COMPARISON BETWEEN DIRECT ANTERIOR APPROACH AND MINIMALLY INVASIVE POSTEROLATERAL APPROACH FOR BIPOLAR HEMIARTHROPLASTY IN ELDERLY PATIENTS WITH FEMORAL NECK FRACTURE

Background: This study was performed to compare the clinical effect of bipolar hemiarthroplasty via the direct anterior approach (DAA) or minimally invasive posterolateral approach (MIPA) in elderly patients with femoral neck fracture.Methods: In total, 196 elderly patients with femoral neck fractures were divided into the DAA group (n=98) and MIPA group (n=98). The clinical data, postoperative pain and complications, time until able to remain seated for 1 hour and walk independently, postoperative Harris score of functional activity at 6 weeks and 2 years postoperatively, and mortality at 2 years postoperatively were compared between the groups.Results: The DAA group had a longer operation time but a lower incidence of pneumonia 72 hours postoperatively, lower visual analogue scale score 24 hours postoperatively, and earlier time until able to remain seated for 1 hour and walk independently (P<0.05). Six weeks postoperatively, the Harris scores for putting on socks, tying shoelaces, sitting comfortably on a chair, and climbing stairs were better in the DAA than the MIPA group (P<0.05). After 2 years, there was no significant difference in the Harris scores between the two groups (P>0.05).Conclusion: In elderly patients undergoing bipolar hemiarthroplasty, the DAA can be more effective than the MIPA in reducing the incidence of complications associated with long-term bed rest, relieving early postoperative pain, and improving early postoperative hip function.