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Direct anterior versus antero-lateral approach in hip joint hemiarthroplasty

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

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.

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Data availability

All data are stored on a media carrier protected with a code. They are only accessible for the authors.

Code availability

NCT 05255198. Start: 1st of May 2016 Enrolment: 1st May 2016 to 31st May 2019

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Authors and Affiliations

  1. AUVA Rehabilitation Clinic Tobelbad, Dr.-Georg-Neubauer-Straße 6, 8144, Tobelbad, Austria

    Renate Krassnig & Renate Wildburger

  2. Department of Trauma Surgery, LKH Feldbach-Fürstenfeld, Ottokar-Kernstock-Straße18, 8330, Fürstenfeld, Austria

    Walter Prager & Gloria M Hohenberger

Authors
  1. Renate Krassnig
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  2. Walter Prager
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  3. Renate Wildburger
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  4. Gloria M Hohenberger
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Correspondence to Renate Krassnig.

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Ethical approval

This study was approved by the responsible Ethics Committees of the level-I university trauma center and the AUVA Ethics Committees (32-310 ex 19/20; Proposal 11/20).

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Krassnig, R., Prager, W., Wildburger, R. et al. Direct anterior versus antero-lateral approach in hip joint hemiarthroplasty. Arch Orthop Trauma Surg 143, 4141–4148 (2023). https://doi.org/10.1007/s00402-022-04685-x

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  • DOI: https://doi.org/10.1007/s00402-022-04685-x

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