Management of fracture neck of femur in elderly patients using dual mobility cup total hip arthroplasty versus bipolar hemiarthroplasty

Abstract

Introduction Fracture neck of femur (FNF) represents a major public health problem worldwide. The aim of this study is to evaluate the clinical, functional outcome and rate of complications of dual mobility cup total hip arthroplasty versus bipolar hemiarthroplasty in the management of displaced fracture neck femur in elderly patients. Methods A prospective Randomized control study was done in a university specialized unit between January 2018 and January 2021 on 40 elderly patients had a mean age of 70.5 years (range 60-91) with displaced intracapsular FNF. 20 patients were managed by Dual Mobility Cup Total Hip Arthroplasty (DMC THA group) and 20 patients underwent Bipolar Hemiarthroplasty (BHA group) for the treatment of their femoral neck fractures with a minimum 24 months follow-up (range 24-35). Rate of dislocation postoperatively was the primary outcomes while functional outcome (Harris Hip Score), intraoperative blood loss and length of operation were the secondary outcomes. Results The Harris hip score (HHS) was higher in the DMC THA group and was most significant after 6 and 12 months with P value (P < 0.05). The dislocation rate was less in the DMC THA group. The BHA group demonstrated less intraoperative blood loss (P < 0.001) and a shorter length of operation (P < 0.001). However, there was no significant difference in two-year mortality with P value (P > 0.05), blood transfusion rate with P value (P = 0.471) and infection rate with P value (P = 1.000). Conclusion In light of our results, the use of THA DMC did not seem to increase mortality, morbidity, or complications rate like infection or bleeding but it decreases dislocation rate and increase functional outcome when compared with BHA.