Comparing surgical approaches for Hemi Hip Arthroplasty in elderly patients: Analysis of >30.000 Hemi Hip arthroplasties in patients over 75 years old in the Dutch Arthroplasty Registry from 2007-2020
Approval date: December 2022
Starting date: May 12th 2022
PB de Witte, RGHH Nelissen, J Hinloopen, M. Gademan
Research proposal abstract
Hemi hip arthroplasty (HHA) is considered as a successful surgical procedure for hip fractures and other indications in the elderly and fragile patients. The primary goals of HHA in this specific patient population are pain reduction (whether or not in a palliative setting), optimizing care-taking, and restoring mobility. Over the past two decades, the Direct Anterior Approach (DAA) has gained popularity in primary total hip arthroplasty (THA), as well as HHA. It’s main reported advantages are superior results on the short and mid-term, compared to the straight lateral approach and other approaches, with regards to pain reduction, lower peri-operative blood loss, shorter hospital stay, and lower dislocation rates. On the longer term, however, differences between these approaches are not that evident. Most studies reporting on differences between surgical approaches of hip arthroplasty focus on large cohorts, THA instead of HHA,
and/or large registries with heterogeneous patient groups. However, it is plausible that specific patient populations might have more benefit of the DAA, such as elderly and/or fragile patients with an indication for HHA. Specifically in this population, lower blood loss, less pain, faster mobilization and shorter hospital stay are even more important, possibly preventing complications, including pneumonia, delirium and death. Therefore, the aim of our study is to assess the association of surgical approach with mortality and prosthesis survival in patients older than 75 years with HHA for fractures and other indications, using data from the Dutch Arthroplasty Registry.