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Randomized Controlled Trial
. 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

Renate Krassnig  1 , Walter Prager  2 , Renate Wildburger  3 , Gloria M Hohenberger  2
Affiliations
Randomized Controlled Trial

Direct anterior versus antero-lateral approach in hip joint hemiarthroplasty

Renate Krassnig et al. Arch Orthop Trauma Surg. 2023 Jul.

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.

Keywords: Barthel-Index; Femoral neck fracture; Postoperative pain.

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