title: Total hip arthroplasty with minimal invasive surgery in elderly patients with neck of femur fractures: our institutional experience.
abstract: The purpose of this study was to investigate whether minimal invasive surgery (MIS) in elderly patients with neck of femur fractures would reduce the peri-operative complications and improve the post-operative ambulation and length of hospital stay in his cohort of patients. Forty elderly patients were treated with either total hip arthroplasty (THA) or bipolar prosthesis using MIS transgluteal approach. A matched reference group treated with a conventional surgical approach formed the control group. All procedures were performed by the same surgeon. Selection of acetabular component included Novae® uncemented press fit dual mobility concept socket or Bipolar Hemi-Arthroplasty (BHA). The femoral implant was Corail® uncemented stem or Fjord® cemented stem when primary instability was encountered. The follow-up was done for all patients and its minimum length was more than thirty-six months. The average length of the skin incision was 7 (6-8) SD 0.7 cm. Eighteen THA, twenty-two BHA, thirty-seven uncemented femoral stems and three cemented stems were implemented. The length of the procedure was the same as those of the reference group. The operative and post-operative blood loss and analgesic use were significantly decreased in the MIS group. Radiographic implants positioning was similar amongst the two groups. No skin complication, no primary infection, no death within ninety days and no dislocations were observed. MIS approach for implanting THA after a femoral neck fracture in the elderly appears to be a reliable procedure.
authors.affiliation: Orthopaedic & Trauma Department, HCL Pavilion T Herriot Hospital, 69003 Lyon, France; Claude Bernard Lyon 1 University - Lyon East Medicine Faculty, Lyon, France. Electronic address: jean-christophe.bel@chu-lyon.fr.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Bel
authors.affiliation: Orthopaedic & Trauma Department, HCL Pavilion T Herriot Hospital, 69003 Lyon, France; Claude Bernard Lyon 1 University - Lyon East Medicine Faculty, Lyon, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Carret
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D004434:Early Ambulation / Q000706:statistics & numerical data*; D005260:Female; D005265:Femoral Neck Fractures / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D011184:Postoperative Period; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Elderly; Femoral neck fracture; Hip fracture; Minimally invasive surgery; Total hip arthroplasty