Details of a Tendon–Sparing Posterior Approach in Hemiarthroplasty in the Treatment of Displaced Intracapsular Neck of Femur Fracture

This paper details a tendon–sparing surgical technique allowing hemiarthroplasty through a posterior approach in all cases whilst preserving the Quadriceps coxa. The SPAIRE (Sparing Piriformis and Internus, Repair Externus) technique, described by Hanly et al. for routine use in total hip replacement, theoretically offers the functional benefits of the posterior approach with reduced risk of dislocation. It may also facilitate early mobilisation after hip fracture surgery with potential reduction in medical complications and mortality. In this study, we report our initial experience using the same SPAIRE technique for hemiarthroplasty to treat all patients with displaced intracapsular neck of femur fractures, irrespective of skeletal dimension and BMI. Our results suggest that the SPAIRE technique is feasible and safe to be used in all cases requiring hemiarthroplasty. Further research should be encouraged to investigate the role of the SPAIRE technique in fractured neck of femur surgery.