• Kevin M Albanese, Prashant Deshmane, Nilesh Patil, David A Larsen, and Nathaniel R Ordway.
• From the Department of Orthopedics, SUNY Upstate Medical University, Syracuse, NY (Dr. Albanese, Dr. Deshmane, and Dr. Ordway), the Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA (Dr. Patil), and the Department of Public Health, Syracuse University, Syracuse, NY (Dr. Larsen).
• J Am Acad Orthop Surg. 2021 Jun 15; 29 (12): e618-e627.

IntroductionFemoral neck fractures have been traditionally managed with hemiarthroplasty (HA) or conventional total hip arthroplasty (CTHA). There has been recent interest in using dual-mobility components (DMC) in total hip arthroplasty for patients with femoral neck fractures to provide increased stability and decrease the need for future revision.MethodsWe conducted a systematic review of the literature reporting on the use of DMC in the management of femoral neck fractures in geriatric patients. We included studies in which DMC were used alone and studies that included a comparison to total hip arthroplasty or HA. The outcomes of interest were postoperative dislocation, revision, and revision surgery rates. Two separate subgroup analyses were conducted. For the comparative studies, we analyzed the differences in outcomes using a random-effects model of relative risks. For the noncomparative studies, we estimated the cumulative incidence of the different outcomes.ResultsEighteen studies met the inclusion criteria and were included in our analysis. Eleven noncomparative studies showed a cumulative incidence of dislocation to be 1.2% (95% confidence interval = 0.3% to 2.7%) when DMC were used alone. Subgroup analyses of the seven comparative studies yielded a relative risk of dislocation using DMC was 59% less than HA and 83% less than CTHA. DMC also compared favorably in terms of revision surgery and revision rates to HA. There was insufficient quality evidence to comment on revision surgery and revision rates when compared with CTHA in comparative studies, but among the noncomparative studies, there was a low rate of revision and revision surgery.ConclusionsOur study revealed overall lower risk of dislocation using DMC compared with both CTHA and HA. There were also lower revision and revision surgery rates when DMC were used compared with HA. Further studies are required to elucidate cost-effectiveness and long-term outcomes of DMC in these scenarios.Level Of EvidenceLevel III-meta-analysis.Copyright © 2020 by the American Academy of Orthopaedic Surgeons.

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