Approach Really Matters in Hemiarthroplasty for Hip Fracture

A don't-miss study on an important topic

What’s the Claim?

A randomized clinical trial comparing the direct lateral to the posterolateral approach, in parallel with a “natural experiment” — where groups of surgeons who were good at one approach did the one they were good at — both found more or less the same thing. Among patients having hemiarthroplasty for hip fracture:

  • More dislocations occurred with the posterolateral approach than with the direct lateral (5.5% versus 0.4% in the RCT; 5.3% versus 1.1% in the natural experiment; odds ratio of 12 [95% CI 3 to 55])
  • Patient-reported outcomes scores did not differ between the two approaches six months after surgery
  • The frequency of falls did not differ between the groups, nor did complications, deaths, discharge disposition, surgical time, or length of stay

How’s It Stack Up?