A comparative approach of Direct lateral vs posterolateral approach to hemiarthroplasty for femoral neck fractures

Abstract

Introduction: Adopting the direct lateral (DL) instead of the posterolateral (PL) approach in hip arthroplasty for femoral neck fracture (FNF) patients could lower the rate of prosthetic dislocation. However, little is known about how the approach influences the functional outcome.
Objective- The evaluate and compare hip function, pain and complication and reoperation rates in fracture neck femur patients operated with HA using the DL and PL approach.Material and methods: In a prospective cohort study, we enrolled 185 patients with a displaced femur neck fractue. Subjects were assigned to treatment using DL (n = 102) or PL approach (n = 83) with a hemiarthroplasty (HA). Functional outcome was assessed by Western Ontario and McMaster Universities Arthritis (WOMAC) index, pain numeric rating scale (PNRS) for pain, mortality and hip complications. Patients were followed-up after 1 year. Results: We found no difference in WOMAC, PNRS and mortality. Seven patients (6.9%) in the DL group and 11 patients (13.3%) in the PL group had undergone a major reoperation (adjusted OR 0.51; 95% CI, 0.18–2.07; P = 0.23). Conclusion : In this prospective cohort study, patients treated with HA for FNF using either the DL or PL approaches had comparable functional outcome after 1 year. The PL approach had a tendency towards a lower reoperation rate.