Dislocation of Bipolar Hip Hemiarthroplasty in the Elderly: Comparison of the Posterolateral and Anterolateral Approaches
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Published:
Oct 27, 2025
Keywords:
Hip prosthesis, hip dislocation, femoral neck fracture, elderly
Main Article Content
Abstract
Objective: To compare the risk of bipolar hip hemiarthroplasty dislocation after femoral neck fracture using the posterolateral versus the anterolateral approach.
Materials and Methods: Patients older than 60 years who underwent bipolar hip hemiarthroplasty for femoral neck fracture between 2021 and 2022 were included. The number of dislocations following the posterolateral or anterolateral approach was recorded.
Results: Seventy-nine cases were included: 46 (58.8%) were treated with the posterolateral approach and 33 (41.8%) with the anterolateral approach. There were 3 dislocations in the posterolateral group and 2 in the anterolateral group; no significant differences were found (p = 0.655).
Conclusions: There were no differences in the risk of bipolar hemiarthroplasty dislocation between the posterolateral and anterolateral approaches in the treatment of femoral neck fractures in the elderly.
Materials and Methods: Patients older than 60 years who underwent bipolar hip hemiarthroplasty for femoral neck fracture between 2021 and 2022 were included. The number of dislocations following the posterolateral or anterolateral approach was recorded.
Results: Seventy-nine cases were included: 46 (58.8%) were treated with the posterolateral approach and 33 (41.8%) with the anterolateral approach. There were 3 dislocations in the posterolateral group and 2 in the anterolateral group; no significant differences were found (p = 0.655).
Conclusions: There were no differences in the risk of bipolar hemiarthroplasty dislocation between the posterolateral and anterolateral approaches in the treatment of femoral neck fractures in the elderly.
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How to Cite
Aguilar Maldonado, A., & Lecca Zavaleta , J. L. (2025). Dislocation of Bipolar Hip Hemiarthroplasty in the Elderly: Comparison of the Posterolateral and Anterolateral Approaches. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 90(5), 426-430. https://doi.org/10.15417/issn.1852-7434.2025.90.5.1972
Section
Clinical Research
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References
1. Cazzato G, Oliva MS, Masci G, Vitiello R, Smimmo A, Matrangolo M R, et al. Femoral neck fracture: the reliability of radiologic classifications. BMC Musculoskelet Disord 2022;22(Suppl 2):1063. https://doi.org/10.1186/s12891-022-05007-3
2. Gašpar D, Crnković T, Durović D, Podsednik D, Slišurić F. AO group, AO subgroup, Garden and Pauwels classification systems of femoral neck fractures: are they reliable and reproducible? Med Glas (Zenica) 2012;9(2):243-7. PMID: 22926358
3. Palm H, Posner E, Ahler-Toftehøj HU, Siesing P, Gylvin S, Aasvang T, et al. High reliability of an algorithm for choice of implants in hip fracture patients. Int Orthop 2013;37(6):1121-6. https://doi.org/10.1007/s00264-013-1831-7
4. Ekhtiari S, Gormley J, Axelrod DE, Devji T, Bhandari M, Guyatt GH. Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fracture: A systematic review and meta-análisis of randomized controlled trials. J Bone Joint Surg Am 2020;102(18):1638-45. https://doi.org/10.2106/JBJS.20.00226
5. Skowronek P, Wojciechowski A, Wypniewsky K, Sibiński M, Polguj M, Maksymiuk-Kłos A, et al. Time efficiency of direct anterior hip arthroplasty compared to postero-lateral approach in elderly patients. Arch Med Sci 2021;17(1):106-12. https://doi.org/10.5114/aoms/86185
6. Abram SG, Murray JB. Outcomes of 807 Thompson hip hemiarthroplasty procedures and the effect of surgical approach on dislocation rates. Injury 2015;46(6):1013-7. https://doi.org/10.1016/j.injury.2014.12.016
