본문 바로가기
KERD
논문KCI 등재

A Comparative Study of Bipolar Hemiarthroplasty for Intertrochanteric Fracture: Direct Anterior Approach versus Conventional Posterolateral Approach

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

초록

Purpose: The aim of this study was to compare short-term results from use of the direct anterior approach (DAA) and the conventional posterolateral approach (PLA) in performance of bipolar hemiarthroplasty for treatment of femoral intertrochanteric fractures in elderly patients. Materials and Methods: A retrospective review of 100 patients with intertrochanteric fractures who underwent bipolar hemiarthroplasty was conducted. The PLA was used in 50 cases from 2016 to 2019; since that time we have used the DAA in 50 cases from 2019 to 2021. Measurements of mean operative time, blood loss, hospitalization period, and ambulation status, greater trochanter (GT) migration and stem subsidence were performed. And the incidence of complications was examined. Results: Operative time was 73.60±14.56 minutes in the PLA group and 79.80±8.89 minutes in the DAA group (P<0.05). However, after experiencing 20 cases using DAA, there was no statistically difference in operative time between two groups (P=0.331). Blood loss was 380.76±180.67 mL in the PLA group and 318.14± 138.51 mL in the DAA group (P<0.05). The hospitalization was 23.76±11.89 days in the PLA group and 21.45 ±4.18 days in the DAA group (P=0.207). In both groups, there were no progressive GT migration, intraoperative fractures or dislocations, although there was one case of infection in the PLA group. Conclusion: Although use of the DAA in performance of bipolar hemiarthroplasty required slightly more time in the beginning compared with the PLA, the DAA may well be an alternative, safe surgical technique as a muscle preserving procedure in elderly patients with intertrochanteric fractures.

Abstract

Purpose: The aim of this study was to compare short-term results from use of the direct anterior approach (DAA) and the conventional posterolateral approach (PLA) in performance of bipolar hemiarthroplasty for treatment of femoral intertrochanteric fractures in elderly patients. Materials and Methods: A retrospective review of 100 patients with intertrochanteric fractures who underwent bipolar hemiarthroplasty was conducted. The PLA was used in 50 cases from 2016 to 2019; since that time we have used the DAA in 50 cases from 2019 to 2021. Measurements of mean operative time, blood loss, hospitalization period, and ambulation status, greater trochanter (GT) migration and stem subsidence were performed. And the incidence of complications was examined. Results: Operative time was 73.60±14.56 minutes in the PLA group and 79.80±8.89 minutes in the DAA group (P<0.05). However, after experiencing 20 cases using DAA, there was no statistically difference in operative time between two groups (P=0.331). Blood loss was 380.76±180.67 mL in the PLA group and 318.14± 138.51 mL in the DAA group (P<0.05). The hospitalization was 23.76±11.89 days in the PLA group and 21.45 ±4.18 days in the DAA group (P=0.207). In both groups, there were no progressive GT migration, intraoperative fractures or dislocations, although there was one case of infection in the PLA group. Conclusion: Although use of the DAA in performance of bipolar hemiarthroplasty required slightly more time in the beginning compared with the PLA, the DAA may well be an alternative, safe surgical technique as a muscle preserving procedure in elderly patients with intertrochanteric fractures.

참고문헌 (28)

