Dual mobility total hip arthroplasty in the treatment of femoral neck fractures

Aims to evaluate the rate of dislocation following dual mobility total hip arthroplasty (Dm-tHa) in patients with displaced femoral neck fractures, and to compare rates of dislocation, surgical-site infection, reoperation, and one-year mortality between Dm-tHa and bipolar hemiarthroplasty (BHa). methods Studies were selected based on the following criteria: 1) study design (retrospective cohort studies, prospective cohort studies, retrospective comparative studies, prospective comparative studies, and randomized controlled studies (Rcts)); 2) study population (patients with femoral neck fracture); 3) intervention (Dm-tHa or BHa); and 4) outcomes (complications during postoperative follow-up and clinical results). Pooled meta-analysis was carried out to evaluate the dislocation rate after Dm-tHa and to compare outcomes between Dm-tHa and BHa. Results a total of 17 studies (ten cohort studies on Dm-tHa and seven comparative studies of Dm-tHa and BHa) were selected. these studies included 2,793 patients (2,799 hips), made up of 2,263 Dm-tHa patients (2,269 hips) and 530 BHa patients (530 hips). in all, 16 studies were analyzed to evaluate dislocation rate after Dm-tHa. the cumulative dislocation rate was 4% (95% confidence interval (CI) 3 to 5). Seven studies were analyzed to compare the rates dislocation and surgical-site infection. The rate of dislocation was significantly lower in the DM-THA group than in the BHA group (risk ratio (RR) 0.3; 95% CI 0.17 to 0.53, p < 0.001, Z −4.11). There was no significant difference in the rate of surgical-site infection between the two groups (p = 0.580). Six studies reported all-cause reoperations. the rate of reoperation was significantly lower in the DM-THA group than in the BHA group (RR 0.5; 95% CI 0.32 to 0.78, p = 0.003, Z −3.01). Five studies reported one-year mortality. The mortality rate was significantly lower in the Dm-tHa group than in the BHa group (RR 0.58 95% ci 0.45 to 0.75, p < 0.0001, Z −4.2). conclusion while the evidence available consisted mainly of non-randomized studies, Dm-tHa appeared to be a viable option for patients with displaced fractures of the femoral neck, with better reported rates of dislocation, reoperation, and mortality than BHa.