Direct anterior approach versus direct lateral approach in total hip arthroplasty and bipolar hemiarthroplasty for femor
- PDF / 1,070,465 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 104 Downloads / 210 Views
ORIGINAL ARTICLE
Direct anterior approach versus direct lateral approach in total hip arthroplasty and bipolar hemiarthroplasty for femoral neck fractures: a retrospective comparative study Mauro Spina1 · Valentina Luppi2 · Jacopo Chiappi2 · Francesco Bagnis2 · Massimo Balsano1 Received: 20 June 2020 / Accepted: 17 August 2020 © Springer Nature Switzerland AG 2020
Abstract Background In the current literature, there is no consensus on the best surgical approach in hip replacement for femoral neck fractures (FNFs). Aim The aim of this study is to compare the direct anterior approach (DAA) and the direct lateral approach (DLA) in patients treated with bipolar hemiarthroplasty (BHA) and total hip arthroplasty (THA) for FNFs. Materials and methods Patients with displaced FNFs (Garden type III and IV) treated operatively using BHA and THA were enrolled. The surgical approach techniques DAA and DLA are compared. The analysed variables are: mean surgery time, number of blood units transfused perioperatively, percentage of patients transfused, perioperative complications, pain and functional outcomes at 1 and 6 months and mortality at 1, 3 and 12 months. Results Between 2015 and 2017, 37 patients underwent BHA by the DAA and 38 patients underwent BHA by the DLA, 69 patients underwent THA by the DAA and 60 patients underwent THA by the DLA. For THA, the DAA compared to the DLA had a higher mean surgery time (100.8 min vs. 97.7 min), a lower mean number of blood units transfused perioperatively (1.4 U vs. 1.9 U), a significantly lower percentage of patients transfused (53.6% vs. 71.7%), a higher rate of perioperative complications (10.1% vs. 1.6%), a lower pain referred and better functional outcomes in the first 6 postoperative months and a significantly lower mortality rate at 12 months (2.9% vs. 16.7%). For BHA, the advantages of the DAA over DLA are not as significant. Conclusions The direct anterior approach in THA for FNFs provides significant benefits in the early post-operative period compared to the direct lateral approach in terms of functional recovery, residual pain, blood loss and mortality rate in the elderly active population. Level of evidence Level IV, retrospective cohort study. Keywords Hip fractures · Direct anterior approach · Direct lateral approach · Total hip arthroplasty · Bipolar hemiarthroplasty
Background
* Mauro Spina [email protected] 1
Department of Orthopedics and Traumatology A, Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale A. Stefani n. 1, 37126 Verona, Italia
Department of Orthopedics and Traumatology B, Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale A. Stefani n. 1, 37126 Verona, Italia
2
Femoral neck fractures (FNFs) are increasing in incidence in the elderly population [1] and represent a significant cause of morbidity and mortality in this population. While undisplaced fractures may be treated with internal fixation [2], hip replacement surgery is indicated in displaced fractures (Garden type III or IV) [3]. Both bipolar hemi
Data Loading...
