, comparative data integrating both clinical and radiographic outcomes from real-world tertiary centers remain limited. Methods: A retrospective comparative study was conducted including 78 patients who underwent THA with a DM acetabular component between January 2019 and December 2024, and 78 matched controls who received conventional fixed-bearing THA during the same period. Matching criteria were age, sex, and procedure type (primary versus revision). Clinical outcomes were assessed using the Harris Hip Score (HHS) and visual analogue scale (VAS) for pain. Radiographic evaluation focused on component positioning, radiolucent lines, and signs of loosening. Complications and revision rates were compared between groups. Results: The mean age was 71 ± 9 years, and 62% of patients were female. Mean follow-up was 38 months. HHS improved from 54 ± 10 preoperatively to 89 ± 8 postoperatively in the DM group (p < 0.001), with similar final functional outcomes in the conventional THA group (90 ± 9, p = 0.48), and comparable improvement between groups (p = 0.62). Radiographic parameters demonstrated stable fixation and appropriate component positioning in both groups, with no significant intergroup differences. The dislocation rate was numerically lower in the DM group (1.3% vs. 5.1%), although this difference did not reach statistical significance (p = 0.37). No cases of intraprosthetic dislocation occurred. Overall implant survival free from revision at five years was 96.5% for DM and 94.7% for conventional THA (p = 0.47). Conclusions: DM THA achieved excellent clinical and radiographic outcomes, with a numerically lower dislocation rate than conventional THA. Mid-term implant survivorship was comparable between groups, supporting DM as a reliable option for improving stability in appropriately selected patients.

Background/Objectives: Delayed bone healing remains a relevant complication after polytrauma, where fracture repair occurs in the setting of systemic inflammation and repeated physiologic stress. This study evaluated whether serial changes in interleukin-6 (IL-6), C-reactive protein (CRP), and fibrinogen are associated with delayed union in polytrauma patients with long-bone fractures. Methods: We performed an exploratory retrospective cohort study including 115 adult polytrauma patients with long-bone fractures treated at a single tertiary trauma center between 2 January 2022 and 14 December 2024. Serum IL-6, CRP, and fibrinogen were recorded at 24 h, 72 h, 1 week, 2 weeks, and 4 weeks after injury. IL-6 was measured in the institutional clinical laboratory using routine immunoassay methods, whereas CRP and fibrinogen were measured using standard hospital analytical methods, including an immunoturbidimetric assay for CRP and the Clauss clotting method for fibrinogen. Radiographic healing was assessed at 6, 12, and 24 weeks using an mRUST-based healing score. The primary endpoint was clinician-assigned delayed union at 24 weeks; nonunion at 9 months was assessed secondarily. Complete-case multivariable logistic regression was performed in 86 patients, and exploratory longitudinal biomarker analyses used generalized estimating equations. Results: Delayed union at 24 weeks occurred in 39/115 patients (33.9%), while nonunion at 9 months occurred in 7/115 patients (6.1%). Patients with delayed union had longer time to definitive fixation (35.3 ± 10.2 h vs. 29.0 ± 14.0 h; p = 0.003) and more frequent shock on admission (43.6% vs. 23.7%; p = 0.047). IL-6 was higher in the delayed-union group at 1 week (57.3 ± 30.3 vs. 46.5 ± 29.2 pg/mL; p = 0.043) and 4 weeks (21.2 ± 11.6 vs. 17.1 ± 10.3 pg/mL; p = 0.022), whereas CRP was markedly higher at 4 weeks (29.4 ± 14.2 vs. 16.3 ± 10.6 mg/L; p < 0.001). After false-discovery-rate correction, only CRP at 4 weeks remained significant among serial biomarker comparisons. In multivariable analysis of 86 complete cases, CRP at 4 weeks remained independently associated with delayed union (adjusted OR 2.16 per 10 mg/L, 95% CI 1.36–3.43; p = 0.001). The model showed apparent discrimination with an AUC of 0.80 and acceptable calibration (Hosmer–Lemeshow p = 0.41). In sensitivity analysis excluding deep surgical-site infection cases, the association between CRP and delayed union persisted (adjusted OR 2.02 per 10 mg/L, 95% CI 1.26–3.26; p = 0.004). Conclusions: In this exploratory retrospective cohort of polytrauma patients with long-bone fractures, persistent post-traumatic CRP elevation at 4 weeks was associated with clinician-assigned delayed union, whereas IL-6 findings were weaker and exploratory. Because CRP is a nonspecific inflammatory marker, the observed association may reflect delayed healing, infection, reoperation, and/or persistent postoperative inflammatory burden. These data support association rather than validated prediction and require prospective validation with standardized outcome adjudication.

Background: The optimal management of comminuted proximal humerus fractures in the elderly remains controversial. Although hemiarthroplasty is widely used for complex fracture patterns, its functional superiority over reconstruction is not consistently demonstrated. The aim of this study was to compare early functional outcomes following open reduction and internal fixation (ORIF) versus hemiarthroplasty in elderly patients with three- and four-part proximal humerus fractures. Methods: This retrospective single-center study included elderly patients with comminuted proximal humerus fractures treated between 2020 and 2024 by either ORIF or hemiarthroplasty. Functional outcomes were assessed at 6 months using the Constant–Murley and DASH scores. Secondary outcomes included complication rates, range of motion, and early reintervention. Results: At 6 months, the ORIF group showed a mean Constant–Murley score of 62.1 ± 9.4 compared with 58.0 ± 10.2 in the hemiarthroplasty group. DASH scores were 34.2 ± 10.8 for ORIF and 38.5 ± 11.3 for hemiarthroplasty. Pain levels were similarly low in both groups (VAS 2.6 ± 1.1 vs. 2.9 ± 1.2). Complication rates were comparable, with fixation-related issues occurring in 17% of ORIF cases and tuberosity-related complications in 11% of hemiarthroplasty cases. Conclusions: Hemiarthroplasty should not be regarded as the default treatment strategy for comminuted proximal humerus fractures in elderly patients. When stable anatomic reduction is achievable, ORIF can yield comparable early functional results, emphasizing that patient selection and tuberosity management remain more important than the choice of implant.

Background: Musculoskeletal disorders represent a substantial global health burden, often leading to pain, functional impairment, and reduced quality of life. Total hip arthroplasty (THA) remains a key intervention for advanced hip pathology, yet postoperative recovery depends heavily on targeted rehabilitation. This study examined muscle strength progression and quality-of-life outcomes following a structured rehabilitation program after THA. Methods: Patients who underwent primary THA were enrolled in a structured postoperative physiotherapy protocol. Muscle strength (abduction, extension, and flexion peak force) was quantified using a validated digital dynamometer (ActivForce 2). Quality of life was evaluated using the Hip Disability and Osteoarthritis Outcome Score (HOOS), including the Quality-of-Life subscale (HOOS_QL). Assessments occurred at discharge (T1), six weeks post-discharge (T2), and twelve weeks postoperatively (T3). Results: Statistically significant longitudinal improvements in muscle strength were observed across all movement planes between T1–T2 and T2–T3 ( p < 0.001). HOOS_QL scores showed a parallel increase over the same intervals. In regression analysis, hip extension peak force at T3 emerged as the only significant individual predictor of quality-of-life outcomes ( p = 0.025). Conclusion: Participation in a structured postoperative rehabilitation program was associated with measurable improvements in muscle strength and patient-reported quality of life following THA. Hip extension strength was identified as an individual predictor of quality-of-life outcomes; however, the overall regression model demonstrated modest explanatory capacity, suggesting that this association warrants confirmation in larger controlled studies.