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The minimally invasive anterolateral approach versus the traditional anterolateral approach (Watson-Jones) for hip hemiarthroplasty after a femoral neck fracture: an analysis of clinical outcomes

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Abstract

Purpose

The minimally invasive (MI) anterolateral approach is a relatively new approach for the treatment of femoral neck fractures with a hemiarthroplasty (HA). There is limited research available presenting clinical outcomes after an HA using the MI approach. Therefore the aim of the present study was to compare clinical outcomes of the MI and traditional anterolateral approaches in patients after HA.

Methods

Data were extracted from a prospective hip fracture database and completed by retrospective review of the electronic medical records. Patients undergoing HA in a level II trauma teaching hospital between 1 January 2011 and 1 May 2016 were enrolled.

Results

A total of 463 patients (67% female), 223 in the MI group (mean age, 82 ± 7) and 240 (mean age, 81 ± 8) in the traditional anterolateral group were enrolled. No significant difference was found in baseline characteristics. The surgeons experience measured by the operations performed per year was in favour of the MI anterolateral group (26 vs 18, p < 0.001). The median operating time for an MI approach was shorter (53 vs 69 min, p < 0.001). No significant differences were found in mortality rates (p = 0.131) and post-operative complications: haematomas (p = 0.63), dislocations (p = 0.63), deep surgical site infections (p = 0.66) and re-operations.

Conclusions

Our findings show the MI anterolateral approach has a minimally shorter operation time with no difference in post-operative complications and clinical outcomes. We, therefore, conclude that the MI anterolateral approach is a safe alternative for the traditional anterolateral approach with an improved operation time, a smaller incision and less surrounding tissue damage.

Level of evidence

Prognostic level III retrospective cohort study.

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Authors and Affiliations

  1. Department of General Surgery, Maasstad Hospital, Maasstadweg 21, 3079 DZ, Rotterdam, The Netherlands

    Louis de Jong & Taco M. A. L. Klem

  2. Surgery Department, Franciscus Hospital, Kleiweg 500, 3045 PM, Rotterdam, the Netherlands

    Louis de Jong & Gert R. Roukema

  3. Science Board, Franciscus Hospital, Kleiweg 500, 3045 PM, Rotterdam, the Netherlands

    Tjallingius M. Kuijper

Authors
  1. Louis de Jong
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  2. Taco M. A. L. Klem
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  3. Tjallingius M. Kuijper
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  4. Gert R. Roukema
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Corresponding author

Correspondence to Louis de Jong.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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de Jong, L., Klem, T.M.A.L., Kuijper, T.M. et al. The minimally invasive anterolateral approach versus the traditional anterolateral approach (Watson-Jones) for hip hemiarthroplasty after a femoral neck fracture: an analysis of clinical outcomes. International Orthopaedics (SICOT) 42, 1943–1948 (2018). https://doi.org/10.1007/s00264-017-3756-z

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  • DOI: https://doi.org/10.1007/s00264-017-3756-z

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