A Twofer on Approaches for Hip Fractures — One Pass, One Keeper

Direct anterior, direct lateral, or posterior for hip fracture surgery involving prosthetic replacement? Read on to find out.

What’s the Claim?

A registry study of patients having THA for femoral neck fracture claimed lower narcotic usage when the direct anterior approach was used compared to the posterior approach. It also claimed lower operative time and lower odds of transfusions, but those findings likely were the result of important confounding, so we have reservations about this study, which otherwise found no important between-group differences (such as complications).

A randomized controlled trial that CORRelations covered in more detail for our Joint Replacement readers was one our Fractures & Trauma readers also needed to see. This practice-changing RCT found that the direct lateral approach to hemiarthroplasty far outperformed the posterolateral approach in terms of risk of dislocation, without cost to patient-reported outcomes scores.

How’s It Stack Up?