Background: A 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. Methods. Sixty 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. Results: A 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. Conclusions: Comparing 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. © 2012 Renken et al.; licensee BioMed Central Ltd.
CITATION STYLE
Renken, F., Renken, S., Paech, A., Wenzl, M., Unger, A., & Schulz, A. P. (2012). Early functional results after Hemiarthroplasty for femoral neck fracture: A randomized comparison between a minimal invasive and a conventional approach. BMC Musculoskeletal Disorders, 13. https://doi.org/10.1186/1471-2474-13-141
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