Treatment of Fracture Neck Femur in Elderly Patients with Dual Mobility Total Hip Arthroplasty

Background: Femoral neck fractures (FNF) represent a major public health problem worldwide. Hip hemiarthroplasty (HA) represents the preferred method of treatment in most cases, due to relative technical ease and low invasiveness of the procedure. On the other hand, total hip arthroplasty (THA) is associated with a lower rate of reoperation, less pain and a better functional outcome. The aim of the work: to evaluate clinical and radiographic outcomes in a group of elderly patients who underwent total hip replacement using a Dual-Mobility (DM) implant after femoral neck fracture. Patients and methods: This Quasi experimental interrupted time series analysis was conducted at AL- Azhar University Hospital in Damietta. This study included 40 patients in orthopedic surgery and all patients aged 65 or older with a diagnosis of a displaced intracapsular femoral neck fracture, for whom the chosen treatment was an arthroplasty as primary treatment. Results: The study included 40 elderly patients with a mean age of 73.07 ± 3.83 years. There was a significant improvement in Harris Hip Score over 12 months (p < 0.001), increasing from a mean of 72.97 at 3 months to 78.57 at 12 months. Pain scores also significantly decreased over time (p < 0.001). Complications were low, with dislocation occurring in 5% and cup loosening in 12.5% of cases, while no periprosthetic fractures were reported. Conclusion: According our study, Surgical management of femoral neck fractures in the elderly by total hip arthroplasty has demonstrated excellent short-term outcomes. THA is one of the best treatments for displaced femoral neck fracture, with a low risk of dislocation. Furthermore, THA with a DM is a safe, effective with good clinical results, low complications and very low dislocation rate for treating displaced femoral neck fracture especially in patients with a high risk of dislocation.