Back to Search
Start Over
Modified direct anterior approach in minimally invasive hip hemiarthroplasty in a geriatric population: a feasibility study and description of the technique.
- Source :
-
Archives of Orthopaedic & Trauma Surgery . Nov2013, Vol. 133 Issue 11, p1509-1516. 8p. - Publication Year :
- 2013
-
Abstract
- Introduction: The direct anterior approach (DAA) is generally accepted method for minimal invasive arthroplasty of the hip. As good results for total hip arthroplasty are already published, there is a lack of evidence for the implantation of bipolar hip hemiarthroplasty (BHH) in elderly patients with osteoporosis after femoral neck fracture. Materials and methods: For hip arthroplasty using a direct anterior approach (DAA) in elderly patients with femoral neck fractures, a number of modifications of the original technique are being described. The modified DAA considers in particular the co-morbidity and the bone quality of the geriatric patient population. A consecutive series of 16 hemiarthroplasties using this technique is presented. In all 16 cases, the BHH was implanted in modified DAA technique. Mobility measured by 4-item Barthel Index, pain via visual analogue scale (VAS), duration of surgery, external length of incision and blood loss were evaluated. Results: There was no major operative complication during the procedures. The pain level decreased from 7 (preoperatively) to 0 at postoperative day 40. The Barthel Index increased from 5 at first postoperative day to 40 at day 40. Early postoperative mobilisation is efficiently accelerated. Mean operating time was 71 min; the medium skin incision length was 8 cm. The mean haemoglobin level decreased from 118 g/dl preoperatively to 101 g/dl at first postoperative day. Conclusion: The described modifications of the DAA help to implant a BHH gently in elderly patients with increasing risk of complications like iatrogenic fractures, wound or prosthesis infections and haematoma. This will hopefully lead to a faster rehabilitation and lower mortality rate for patients with femoral neck fractures in the future. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09368051
- Volume :
- 133
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- Archives of Orthopaedic & Trauma Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 91528872
- Full Text :
- https://doi.org/10.1007/s00402-013-1831-5