Hip hemiarthroplasty for senile femoral neck fractures: Minimally invasive SuperPath approach versus traditional posterior approach |
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| Institution: | 1. Department of Orthopaedics, Shanghai Pudong Hospital, Shanghai 201399, China;2. Shanghai Tenth People''s Hospital, Shanghai 201399, China;1. Trauma and Orthopaedics, Northern Deanery, Newcastle upon Tyne, Tyne and Wear NE21HJ, UK;2. North Tyneside General Hospital, UK;3. Wansbeck General Hospital, UK;1. Department of Orthopedics, Skane University Hospital, Malmö, Sweden;2. Lund University, Department of Clinical Sciences, Malmö, Sweden;3. Swedish Hip Arthroplasty Register, Center for Registers, Västra Götaland, Gothenburg, Sweden;4. Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;1. University Hospital “Sisters of Mercy”, Department of Trauma and Orthopaedic Reconstructive Surgery, Vinogradska cesta 29, 10000 Zagreb, Croatia;2. University Hospital “Sisters of Mercy”, Department for Oncology and Nucelar Medicine, Vinogradska cesta 29, 10000 Zagreb, Croatia;3. University Hospital “Sisters of Mercy”, Clinic for Traumatology, Draškovićeva 19, 10000 Zagreb, Croatia;4. Department of Surgery, General Hospital Karlovac, Dr. Andrije Štampara 3, 47000 Karlovac, Croatia |
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| Abstract: | BackgroundThe supercapsular percutaneously-assisted total hip (SuperPATH®) approach was created by combining the percutaneous preparation of the acetabulum using the percutaneously-assisted total hip (PATH), femoral reaming, and broaching of superior capsulotomy (SuperCap) approach. This technique reported a low complication rate, excellent gait kinematics, low transfusion rate, a shorter length of hospital stay, and a high proportion of discharge from the hospital. As minimally invasive SuperPath approach is designed for both trauma and end-stage degenerative joint disease, we investigated if this technique and standard surgical tools can replace artificial femoral head in elderly patients with femoral neck fracture. We also tested if it has advantages over the traditional posterior approach.MethodsA prospective study was performed in 100 cases of eligible femoral neck fractures from May 01, 2015 to October 31, 2016. They were randomly divided into SuperPath and traditional group. The outcomes were evaluated using preoperative index, intraoperative data, and postoperative function data.ResultsNo significant difference was detected in the operation time between the two groups. Compared with the traditional group, SuperPath group had smaller incision length, less intraoperative bleeding, lower transfusion rate, and a shorter starting time of weight-bearing activity. Harris Hip Score, Barthel Index, and VAS for pain-level scores in the SuperPath group at 1-week follow-up intervals were significantly lower than the conventional group, but not significantly different at 3-month and 2-year follow-up post-operation.ConclusionsSuperPath approach for artificial femoral head replacement can reduce surgical injury due to smaller size of incision and accelerate weight-bearing activities post-operation to treat senile femoral neck fractures compared with traditional posterior approach surgeries. |
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| Keywords: | Femoral neck fracture Arthroplasty Hip SuperPath method Posterior approach |
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