Outcomes of direct anterior approach for uncemented total hip replacement in medial femoral neck fractures: a retrospective comparative study on the first 100 consecutive patients

BMC Musculoskeletal Disorders

Research Article

Giuseppe Geraci¹  Leonardo Tassinari¹  Alberto Di Martino¹  Davide Pederiva¹  Matteo Brunello¹  Cesare Faldini¹  Niccolò Stefanini¹ 

[1] IRCCS - Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy;Department of Biomedical and Neuromotor Sciences - DIBINEM, University of Bologna, Bologna, Italy;

关键词: Total hip arthroplasty;    Proximal femur fractures;    Direct anterior approach;    Posterolateral approach;   

DOI  :  10.1186/s12891-023-06919-4

 received in 2023-02-23, accepted in 2023-09-22,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundWith the aging of the population, the incidence of medial femoral neck fractures is likely to increase, and along them the need for total hip replacement. The present study aimed to analyze whether the use of the direct anterior hip approach, compared with posterolateral approach in medial proximal femur fracture patients, results in any advantage in terms of complications rate and functional recovery.MethodsA total of 162 patients were included in the study, and divided by approach: 100 performed with direct anterior approach (group A) and 62 with posterolateral approach (group B). The two populations were overlapping in age (75 vs 74 years; p = 0.13), sex (58F 42M vs 46F 16M; p = 0.12) and BMI (24 vs 24; p = 0.77).ResultsGroup A showed a higher ASA score compared to group B (3 vs 2; p = 0.04). Similar hospital stays (7 vs 7 days; p = 0.55) and complication rates (6% vs 8%; p = 0.61) were observed among groups, the most frequent being periprosthetic fractures, and need for allogeneic blood transfusion (20% vs 13%; p = 0.25). Patients in group A (96 vs 85 min; p = 0.10) showed a slightly, longer surgical time and a faster postoperative functional recovery witnessed by the ability to climb stairs at hospital discharge (37% vs 21%; p = 0.041).ConclusionThe use of the direct anterior hip approach was effective in the management of frail patients with medial femoral neck fractures managed by total hip arthroplasty, allowing faster functional recovery in the elderly population.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 2