26dkou114 10.3205/26dkou114 urn:nbn:de:0183-26dkou1143 Meeting Abstract Beckers Beckers Gautier G

Klinikum der Universität München Campus Großhadern, München, Deutschland

author Simon Simon Dominic D

Klinikum der Universität München Campus Großhadern, München, Deutschland

author Grimberg Grimberg Alexander A

German Arthroplasty Registry (EPRD Deutsche Endoprothesenregister GmbH), Berlin, Deutschland

author Wu Wu Yinan Y

German Arthroplasty Registry (EPRD Deutsche Endoprothesenregister GmbH), Berlin, Deutschland

author Steinbrück Steinbrück Arnd A

German Arthroplasty Registry (EPRD Deutsche Endoprothesenregister GmbH), Berlin, Deutschland

author Holzapfel Holzapfel Boris B

Klinikum der Universität München Campus Großhadern, München, Deutschland

author German Medical Science GMS Publishing House

Düsseldorf

610 20261020 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0659 114 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie Deutsche Gesellschaft für Unfallchirurgie Berufsverband für Orthopädie und Unfallchirurgie Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2026) Abstracts | Optimierte Ergebnisse nach Endoprothetik Berlin 20261020 20261023 DKOU26_Abs_2441 TextObjectives and questions: The effect of femoral head length on implant survival in total hip arthroplasty (THA) has been little studied so far. Longer heads may increase taper corrosion and reflect intraoperative complexity. This study evaluated factors associated with the use of extra-long heads (≥XL) and their impact on implant survival.Material and methods: We analyzed 562,001 primary THA from the German Arthroplasty Registry. Subgroup analyses were performed by hospital annual primary THA volume (≤250, 251–500, ≥501), surgical indication (primary osteoarthritis [OA] vs. femoral neck fracture [FNF]), and fixation method (cemented vs. cementless). Logistic regression identified factors associated with ≥XL head use, and implant survival was compared between head lengths using Kaplan–Meier analysis in both subgroups and the overall cohort.Results: The use of ≥XL femoral heads decreased with increasing hospital volume (5.4% low, 4.5% medium, 3.0% high; p < 0.001). Rates were higher in FNF than OA across all volumes (8.1% vs. 4.7% in low-volume hospitals; 5.0% vs. 2.7% in high-volume hospitals). Cemented fixation was independently associated with higher odds of ≥XL head use (OR 1.14, 95% CI 1.09–1.18, p < 0.001), with additional predictors including male sex (OR 2.13, 95% CI 2.06–2.19), BMI ≥40 (OR 1.94, 95% CI 1.77–2.12), higher Elixhauser comorbidity score (OR 1.09, 95% CI 1.04–1.15), and surgery for FNF (OR 1.92, 95% CI 1.83–2.02), while treatment at high-volume hospitals was associated with lower odds (OR 0.56, 95% CI 0.54–0.58). Kaplan–Meier analysis revealed higher cumulative revision rates with ≥XL heads (7.2% vs. 4.5% at 9 years), consistent across all subgroups.Discussion and conclusions: The use of femoral heads ≥XL was independently associated with lower hospital THA volume, femoral neck fracture, cemented fixation, male sex, higher BMI, and greater comorbidity burden. Their implantation was also linked to higher revision rates, suggesting that ≥XL heads may serve as a surrogate marker for increased revision risk after primary THA. 0 0 0 0