title: The surgical approach for hemiarthroplasty does not influence patient-reported outcome : a national survey of 2118 patients with one-year follow-up.
abstract: Hemiarthroplasty of the hip is usually carried out through either a direct lateral or posterior approach. The aim of this prospective observational study was to determine any differences in patient-reported outcomes between the two surgical approaches.
  
  
  
  From the Swedish Hip Arthroplasty Register we identified patients of 70 years and above who were recorded as having had a hemiarthroplasty during 2009. Only patients who had been treated with modern prostheses were included. A questionnaire was posted to those who remained alive one year after surgery. A total of 2118 patients (78% of those available) with a mean age of 85 years (70 to 102) returned the questionnaire.
  
  
  
  Patients who had undergone surgery through a posterior approach reported a higher health-related quality of life (HRQoL, EQ-5D mean 0.52 versus 0.47, p = 0.009), less pain (visual analogue scale mean 17 versus 19, p = 0.02) and greater satisfaction with the result of surgery (visual analogue scale mean 22 versus 24, p = 0.02) than those who had a direct lateral approach. However, after adjusting for age, gender, cognitive impairment and American Society of Anesthesiologists grade, no association was found between surgical approach and HRQoL, residual pain or patient satisfaction.
  
  
  
  The surgical approach for hemiarthroplasty does not seem to affect the patient-perceived HRQoL, residual pain or patient satisfaction one year after surgery on elderly patients. The choice of approach should be based on other factors, such as the risk of dislocation.
authors.affiliation: Swedish Hip Arthroplasty Register, Registercentrum Västra Götaland S-413 45 Göteborg, Sweden, Blekinge Hospital, S-371 85 Karlskrona, Sweden and Institution for Clinical Sciences, Lund University, Sweden.
authors.forename: O
authors.initials: O
authors.lastname: Leonardsson
authors.affiliation: Swedish Hip Arthroplasty Register, Registercentrum Västra Götaland, S-413 45 Göteborg, Sweden.
authors.forename: O
authors.initials: O
authors.lastname: Rolfson
authors.affiliation: Swedish Hip Arthroplasty Register, Registercentrum Västra Götaland S-413 45 Göteborg, Sweden; Department of Orthopedics, Skåne Unveirsity Hospital, S-214 28 Malmö, Sweden.
authors.forename: C
authors.initials: C
authors.lastname: Rogmark
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D062785:Hemiarthroplasty / Q000379:methods*; D006801:Humans; D008297:Male; D015207:Osteoarthritis, Hip / Q000601:surgery*; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012042:Registries; D011795:Surveys and Questionnaires; D013548:Sweden; D013997:Time Factors; D016896:Treatment Outcome
keywords: EQ-5D; Health-related quality of life; Hemiarthroplasty; Hip fracture; Patient-reported outcome; Surgical approach; Trauma