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Direct anterior approach provides better functional outcomes when compared to direct lateral approach in hip hemiarthroplasty following femoral neck fracture

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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.

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Acknowledgements

The authors wish to express their thanks to the Orthogeriatric Unit of our Institution, especially Dr. Maria del Mar Villar, for their invaluable co-working with our Orthopaedic and Traumatology Department in the multidisciplinary management of hip fractures in older patients.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Traumatology and Orthopedic Surgery, Hospital Universitari Valld’Hebron, Passeig de la Vall d’Hebron, 119-129, 08035, Barcelona, Spain

    Kushal Lakhani, Iñaki Mimendia, Juan Antonio Porcel, Ernesto Guerra-Farfán & Víctor Barro

  2. Universitat Autónoma de Barcelona, Passeig de la Vall d’Hebron, 119-129, 08035, Barcelona, Spain

    Kushal Lakhani, Iñaki Mimendia, Juan Antonio Porcel, Ernesto Guerra-Farfán & Víctor Barro

  3. Hip Surgery Unit, Department of Traumatology and Orthopaedic Surgery, Hospital Universitari Vall d’Hebron, Barcelona, Spain

    Iñaki Mimendia, Ernesto Guerra-Farfán & Víctor Barro

  4. Department of Traumatology and Orthopaedic Surgery, Hospital Universitari Dexeus, Barcelona, Spain

    Lidia A. Martín-Domínguez

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  1. Kushal Lakhani
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  2. Iñaki Mimendia
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Correspondence to Kushal Lakhani.

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Lakhani, K., Mimendia, I., Porcel, J.A. et al. Direct anterior approach provides better functional outcomes when compared to direct lateral approach in hip hemiarthroplasty following femoral neck fracture. Eur J Orthop Surg Traumatol 32, 137–143 (2022). https://doi.org/10.1007/s00590-021-02941-1

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  • DOI: https://doi.org/10.1007/s00590-021-02941-1

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