Femoral Neck Fractures in Elderly Patients: Dual Mobility Cup Arthroplasty or Hemiarthroplasty? A Narrative Review of the Literature

Proximal femoral fractures (PFFs) are the most frequent type of bone injury among the elderly. In Italy alone, 906,111 hospital admissions for hip fractures were recorded between 2007 and 2017. Globally, due to the aging population, the number of cases is expected to rise to 21.3 million by 2050. In older individuals, fractures of the femoral neck are commonly managed with prosthetic implants. While hemiarthroplasty has long been the standard treatment, total hip arthroplasty (THA) is increasingly favored for more active or functionally demanding patients. Among the surgical options, dual mobility THA (DM-THA) stands out for its potential to significantly reduce postoperative complications, particularly dislocations, when compared to both conventional THA and hemiarthroplasty. This study aimed to determine the most effective surgical strategy—dual mobility THA versus hemiarthroplasty—for managing femoral neck fractures in elderly patients. A thorough literature review was conducted using PubMed, Web of Science, and Scopus, focusing on the most recent and relevant publications. The findings highlight a consistent trend: patients treated with DM-THA generally experience better outcomes than those receiving hemiarthroplasty. Based on current evidence, DM-THA should be regarded as the preferred intervention for elderly individuals with femoral neck fractures, except in cases where severe comorbidities or anesthesia-related risks require a more conservative approach.