Arthroscopic surgery of the hip is a procedure with a relatively low rate of complications, although some may be significant in this young cohort of patients. This study relied on the reported complications only and the results should be interpreted with caution. Cite this article: 2017;99-B:1577-83.

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With increasing life expectancy and rising incidence of osteoporosis, the number of femoral neck fractures among the elderly is expected to rise. The treatment however remains controversial. Historically, when prosthetic replacement of the femoral head is chosen, hemiarthroplasty is preferred in most circumstances. Total Hip Arthroplasty, however, is currently an accepted treatment option though reserved for patients with concurrent acetabular disease. We reviewed 97 consecutive cemented total hip arthroplasty in 17 men and 80 women who had an acute displaced femoral neck fracture and present our results.Fifty one were Exeter, 17 Charnley, 21 CPT and 8 Stanmore hips were implanted. Majority of the patients had a Rogmark score of 15 or above and no pre-existing hip pain. The patients had a mean age of 71 years (range: 41-90) at the time of operation and were followed up for a minimum of 2 years postoperatively (or until revision surgery or the patient had died). Oxford hip scores, Visual Analogue Scores and satisfaction were assessed at review.Four hips (4%) were revised, one each for periprosthetic fracture and recurrent dislocation and two for infection. At time of last review, 13 patients had died due to other medical causes, 9 patients (9%) had had a perioperative complication. Eight cases (8%) of dislocation were recorded, 6 were early (1 due to component malposition resulting in recurrent dislocation and underwent subsequent revision), and 2 were late dislocations. Majority of the patients were satisfied with the surgery had no pain or mild pain and were walking unaided or with the help of one stick.With strict selection criteria, THA is likely to offer some patients more predictable pain relief and return to near prefracture level of ambulation. Lack of significant joint arthritis prefracture need not be a contraindication to obtaining a satisfactory result.

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