A Study of Functional Outcome and Complications Following Total Hip Arthroplasty in Elderly Patients with Fracture Neck of Femur

Abstract Background: Fracture neck of femur in elderly patients represents a major public health challenge with significant morbidity and mortality. Total hip arthroplasty (THA) has emerged as a preferred treatment option for displaced femoral neck fractures in elderly patients, offering immediate stability and early mobilization. This study evaluated the functional outcomes and complications following THA in elderly patients with femoral neck fractures. Methods: This prospective observational study included 78 elderly patients (aged ≥60 years) with displaced femoral neck fractures treated with primary THA between January 2023 and December 2024. Functional outcomes were assessed using the Harris Hip Score (HHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at 3, 6, and 12 months postoperatively. Radiological evaluation included assessment of implant position, acetabular and femoral component stability, and complications. Statistical analysis was performed with significance set at p<0.05. Results: The mean age was 68.4±6.2 years with female preponderance (62.8%). The mean Harris Hip Score improved from 42.6±8.4 preoperatively to 86.4±9.2 at 12 months (p<0.001). According to HHS categories, excellent to good results were achieved in 83.3% of patients at final follow-up. The mean WOMAC score decreased from 68.4±10.2 preoperatively to 18.6±8.4 at 12 months. Complications occurred in 14.1% of patients, including dislocation (6.4%), superficial infection (3.8%), deep vein thrombosis (2.6%), and periprosthetic fracture (1.3%). One-year mortality was 5.1%. Functional outcomes showed significant correlation with preoperative mobility status (p=0.004) and comorbidity burden (p=0.012). Conclusion: Primary THA provides excellent functional outcomes and acceptable complication rates in elderly patients with femoral neck fractures. Early mobilization and rehabilitation are key factors for successful outcomes. Patient selection and perioperative optimization significantly influence postoperative recovery and complication rates.