Bipolar hemiarthroplasty (BA) has long been the preferred treatment and is performed in most patients with femoral neck fracture (FNF). The dual mobility cup total hip arthroplasty (DMTHA) has emerged as a relevant alternative to BA. Since then there is an on-going debate on the best implant to use. Age, comorbidities, patient independence, and potential surgical complications must be considered when choosing implants. The risk of dislocation is a crucial factor because of its important consequences. The authors evaluated the functional and mechanical outcomes of BA versus DMTHA in FNF in active elderly patients.
This study was a randomized comparative interventional single-blinded study that was performed at Ain Shams University Hospitals. A total of 33 patients underwent DMTHA or BA after displaced FNF. Primary outcomes were functional outcome and postoperative dislocation rate. Secondary outcomes were operative time and amount of blood loss.
There were no significant differences between the demographic data and preoperative parameters between the two groups. There was a significant difference in the postoperative Harris Hip Score (HHS) between the two groups (P=0.01). VAS of groin pain was significantly different between the two groups (P<0.001). There was no significant difference between the two groups regarding the dislocation rate.
The authors concluded that DMTHA offered a better functional outcome than BA with no significant complications or mortality, and there was no significant difference between DMTHA and BA in the rate of dislocation.
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