Outcomes of Total Hip Arthroplasty for Femoral Neck Fracture in Elderly Patients

Open Access

Abstract

Background: Femoral neck fractures in older adults, usually from low-energy falls, are increasing with population ageing and remain linked to significant mortality, complications, and loss of independence, particularly where surgical delays and resource constraints are common. Total hip replacement can provide durable pain relief and functional recovery for selected elderly patients with displaced fractures. Methods & Materials: This observational cohort study at NITOR, Dhaka, enrolled 35 consecutive elderly patients with femoral neck fracture treated by total hip replacement from January 2024 to July 2025. Patients were followed up to 12 months for complications, readmission, revision, and mortality. Data were summarized descriptively in SPSS v26. Results: In 35 elderly patients undergoing total hip replacement for femoral neck fracture, the mean age was 71.8 ± 7.2 years. Most fractures resulted from simple falls (85.7%), were sub capital (54.3%) and displaced (91.4%), with Garden III–IV in 91.5%; median injury-to-surgery time was 72 hours (IQR 48–120). Spinal anesthesia (80.0%) and posterior approach (68.6%) predominated, with cemented fixation in 62.9%; mean operative time was 98 ± 18 minutes and median blood loss 350 mL (IQR 250–500). At least one complication occurred in 31.4%, with deep infection/PJI, dislocation, and DVT each 2.9%, and 12-month mortality was 8.6%. Functional outcomes improved markedly, with the Harris Hip Score rising from 35.2 ± 7.8 to 87.0 ± 8.5 and pain VAS falling from 8 to 1 by 12 months, while independent ambulation reached 71.9%. Conclusion: Total hip replacement for femoral neck fractures in elderly patients resulted in significant functional improvement and effective pain relief over a 12-month period, while maintaining acceptable rates of major complications and mortality.