Improved outcomes with direct anterior approach hemiarthroplasty in femoral neck fractures
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TAMPA, Fla. — Early data presented here showed improved 6-week postoperative functional outcomes for patients with femoral neck fractures who have hemiarthroplasty by the direct anterior approach compared with anterolateral approach.
“The direct anterior approach (DAA) has been shown to be effective in helping elective total hip [arthroplasty] patients quickly obtain high postoperative function,” Rachel Honig, MD, said in her presentation at the Orthopaedic Trauma Association Annual Meeting. “For geriatric patients with displaced femoral neck fractures, does the DAA lead to a clinically relevant improvement in postoperative function compared to the anterolateral approach (ALA)?” she added.
In the prospective randomized controlled trial, Honig and colleagues at the Mayo Clinic, Rochester studied 30 patients who underwent hemiarthroplasty with the DAA, and 32 patients who had hemiarthroplasty with the ALA. The primary outcome measure was the timed up and go (TUG) test, which was collected at the 6-week follow-up.
At 6 weeks, patients in the DAA group had a TUG test time of 23 seconds compared with 35 seconds for patients in the ALA group. Patients in the DAA group also had significant improvement in mean 30-second chair stand value with a score of 5 compared with a score of 2 for the ALA group.
While the DAA cohort exhibited superior functional outcomes in this short-term analysis, further studies should address other outcome measures and long-term differences, Honig said.
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Honig R, et al. Paper 70. Presented at: Orthopaedic Trauma Association Annual Meeting; Oct. 12-15, 2022; Tampa, Fla.
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