Comparison Between Minimally Invasive Anterolateral and Conventional Posterior Hip Approaches for Hemiarthroplasty in Hip Fractures

Authors

  • Pranpawee Rojcharoenngam, MD Department of Orthopedics, Maharaj Nakhon Si Thammarat Hospital, Nakhon Si Thammarat, Thailand

DOI:

https://doi.org/10.56929/jseaortho.v46i2.22

Keywords:

Hip hemiarthroplasty, Hip fractures in the elderly, Minimally invasive hip surgery, Surgical hip approach

Abstract

Purpose: To compare the results between minimally invasive anterolateral and conventional posterior hip approaches for hemiarthroplasty in hip fractures.

Methods: The elderly patients who had undergone hip hemiarthroplasty for hip fractures in Maharaj Nakhon Si Thammarat Hospital, were randomly divided into two groups: minimally invasive anterolateral and posterior approach groups Data were collected from March 2020 to November 2021, which included the duration of the surgery, length of the surgical wound, intraoperative bleeding volume, postoperative days of walking with a walker, morphine dosage for pain relief, and postoperative complications.

Results: No significant difference (P-value > 0.05) was found between the baseline data of patients in both the groups, which included sex, age, body mass index, underlying musculoskeletal disease, and drug usage. The minimally invasive anterolateral approach group used an average surgical time of 53.48 ± 8.22 min, while the conventional posterior approach group required 65 ± 20.41 min; the length of the surgical wound was 7.78 ± 0.87 and 13.78 ± 1.37 cm, respectively; the volume of intraoperative bleeding was 82.17 ± 48.94 and 195.65 + 163.24 ml, respectively; the postoperative days of walking with a walker were 3.09 ± 0.92 and 6.59 ± 2.52 days, respectively; and the postoperative analgesic doses of morphine were 6.59 ± 2.80 and 11.09 ± 3.89 mg, respectively. The blood transfusion was required in 4 patients in the minimally invasive anterolateral approach group, while it was required in 14 patients in the conventional posterior approach group. Statistically significant (P-value < 0.05). Postoperative complications included, prosthetic hip joint dislocation in a patient in each group and sciatic nerve neurapraxia in a patient in the conventional posterior approach group.

Conclusions: Hip hemiarthroplasty with the minimally invasive anterolateral approach in elderly patients with hip fractures was found to be superior to the conventional posterior approach.

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References

Facts and Statistic. International Osteoporosis Foundation. Available from: http://www.iofbonehealth.org/facts-statistics.

Kanis JA, Oden A, McCloskey EV, et al. A systematic review of hip fracture incidence and probability of fracture worldwide. Osteoporosis int 2012:23:2239-56. DOI: https://doi.org/10.1007/s00198-012-1964-3

United State Census Bureau 2013, Census. Gou, September 2013, Available from: http://www.census.gov/population/international/data/idb/ informationGateway.php.

Rojcharoenngam P. Risk factors for falls and hip fractures of the elderly in Nakhon Si Thammarat. 12th RMJ 2017;28:58-64.

Wongworaphithak C. Mortality at one year in elderly hip fracture patients treated with nonoperative procedures. 11th RMJ 2016;30:345-55.

Palanisamy AM, dorshi HK, Selvaraj D, et al. Fixation versus replacement in geriatric hip fractures: does functional outcome and independence in self-care differ?. Geriatr Orthop Surg Rehabil 2015;6:258-62. DOI: https://doi.org/10.1177/2151458515595435

Viberga B, Froslevc T, Overgaardd S, et al. Mortality and revision risk after femoral neck fracture: comparison of internal fixation for undisplaced fracture with arthroplasty for displaced fracture: a population-based study from Danish National Registries. Acta Orthop 2021;92:163-9. DOI: https://doi.org/10.1080/17453674.2020.1850940

Onyemaechi N, Anyanwu E, Obikili E, et al. Anatomical basis for surgical approaches to the hip. Ann Med Health Sci Res 2014;4:487-94. DOI: https://doi.org/10.4103/2141-9248.139278

Jerosch J, Theising C, Fadel ME. Antero-lateral minimal invasive (ALMI) approach for total hip arthroplasty technique and early results. Arch Orthop Trauma Surg 2006;126:164-73. DOI: https://doi.org/10.1007/s00402-006-0113-x

Pfeil J, Siebert WE. Minimally Invasive Surgery in Total Hip Arthroplasty. Berlin, Heidelberg: Springer Verlag; 2000.

Gulan G, Jurdana H, Mikačević M, et al. Anterolateral minimally invasive approach in hip arthroplasty– a surgical technique. Medicina Fluminensis 2015;51:41-51.

Mahmoud Awad AK, Tammam H, Said E, et al. Evaluation of minimally invasive versus conventional total hip replacement. SVU-IJMS 2021:4;231-9. DOI: https://doi.org/10.21608/svuijm.2021.83252.1195

Martin R, Clayson PE, Troussel S, et al. Anterolateral minimally invasive total hip arthroplasty: a prospective randomized controlled study with a follow-up of 1 year. J Arthroplasty 2011;26:1362-72. DOI: https://doi.org/10.1016/j.arth.2010.11.016

Bergin PF, Doppelt JD, Kephart CJ, et al. Comparison of minimally invasive direct anterior versus posterior total hip arthroplasty based on inflammation and muscle damage markers. J Bone Joint Surg Am 2011;93:1392-8. DOI: https://doi.org/10.2106/JBJS.J.00557

Innmann MM, Streit MR, Kolb J, et al. Influence of surgical approach on component positioning in primary total hip arthroplasty. BMC Musculoskelet Disord 2015;16:180. DOI: https://doi.org/10.1186/s12891-015-0623-1

Fink B, Mittelstaedt A, Schulz MS, et al. Comparison of a minimally invasive posterior approach and the standard posterior approach for total hip arthroplasty A prospective and comparative study. J Orthop Surg Res 2010;5:46. DOI: https://doi.org/10.1186/1749-799X-5-46

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Published

2022-07-28

How to Cite

1.
Rojcharoenngam, MD P. Comparison Between Minimally Invasive Anterolateral and Conventional Posterior Hip Approaches for Hemiarthroplasty in Hip Fractures. JseaOrtho [Internet]. 2022 Jul. 28 [cited 2022 Oct. 7];46(2):17-23. Available from: https://www.jseaortho.org/index.php/jsao/article/view/22

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