Early functional results after Hemiarthroplasty for femoral neck fracture: a randomized comparison between a minimal invasive and a conventional approachReport as inadecuate




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BMC Musculoskeletal Disorders

, 13:141

First Online: 08 August 2012Received: 09 November 2011Accepted: 02 July 2012

Abstract

BackgroundA minimal invasive approach for elective hip surgery has been implemented in our institution in the past. It is widely hypothesized that implanting artificial hips in a minimal invasive fashion decreases surgical trauma and is helpful in the rehabilitation process in elective hip surgery. Thereby geriatric patients requiring emergency hip surgery also could theoretically benefit from a procedure that involves less tissue trauma.

MethodsSixty patients who sustained a fractured neck of femur were randomly assigned into two groups. In the minimal invasive arm, the so called -direct anterior approach- DAA was chosen, in the conventional arm the Watson-Jones-Approach was used for implantation of a bipolar hemi-arthroplasty.

Primary outcome parameter was the mobility as measured by the four-item-Barthel index. Secondary outcome parameters included pain, haemoglobin-levels, complications, duration of surgery, administration of blood transfusion and external length of incision. Radiographs were evaluated.

ResultsA statistically significant difference p = 0,009 regarding the mobility as measured with the four-item Barthel index was found at the 5th postoperative day, favouring the DAA. Evaluation of the intensity of pain with a visual analogue scale VAS showed a statistically significant difference p = 0,035 at day 16. No difference was evident in the comparison of radiographic results.

ConclusionsComparing two different approaches to the hip joint for the implantation of a bipolar hemi-arthroplasty after fractured neck of femur, it can be stated that mobilization status is improved for the DAA compared to the WJA when measured by the four-item Barthel index, there is less pain as measured using the VAS. There is no radiographic evidence that a minimal invasive technique leads to inferior implant position.

Level of Evidence: Level II therapeutic study.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2474-13-141 contains supplementary material, which is available to authorized users.

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Author: Felix Renken - Svenja Renken - Andreas Paech - Michael Wenzl - Andreas Unger - Arndt P Schulz

Source: https://link.springer.com/







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