Modes of failure of hip hemiarthroplasty for femoral neck fracture.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Competing interests: T. Tung and E. Trepman received fellowship support from the Concordia Foundation, DePuy Synthes, and Smith & Nephew. T. Gascoyne, E. Bohm, C. Burnell, D. Hedden, and T. Turgeon have received institutional funding from DePuy, Smith & Nephew, Zimmer Biomet, Hip Innovation Technology, and Össur. E. Bohm is a consultant to Stryker Canada and declares receiving payment for expert testimony from the Government of British Columbia. He is also an editorial board member of The Bone and Joint Journal. C. Burnell reports travel reimbursement from Hip Innovation Technology. D. Hedden was a paid consultant for Smith & Nephew. No other competing interests were declared. 5. Arch Orthop Trauma Surg. 2023 Jul;143(7):4141-4148. doi: 10.1007/s00402-022-04685-x. Epub 2022 Nov 17. Direct anterior versus antero-lateral approach in hip joint hemiarthroplasty. Krassnig R(1), Prager W(2), Wildburger R(3), Hohenberger GM(2). Author information: (1)AUVA Rehabilitation Clinic Tobelbad, Dr.-Georg-Neubauer-Straße 6, 8144, Tobelbad, Austria. renate.krassnig@auva.at. (2)Department of Trauma Surgery, LKH Feldbach-Fürstenfeld, Ottokar-Kernstock-Straße18, 8330, Fürstenfeld, Austria. (3)AUVA Rehabilitation Clinic Tobelbad, Dr.-Georg-Neubauer-Straße 6, 8144, Tobelbad, Austria. BACKGROUND: Femoral neck fractures are common injuries in the elderly and represent a major source of morbidity and mortality. Due to the benefits, bipolar hip hemiarthroplasty (BHH) is a popular method to treat. The purpose of this study is to evaluate the functional and radiographic outcomes for BHH comparing the direct anterior approach (DAA) to the anterolateral approach (ALA) to the hip joint. METHODS: We used a prospective, randomized observational study design, where we enrolled 83 patients at a level-I-trauma center presenting with indication for BHH. We followed up the participants at defined intervals over a period of 1 year. The follow-up examinations were carried out at defined time intervals for a period of 1 year. Calculations were performed with Statistical Package for Social Sciences (SPSS) 21.0. RESULTS: Concerning postoperative pain sensation, the anterior group had statistically significantly decreased pain levels at one (p = 0.02), seven (p = 0.04) and 14 days (p = 0.02) following the intervention when compared to the ALA sample. The postoperative modified Barthel-Index showed a statistically significant difference on the first postoperative day at the anterior group. CONCLUSION: Although we compared two minimally invasive approaches, our results shows a statistically significant difference in pain intensity and mobility for the early postoperative period using the direct anterior approach. © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. DOI: 10.1007/s00402-022-04685-x