Thus , while DAA hip arthroplasty can be successfully performed , it is not without complications .
Modified direct anterior approach in minimally invasive hip hemiarthroplasty in a geriatric population: a feasibility study and description of the technique
Introduction The direct anterior approach ( DAA ) is generally accepted method for minimal invasive arthroplasty of the hip . As good results for total hip arthroplasty are already published , there is a lack of evidence for the implantation of bipolar hip hemiarthroplasty ( BHH ) in elderly patients with osteoporosis after femoral neck fracture . Material s and methods For hip arthroplasty using a direct anterior approach ( DAA ) in elderly patients with femoral neck fractures , a number of modifications of the original technique are being described . The modified DAA considers in particular the co-morbidity and the bone quality of the geriatric patient population . A consecutive series of 16 hemiarthroplasties using this technique is presented . In all 16 cases , the BHH was implanted in modified DAA technique . Mobility measured by 4-item Barthel Index , pain via visual analogue scale ( VAS ) , duration of surgery , external length of incision and blood loss were evaluated . Results There was no major operative complication during the procedures . The pain level decreased from 7 ( preoperatively ) to 0 at postoperative day 40 . The Barthel Index increased from 5 at first postoperative day to 40 at day 40 . Early postoperative mobilisation is efficiently accelerated . Mean operating time was 71 min ; the medium skin incision length was 8 cm . The mean haemoglobin level decreased from 118 g/dl preoperatively to 101 g/dl at first postoperative day . Conclusion The described modifications of the DAA help to implant a BHH gently in elderly patients with increasing risk of complications like iatrogenic fractures , wound or prosthesis infections and haematoma . This will hopefully lead to a faster rehabilitation and lower mortality rate for patients with femoral neck fractures in the future
Thus , while DAA hip arthroplasty can be successfully performed , it is not without complications .