Superpath is Superior to Posterolateral Approach for Hemiarthroplasty in Geriatric Patients with High Risk for...

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Biomedical Engineering

Background:

• Dislocation is a severe complication of hemiarthroplasty (HA) for femoral neck fractures in the elderly.
• The tissue-sparing SuperPATH (SP) approach has shown promise in improving functional recovery and reducing complications like dislocation.

Purpose of the Study:

• To compare the clinical outcomes, perioperative complications, and mortality rates of the SuperPATH (SP) and posterolateral (PL) approaches in geriatric patients at high risk for dislocation after HA.

Main Methods:

• A retrospective review of 621 patients from January 2015 to January 2024.
• Included 39 patients using the SP approach and 42 using the PL approach, all with high dislocation risk.
• Evaluated operation time, incision length, blood loss, complications, and postoperative outcomes (dislocation, mortality) at 1-month, 6-month, and 1-year follow-ups.

Main Results:

• The SP group had significantly smaller incisions and lower blood transfusion rates compared to the PL group.
• Early Harris hip scores were significantly higher in the SP group at 1 week postoperatively.
• No dislocations occurred in the SP group, versus 8 dislocations in the PL group (p = 0.004). Reoperation rates were also lower in the SP group.

Conclusions:

• The SuperPATH approach for hemiarthroplasty in high-risk elderly patients reduces dislocation incidence and accelerates early hip function recovery.
• Identifying dislocation risk factors can guide the selection of tissue-sparing approaches or constrained prostheses to prevent complications.