Key result
Direct anterior THA is linked to improved perioperative metrics and 0 dislocations versus posterolateral approach.
Why the study?
The clinical efficacy of total hip arthroplasty through the direct anterior approach in elderly femoral neck fracture patients was not well evaluated.
Does direct anterior approach improve recovery and reduce pain compared to posterolateral approach in elderly patients undergoing total hip arthroplasty for femoral neck fracture?
Cohort (n=60)
Does direct anterior approach improve recovery and reduce pain compared to posterolateral approach in elderly patients undergoing total hip arthroplasty for femoral neck fracture?
Direct anterior approach for total hip arthroplasty in elderly patients with femoral neck fracture offers faster recovery, less bleeding, and less pain compared to the posterolateral approach.
Answers are grounded in this paper and cite their sources.
Lateral decubitus DAA may be feasible for THA in elderly femoral neck fracture; hypothesis-generating and should not yet change practice.
Objective To investigate the evaluation of lateral decubitus position direct anterior approach(DAA) for primary total hip arthroplasty(THA) in the treatment of elderly femoral neck fracture. Methods A retrospective study was performed on 60 patients with elderly femoral neck fracture that underwent primary unilateral THA that were admitted from October 2015 to April 2017.According to different approaches, patients were divided into the DAA group and the PLA group, with 30 cases in each group.The operation time, intraoperative blood loss, postoperative drainage, postoperative bed time, hospitalization time, postoperative complications, Harris hip score and VAS score of postoperative 1 week, 1 month, 3 months and 6 months were evaluated to access the hip function and hip pain. Results All patients received follow-up for 3-9 months, with an average of 6.8 months.The operation time between the two groups had no statistically significant difference(P>0.05); the intraoperative blood loss, postoperative drainage, postoperative activity time, hospitality stay had statistically significant difference(P 0.05). There were 1 case of postoperative dislocation in PLA group and no dislocation in DAA group, no other early postoperative complications occurred. Conclusion Compared with PLA, DAA in THA had the advantages of less bleeding, less pain, stronger anti dislocation ability and faster postoperative recovery.The method is feasible and the effect is better.
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He et al. (2017) conducted a cohort in Elderly femoral neck fracture (n=60). Direct anterior approach (DAA) vs. Posterolateral approach (PLA) was evaluated on Operation time, intraoperative blood loss, postoperative drainage, postoperative bed time, hospitalization time, postoperative complications, Harris hip score and VAS score. In 60 elderly patients with femoral neck fracture, direct anterior approach for total hip arthroplasty improved perioperative metrics and had 0 dislocations vs 1 with the posterolateral approach.
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