Brief Article
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Orthop. Apr 18, 2013; 4(2): 85-89
Published online Apr 18, 2013. doi: 10.5312/wjo.v4.i2.85
Bipolar hemiarthroplasty for femoral neck fracture using the direct anterior approach
Tomonori Baba, Katsuo Shitoto, Kazuo Kaneko
Tomonori Baba, Kazuo Kaneko, Department of Orthopedic Surgery, Juntendo University School of Medicine, Tokyo 113-8421, Japan
Tomonori Baba, Katsuo Shitoto, Department of Orthopedic Surgery, Juntendo University Urayasu Hospital, Chiba 279-0021, Japan
Author contributions: Baba T drafted the manuscript; Baba T and Kaneko K analyzed the data; Baba T and Shitoto K contributed to the manuscript preparation; all the authors read and approved the final manuscript.
Correspondence to: Tomonori Baba, MD, PhD, Assistant Professor, Department of Orthopedic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyoku, Tokyo 113-8421, Japan. tobaba@juntendo.ac.jp
Telephone: +81-3-38133111 Fax: +81-3-38133428
Received: June 5, 2012
Revised: November 16, 2012
Accepted: December 6, 2012
Published online: April 18, 2013
Abstract

AIM: To evaluate whether walking ability recovers early after bipolar hemiarthroplasty (BHA) using a direct anterior approach.

METHODS: Between 2008 and 2010, 81 patients with femoral neck fracture underwent BHA using the direct anterior approach (DAA) or the posterior approach (PA). The mean observation period was 36 mo. The age, sex, body mass index (BMI), time from admission to surgery, length of hospitalization, outcome after discharge, walking ability, duration of surgery, blood loss and complications were compared.

RESULTS: There was no significant difference in the age, sex, BMI, time from admission to surgery, length of hospitalization, outcome after discharge, duration of surgery and blood loss between the two groups. Two weeks after the operation, assistance was not necessary for walking in the hospital in 65.0% of the patients in the DAA group and in 33.3% in the PA group (P < 0.05). As for complications, fracture of the femoral greater trochanter developed in 1 patient in the DAA group and calcar crack and dislocation in 1 patient each in the PA group.

CONCLUSION: DAA is an approach more useful for BHA for femoral neck fracture in elderly patients than total hip arthroplasty in terms of the early acquisition of walking ability.

Keywords: Direct anterior approach; Bipolar hemiarthroplasty; Posterior approach; Femoral neck fracture; Muscle presentation; Walking ability