Key result
The posterolateral approach during bipolar hemiarthroplasty for hip fractures caused significantly more varus femoral stem alignment compared to the direct lateral approach (22 of 103 patients vs 0 of 48 patients, p<0.001).
Why the study?
The study was conducted to compare the postoperative effects of different surgical techniques used during bipolar hemiarthroplasty for hip fractures.
Does the posterolateral approach compared to the direct lateral approach improve prosthetic alignment and postoperative outcomes in elderly patients undergoing hemiarthroplasty for hip fractures?
Cohort (n=151)
No
Does the posterolateral approach compared to the direct lateral approach improve prosthetic alignment and postoperative outcomes in elderly patients undergoing hemiarthroplasty for hip fractures?
p-value: p=<0.001
The posterolateral approach for hip hemiarthroplasty is associated with a higher risk of varus femoral stem alignment compared to the direct lateral approach, which may increase the risk of femoral collapse.
Objective: To compare the postoperative effects of different surgical techniques used during bipolar hemiarthroplasty (HA) for hip fractures. Material and Method:The study included 151 patients (67 males, 84 females) who presented to our Orthopedics and Traumatology Clinic between January 2016 and December 2021 and who underwent HA with a Direct Lateral (DL) approach (n: 48) or Posterolateral (PL) approach (n: 103) for hip fracture) were included in the study.Patients' postoperative 90-day mortality, wound site infection, bedsore, presence of fracture, varus/valgus angle on postoperative anteroposterior (AP) radiograph, operative time, mobilization status within the first 3 days and the number of people during surgery were evaluated retrospectively.Results: While 44 patients treated with the DL approach had neutral and 4 patients had valgus alignment, none of them had varus alignment.In the PL approach, neutral alignment was observed in 79 patients, valgus alignment in 2 patients, and varus alignment in 22 patients.It was determined that there was a significant difference between the two approaches in the proportions of prostheses placed with both neutral and varus alignment (p<0.001).Conclusions: Among the approaches used during HA application, it was observed that the PL approach caused more varus femoral stem alignment problems than the DL approach.In addition to increasing the risk of femoral collapse, this may cause worse functional outcomes.
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Kuyubaşı et al. (2023) conducted a cohort in Hip fractures (n=151). Posterolateral approach vs. Direct lateral approach was evaluated on Prosthetic alignment (neutral and varus) (p=<0.001). The posterolateral approach during bipolar hemiarthroplasty for hip fractures caused significantly more varus femoral stem alignment compared to the direct lateral approach (22 of 103 patients vs 0 of 48 patients, p<0.001).
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