Posterior and Posteroinferior Approaches

Lusty, P.J.; Walter, William K.; Young, David

doi:10.1016/b978-1-4160-5898-4.00014-8

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…The joint capsule was partially closed by suturing the vertical branch resulting from the T-shaped capsulotomy and the piriformis tendon was reinserted into the greater trochanter by means of transosseous sutures. 3…”

Section: Methodsmentioning

confidence: 99%

“…It provides optimal visualisation of both the acetabulum and the proximal femur without violating the abductor mechanism and it can easily be extended to the distal area in case of intraoperative fractures of the femoral shaft. 3 However, this approach is characterized by a higher dislocation rate with respect to its anterior and lateral counterparts. 4–6…”

Section: Introductionmentioning

confidence: 99%

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Direct anterior versus posterolateral approach for bipolar hip hemiarthroplasty in femoral neck fractures: a prospective randomised study

et al. 2019

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Introduction: Femoral neck fractures are a major problem in orthopaedic practice, having a huge impact on society, and involving a large number of elderly patients for whom early recovery is paramount. Thus, the aim of this study was to compare 2 surgical approaches, direct anterior (DA group) versus posterolateral (PL group), used for bipolar hip hemiarthroplasty (BHA) with femoral neck fractures in order to assess pain recovery after surgery. Our hypothesis was that early pain recovery would be faster in the DA group. Methods: 100 patients were randomised to surgery using either a DA group or PL group approach, and were then followed up for 6 months. Surgical time, intra- and postoperative complications were recorded for each patient. The main outcome, pain, was recorded using an NRS scale at 3 days, 1, 3 and 6 months after surgery. At the same time, patient status was evaluated using Activities of Daily Living and Cumulated Ambulation Score scales. Results: Surgical time was longer in the DA group ( p < 0.0001). Pain perception at 3 days and at 1 month after surgery was significantly lower in DA group patients ( p < 0.0001). The results of the other scales were comparable in the 2 groups (at 3 days, 1 and 3 months after surgery). Discussion: The DA approach offers a significant advantage in terms of pain perception up to 1 month after the operation. Early recovery in terms of pain perception is an important finding. Future studies should explore whether this early pain reduction could translate into a faster rehabilitation programme for an earlier recovery of full function. Clinical trial registration: Protocol 423/CE; Study n. CE 41/15.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Direct anterior versus posterolateral approach for bipolar hip hemiarthroplasty in femoral neck fractures: a prospective randomised study

et al. 2019

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“…They were the MITCH TRH system (Stryker Orthopaedics, Mahwah NJ), the Birmingham Hip resurfacing system (Smith & Nephew, Memphis, TN), the Articular Surface Replacement (De Puy, Warsaw, IN), the ADEPT hip resurfacing system (MatOrtho, Leatherhead, UK), the Durom hip resurfacing system (Zimmer, Warsaw, IN), and the Cormet hip resurfacing system (Corin, Tampa, FL). All surgeries were performed using the posterior or posteroinferior approach (17), and in all cases an operative inclination of 45° and an anteversion of 25° was aimed for.…”

Section: Methodsmentioning

confidence: 99%

Factors Affecting Squeaking in Metal on Metal Hip Resurfacings

et al. 2014

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We reviewed 380 hip resurfacings cases between December 1999 and Dec 2012. 11 cases (2.89%) squeaked postoperatively. Mean follow-up was 88.6 months (19-130 months). Mean time to squeak was 11.3 months (3-22 months). Ten (91%) cases were male and nine (81%) cases had a Birmingham hip resurfacing. Cases were matched for age, gender, BMI and implant to three controls. Radiographs were analysed using EBRA (Einzel-Bild-Roentgen-Analysis, University of Innsbruck, Austria) software to evaluate cup orientation. There was no significant difference between the mean inclination angle of the cups (p = 0.26) or the mean anteversion angle (p = 0.29). There was no difference in serum cobalt (p = 0.20) or serum chromium (p = 0.45) levels at latest follow-up. Three of the 11 (27.3%) cases had revision surgery at a mean follow-up of 101 months (72-117 months). Squeaking was not influenced by patient demographic parameters and resolved in all cases that did not undergo revision surgery. Males with a resurfacing head size <50 mm had significantly increased odds of squeaking when compared to controls (odds ratio = 26.6; 95% CI = 1.2-573.3; p<0.05). Based on our findings, we do not recommend that squeaking on its own should be an indication for revision of hip resurfacing components.

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“…11 Some surgeons use the modified Hardinge procedure routinely for their primary total hip arthroplasty in cases of high risk of posterior dislocation postoperatively. 12 This study compared hemiarthoplasty using anterolateral (Modified Hardinge) and posterior approaches among fragility hip fracture patients and evaluated early functional outcome and gait analysis postoperatively.…”

Section: Introductionmentioning

confidence: 99%

Prospective study comparing early functional outcome and gait analysis in femoral neck fracture treated by cemented hemiarthroplasty using modified Hardinge approach and conventional posterior approach

et al. 2022

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Background: A prospective study was done to compare the outcomes of management of fracture neck of femur by cemented hemiarthroplasty using modified Hardinge approach and conventional posterior approachMethods: The 2019 to 2022 50 patients underwent bipolar hemiarthroplasty for femoral neck fracture. Group A (Femoral neck fracture treated using conventional posterior approach) and group B (Femoral neck fracture treated using modified Hardinge approach) with 25 patients in each group. Outcomes were evaluated based on mean surgical time and Harris hip score and SF-36.Results: Mean duration of surgery in minutes was more for modified Hardinge approach. Harris hip score with standard deviation for modified Hardinge Approach for follow-ups was better and statistically significant than posterior approach. Similarly, quality of life after surgery, in terms of mean SF-36 score with standard deviation for modified Hardinge approach was better and statistically significant than posterior approach. Modified Hardinge approach has fewer complications in comparison to the posterior approach. With the advantages comes a longer learning curve to operate without complications. Hence, with proper surgical technique, and proper tight closure, we prefer the modified Hardinge approach over other approaches as it had nil dislocations and abductor lurch.Conclusions: Modified Hardinge approach for hip arthroplasty in elderly people with femoral neck fracture provide significant benefit in the early post operative period when compared to conventional posterior approach in terms of post operative pain, time of recovery, dislocation rate and quality of life.

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Posterior and Posteroinferior Approaches

Cited by 3 publications

References 6 publications

Direct anterior versus posterolateral approach for bipolar hip hemiarthroplasty in femoral neck fractures: a prospective randomised study

Direct anterior versus posterolateral approach for bipolar hip hemiarthroplasty in femoral neck fractures: a prospective randomised study

Factors Affecting Squeaking in Metal on Metal Hip Resurfacings

Prospective study comparing early functional outcome and gait analysis in femoral neck fracture treated by cemented hemiarthroplasty using modified Hardinge approach and conventional posterior approach

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