  1. 박봉주, "A Comparison of Internal Fixation and Bipolar Hemiarthroplasty for the Treatment of Reverse Oblique Intertrochanteric Femoral Fractures in Elderly Patients", Hip and Pelvis, 27(3), pp.152~163 (2015), 대한고관절학회[DOI]
  2. Green S, "Bipolar prosthetic replacement for the management of unstable intertrochanteric hip fractures in the elderly", Clin Orthop Relat Res, (224), pp.169~177 (1987)
  3. Young-Kyun Lee, "Cementless Bipolar Hemiarthroplasty Using a Hydroxyapatite-Coated Long Stem for Osteoporotic Unstable Intertrochanteric Fractures", The Journal of Arthroplasty, 26(4), pp.626~632 (2011), Elsevier BV[DOI]
  4. Chris Grimsrud, "Cemented Hip Arthroplasty With a Novel Cerclage Cable Technique for Unstable Intertrochanteric Hip Fractures", The Journal of Arthroplasty, 20(3), pp.337~343 (2005), Elsevier BV[DOI]
  5. Franz Rachbauer, "The History of the Anterior Approach to the Hip", Orthopedic Clinics of North America, 40(3), pp.311~320 (2009), Elsevier BV[DOI]
  6. 유준일, "Early Rehabilitation in Elderly after Arthroplasty versus Internal Fixation for Unstable Intertrochanteric Fractures of Femur: Systematic Review and Meta-Analysis", Journal of Korean Medical Science, 32(5), pp.858~867 (2017), 대한의학회
  7. Lene Krenk, "Cognitive Dysfunction After Fast-Track Hip and Knee Replacement", Anesthesia &amp; Analgesia, 118(5), pp.1034~1040 (2014), Ovid Technologies (Wolters Kluwer Health)[DOI]
  8. L. Krenk, "Delirium after fast-track hip and knee arthroplasty", British Journal of Anaesthesia, 108(4), pp.607~611 (2012), Elsevier BV[DOI]
  9. Steven Kurtz, "Projections of Primary and Revision Hip and Knee Arthroplasty in the United States from 2005 to 2030", The Journal of Bone &amp; Joint Surgery, 89(4), pp.780~785 (2007), Ovid Technologies (Wolters Kluwer Health)[DOI]
  10. ROBERT E. KENNON, "TOTAL HIP ARTHROPLASTY THROUGH A MINIMALLY INVASIVE ANTERIOR SURGICAL APPROACH", The Journal of Bone and Joint Surgery-American Volume, 85, pp.39~48 (2003), Ovid Technologies (Wolters Kluwer Health)[DOI]
  11. Udai S. Sibia, "The Impact of Surgical Technique on Patient Reported Outcome Measures and Early Complications After Total Hip Arthroplasty", The Journal of Arthroplasty, 32(4), pp.1171~1175 (2017), Elsevier BV[DOI]
  12. Ji-Hun Park, "Hemiarthroplasty through Direct Anterior Approach for Unstable Femoral Intertrochanteric Fractures in the Elderly: Analysis of Early Cases", Hip and Pelvis, 34(2), pp.79~86 (2022), 대한고관절학회[DOI]
  13. 김민욱, "Selecting Arthroplasty Fixation Approach Based on Greater Trochanter Fracture Type in Unstable Intertrochanteric Fractures", Hip and Pelvis, 31(3), pp.144~149 (2019), 대한고관절학회
  14. Tomonori Baba, "Bipolar hemiarthroplasty for femoral neck fracture using the direct anterior approach", World Journal of Orthopedics, 4(2), pp.85~ (2013), Baishideng Publishing Group Inc.[DOI]
  15. Deuk Soo Hwang, "Recovery of Walking Ability After Operation for Unstable Intertrochanteric fractures of the Femur in Elderly. -Timing on weight Bearing-", Journal of the Korean Society of Fractures, 11(2), pp.296~ (1998), The Korean Fracture Society[DOI]
  16. Ceder L, "Prognostic indicators and early home rehabilitation in elderly patients with hip fractures", Clin Orthop Relat Res, (152), pp.173~184 (1980)
  17. Stern MB, "Comminuted intertrochanteric fractures treated with a Leinbach prosthesis", Clin Orthop Relat Res, (218), pp.75~80 (1987)
  18. K. Casey Chan, "Cemented Hemiarthroplasties for Elderly Patients With Intertrochanteric Fractures", Clinical Orthopaedics and Related Research, 371, pp.206~215 (2000), Ovid Technologies (Wolters Kluwer Health)[DOI]
  19. Yvon M. den Hartog, "The Less Invasive Anterior Approach for Total HIP Arthroplasty: A Comparison to other Approaches and an Evaluation of the Learning Curve - A Systematic Review", HIP International, 26(2), pp.105~120 (2016), SAGE Publications[DOI]
  20. Andrea H. Stone, "Evaluation of the Learning Curve When Transitioning From Posterolateral to Direct Anterior Hip Arthroplasty: A Consecutive Series of 1000 Cases", The Journal of Arthroplasty, 33(8), pp.2530~2534 (2018), Elsevier BV[DOI]
  21. Anne J Spaans, "High complication rate in the early experience of minimally invasive total hip arthroplasty by the direct anterior approach", Acta Orthopaedica, 83(4), pp.342~346 (2012), Medical Journals Sweden AB[DOI]
  22. William P. Barrett, "Prospective Randomized Study of Direct Anterior vs Postero-Lateral Approach for Total Hip Arthroplasty", The Journal of Arthroplasty, 28(9), pp.1634~1638 (2013), Elsevier BV[DOI]
  23. Katsuya Nakata, "A Clinical Comparative Study of the Direct Anterior With Mini-Posterior Approach", The Journal of Arthroplasty, 24(5), pp.698~704 (2009), Elsevier BV[DOI]
  24. MOUSSA HAMADOUCHE, "REATTACHMENT OF THE UNUNITED GREATER TROCHANTER FOLLOWING TOTAL HIP ARTHROPLASTY", The Journal of Bone and Joint Surgery-American Volume, 85(7), pp.1330~1337 (2003), Ovid Technologies (Wolters Kluwer Health)[DOI]
  25. Kee Haeng Lee, "Is rigid fixation of the greater trochanter necessary for arthroplasty of intertrochanteric fractures?", Orthopaedics &amp; Traumatology: Surgery &amp; Research, 105(1), pp.41~45 (2019), Elsevier BV[DOI]
  26. James M. Hartford, "Risk Factors for Perioperative Femoral Fractures: Cementless Femoral Implants and the Direct Anterior Approach Using a Fracture Table", The Journal of Arthroplasty, 31(9), pp.2013~2018 (2016), Elsevier BV[DOI]
  27. Keith R. Berend, "Risk of Periprosthetic Fractures With Direct Anterior Primary Total Hip Arthroplasty", The Journal of Arthroplasty, 31(10), pp.2295~2298 (2016), Elsevier BV[DOI]
  28. Brian A. Jewett, "High Complication Rate With Anterior Total Hip Arthroplasties on a Fracture Table", Clinical Orthopaedics &amp; Related Research, 469(2), pp.503~507 (2011), Ovid Technologies (Wolters Kluwer Health)[DOI]

관련 논문AI추천

이 간행물의 다른 논문 (8건)