Early functional results after Hemiarthroplasty for femoral neck fracture: a randomized comparison between a minimal invasive and a conventional approach
| Autor: | Svenja Renken, Arndt P. Schulz, Michael Wenzl, Andreas Unger, Felix Renken, Andreas Paech |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty lcsh:Diseases of the musculoskeletal system Time Factors Visual analogue scale Femoral Neck Fractures Disability Evaluation Rheumatology Germany Activities of Daily Living medicine Humans Minimally Invasive Surgical Procedures Femur Orthopedics and Sports Medicine Prospective Studies Mobility Limitation Prospective cohort study Femoral neck Aged Pain Measurement Hip surgery Aged 80 and over Fracture Healing Pain Postoperative business.industry Recovery of Function Surgery Biomechanical Phenomena Radiography medicine.anatomical_structure Treatment Outcome Orthopedic surgery Female Hip Joint Implant Hemiarthroplasty lcsh:RC925-935 business Research Article |
| Zdroj: | BMC Musculoskeletal Disorders BMC Musculoskeletal Disorders, Vol 13, Iss 1, p 141 (2012) |
| ISSN: | 1471-2474 |
| Popis: | Background A minimal invasive approach for elective hip surgery has been implemented in our institution in the past. It is widely hypothesized that implanting artificial hips in a minimal invasive fashion decreases surgical trauma and is helpful in the rehabilitation process in elective hip surgery. Thereby geriatric patients requiring emergency hip surgery also could theoretically benefit from a procedure that involves less tissue trauma. Methods Sixty patients who sustained a fractured neck of femur were randomly assigned into two groups. In the minimal invasive arm, the so called “direct anterior approach” (DAA) was chosen, in the conventional arm the Watson-Jones-Approach was used for implantation of a bipolar hemi-arthroplasty. Primary outcome parameter was the mobility as measured by the four-item-Barthel index. Secondary outcome parameters included pain, haemoglobin-levels, complications, duration of surgery, administration of blood transfusion and external length of incision. Radiographs were evaluated. Results A statistically significant difference (p = 0,009) regarding the mobility as measured with the four-item Barthel index was found at the 5th postoperative day, favouring the DAA. Evaluation of the intensity of pain with a visual analogue scale (VAS) showed a statistically significant difference (p = 0,035) at day 16. No difference was evident in the comparison of radiographic results. Conclusions Comparing two different approaches to the hip joint for the implantation of a bipolar hemi-arthroplasty after fractured neck of femur, it can be stated that mobilization status is improved for the DAA compared to the WJA when measured by the four-item Barthel index, there is less pain as measured using the VAS. There is no radiographic evidence that a minimal invasive technique leads to inferior implant position. Level of Evidence: Level II therapeutic study. |
| Databáze: | OpenAIRE |
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