Kushal Lakhani1,2, Iñaki Mimendia3,4,5, Juan Antonio Porcel3,4, Lidia A Martín-Domínguez6, Ernesto Guerra-Farfán3,4,5, Víctor Barro3,4,5. 1. Department of Traumatology and Orthopedic Surgery, Hospital Universitari Valld'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain. klakhani@vhebron.net. 2. Universitat Autónoma de Barcelona, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain. klakhani@vhebron.net. 3. Department of Traumatology and Orthopedic Surgery, Hospital Universitari Valld'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain. 4. Universitat Autónoma de Barcelona, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain. 5. Hip Surgery Unit, Department of Traumatology and Orthopaedic Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain. 6. Department of Traumatology and Orthopaedic Surgery, Hospital Universitari Dexeus, Barcelona, Spain.
Abstract
PURPOSE: This study aims to compare the differences between direct anterior approach (DAA) and direct lateral approach (DLA) in hip hemiarthroplasty (HHA) after displaced femoral neck fracture (FNF) in early functional outcome, hospital length of stay, morbidity and mortality rates. METHODS: This non-interventional retrospective study, carried out at a tertiary trauma centre within the Spanish National Health System, included all patients who underwent a bipolar HHA between 1st January 2018 and 31st December 2019 performed by 2 of our hip unit surgeons. RESULTS: A total of 94 patients were included (40 in DAA group and 54 in DLA group). Median follow-up was 19.2 months (range 8-30.8 months). Postoperative degree of mobilisation showed statistically significant differences in favour of DAA group, where 35% of patients were able to walk with no assistance after surgery. DAA group had 1 day less of hospitalisation in contrast with DLA group overall (8 days vs 9 days, respectively, p < 0.05). Statistically significant differences were not detected in comparing postoperative complications, re-operations rates or 6-months mortality rate. CONCLUSION: Our study highlights the benefits of DAA for HHA after displaced FNF in terms of postoperative mobilisation degree and hospitalisation length of stay when compared to DLA.
PURPOSE: This study aims to compare the differences between direct anterior approach (DAA) and direct lateral approach (DLA) in hip hemiarthroplasty (HHA) after displaced femoral neck fracture (FNF) in early functional outcome, hospital length of stay, morbidity and mortality rates. METHODS: This non-interventional retrospective study, carried out at a tertiary trauma centre within the Spanish National Health System, included all patients who underwent a bipolar HHA between 1st January 2018 and 31st December 2019 performed by 2 of our hip unit surgeons. RESULTS: A total of 94 patients were included (40 in DAA group and 54 in DLA group). Median follow-up was 19.2 months (range 8-30.8 months). Postoperative degree of mobilisation showed statistically significant differences in favour of DAA group, where 35% of patients were able to walk with no assistance after surgery. DAA group had 1 day less of hospitalisation in contrast with DLA group overall (8 days vs 9 days, respectively, p < 0.05). Statistically significant differences were not detected in comparing postoperative complications, re-operations rates or 6-months mortality rate. CONCLUSION: Our study highlights the benefits of DAA for HHA after displaced FNF in terms of postoperative mobilisation degree and hospitalisation length of stay when compared to DLA.
Authors: M Orth; D Osche; P Mörsdorf; J H Holstein; M F Rollmann; T Fritz; T Pohlemann; A Pizanis Journal: Arch Orthop Trauma Surg Date: 2022-09-02 Impact factor: 2.928