Dual Mobility Cups Hip Arthroplasty as A Treatment for Displaced Fracture of the Femoral Neck in the Elderly Patients: A Prospective Study

Arthroplasty is a better treatment for displaced fractures of the femoral neck in the elderly. The type of arthroplasty remains controversial as total hip replacements potentially have a higher dislocation rate. The study aimed to evaluate dual mobility cups to manage fractures of the femoral neck with the posterior approach in the elderly.  This prospective study was conducted in Amritsar (Punjab), India. All patients with displaced fractures of the femoral neck treated via arthroplasty were operated on with the insertion of a dual mobility cup with the posterior approach. All patients were fallow up by clinical and radiological assessment at immediate post-op, 3 and 6 months, and 1 and 3 years after surgery. Overall in the 240 patients, surgeries on the right hip of 121 (50.4%) and the left hip of 119 (49.6%) cases were performed. Male was the majority of patients, and all patients were followed-up. The mean Harris hip score improved from 16.62 ± 6.34 preoperatively to 92.86 ± 2.28 at one-year follow-up and 95.20 ± 1.82 at three years’ follow-up. Three dislocations occurred, and Open Reduction was performed through a posterior approach under regional anesthesia for two patients. Close Reduction was performed on one patient, and there was no recurrence of dislocation. The low dislocation rate after acute total hip replacement using dual mobility design cups is comparable with hemi arthroplasties. The dual mobility cups might be considered a valuable option to prevent postoperative dislocation when treating displaced intra-capsular fractures of the proximal femur in elderly patients. A dual mobility cup reduces the incidence of postoperative instability even after using the posterior approach.