Complication rates after direct anterior vs posterior approach for hip hemiarthroplasty in elderly individuals with femoral neck fractures

Table 1 Demographic data, mean ± SD

	DAA (n = 109)	PL (n = 171)	P value
Age (yr)	82.3 ± 7.2	82.6 ± 8.2	0.72
Sex (M/F, %)	29 (27)/80 (73)	50 (29)/121 (71)	0.63
BMI (kg/m2)	23.1 ± 5.4	23.6 ± 4.5	0.91
ASA Score (%)			0.87
ASA 1	0	0
ASA 2	33 (30)	68 (40)
ASA 3	69 (63)	90 (53)
ASA 4	90 (53)	8 (5)

ASA: American Society of Anaesthesiologists; BMI: Body mass index; DAA: Direct anterior approach; F: Female; M: Male; PL: Posterolateral approach.

Table 2 Surgical data, mean ± SD

	DAA	PL	P value
Delay to surgery (d)	2.5 ± 3.3	1.9 ± 2.9	0.19
Surgical time (min)	96.7 ± 33.6	99.2 ± 30.4	0.41
Blood loss (mL)	307 ± 184	359 ± 265	0.43

DAA: Direct anterior approach; PL: Posterolateral approach.

Table 3 Thirty-day mortality rates

	Anterior approach	Posterior approach
ASA 1 + ASA 2 (%)	0/33 (0)	5/68 (6.8)
ASA 3 + ASA 4	4/72 (5.3)	12/86 (12.2)
Log-linear model: Including approach, ASA score, and Death; Chi2 = 12.93-P = 0.039, indicating statistically significant differences from the fitted model, showing that the model did not fit the observed data
The interaction: Approach × Death: P = 0.06
The interaction: ASA score × Death: P = 0.028

ASA: American Society of Anaesthesiologists.

Table 4 Complications, n (%)

	DAA (n = 105)	PL (n = 154)	P value
Fractures			0.87
Perioperative fracture	2 (1.9)	4 (2.6)
Postoperative fracture	2 (1.9)	4 (2.6)
Infection			0.96
Superficial	1 (1.0)	2 (1.3)
Deep (implant retained)	1 (1.0)	1 (0.6)
Deep (implant changed)	2 (1.9)	2 (1.3)
Overall Dislocations	0	14 (9.1)	0.0015
Revision surgery for recurrent dislocation	0	8 (5.2)	0.018
Total hips operated (n) vs dislocated hips (Dis)
n/Dis	105/0	154/14 (9.1)
Senior surgeon
n/Dis	60/0	38/3 (7.9)
Resident surgeon
n/Dis	32/0	77/6 (7.8)
Trainee
n/Dis	13/0	39/5 (12.8)

DAA: Direct anterior approach, Dis: Dislocated hips, PL: Posterolateral approach.