7. Shuai L, Huiwen W, Shihao D, Fangyuan W, Juehua J, Jun L. A comparison of different surgical approaches to hemiarthroplasty for the femoral neck fractures: A meta-analysis. Front Surg 2023;9:1049534. https://doi.org/10.3389/fsurg.2022.1049534
8. Van der Sijp MPL, van Delft D, Krijnen P, Niggebrugge AHP, Schipper IB. Surgical approaches and hemiarthroplasty outcomes for femoral neck fractures: A meta-analysis. J Arthroplasty 2018;33(5):1617-27.e9. https://doi.org/10.1016/j.arth.2017.12.029
9. Parker MJ. Lateral versus posterior approach for insertion of hemiarthroplasties for hip fractures: A randomized trial of 216 patients. Injury 2015;46(6):1023-7. https://doi.org/10.1016/j.injury.2015.02.020
10. Mukka S, Mahmood S, Kadum B, Sköldenberg O, Sayed-Noor A. Direct lateral vs posterolateral approach to hemiarthroplasty for femoral neck fractures. Orthop Traumatol Surg Res 2016;102(8):1049-54. https://doi.org/10.1016/j.otsr.2016.08.017
11. Enocson A, Tidermark J, Tornkvist H, Lapidus LJ. Dislocation of hemiarthroplasty after femoral neck fracture: better outcome after the anterolateral approach in a prospective cohort study on 739 consecutive hips. Acta Orthop 2008;79(2):211-7. https://doi.org/10.1080/17453670710014996
12. Guzon-Illescas O, Perez Fernandez E, Crespí Villarias N, Quirós Donate FJ, Peña M, Alonso-Blas C, et al. Mortality after osteoporotic hip fracture: incidence, trends, and associated factors. J Orthop Surg Res 2019;14(1):203. https://doi.org/10.1186/s13018-019-1226-6
13. Omsland TK, Emaus N, Tell GS, Magnus JH, Ahmed LA, Holvik K, et al. Mortality following the first hip fracture in Norwegian women and men (1999-2008). A NOREPOS study. Bone 2014;63:81-6. https://doi.org/10.1016/j.bone.2014.02.016
14. Chang W, Lv H, Feng C, Yuwen P, Wei N, Chen W, et al. Preventable risk factors of mortality after hip fracture surgery: Systematic review and meta-analysis. Int J Surg 2018;52:320-8. https://doi.org/10.1016/j.ijsu.2018.02.061
15. Rae HC, Harris IA, McEvoy L, Todorova T. Delay to surgery and mortality after hip fracture. ANZ J Surg 2007;77(10):889-91. https://doi.org/10.1111/j.1445-2197.2007.04267.x
16. Hedlundh U, Ahnfelt L, Hybbinette CH, Weckstrom J, Fredin H. Surgical experience related to dislocations after total hip arthroplasty. J Bone Joint Surg Br 1996;78(2):206-9. PMID: 8666625
2. Gašpar D, Crnković T, Durović D, Podsednik D, Slišurić F. AO group, AO subgroup, Garden and Pauwels classification systems of femoral neck fractures: are they reliable and reproducible? Med Glas (Zenica) 2012;9(2):243-7. PMID: 22926358
3. Palm H, Posner E, Ahler-Toftehøj HU, Siesing P, Gylvin S, Aasvang T, et al. High reliability of an algorithm for choice of implants in hip fracture patients. Int Orthop 2013;37(6):1121-6. https://doi.org/10.1007/s00264-013-1831-7
4. Ekhtiari S, Gormley J, Axelrod DE, Devji T, Bhandari M, Guyatt GH. Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fracture: A systematic review and meta-análisis of randomized controlled trials. J Bone Joint Surg Am 2020;102(18):1638-45. https://doi.org/10.2106/JBJS.20.00226
5. Skowronek P, Wojciechowski A, Wypniewsky K, Sibiński M, Polguj M, Maksymiuk-Kłos A, et al. Time efficiency of direct anterior hip arthroplasty compared to postero-lateral approach in elderly patients. Arch Med Sci 2021;17(1):106-12. https://doi.org/10.5114/aoms/86185
6. Abram SG, Murray JB. Outcomes of 807 Thompson hip hemiarthroplasty procedures and the effect of surgical approach on dislocation rates. Injury 2015;46(6):1013-7. https://doi.org/10.1016/j.injury.2014.12.016
7. Shuai L, Huiwen W, Shihao D, Fangyuan W, Juehua J, Jun L. A comparison of different surgical approaches to hemiarthroplasty for the femoral neck fractures: A meta-analysis. Front Surg 2023;9:1049534. https://doi.org/10.3389/fsurg.2022.1049534
8. Van der Sijp MPL, van Delft D, Krijnen P, Niggebrugge AHP, Schipper IB. Surgical approaches and hemiarthroplasty outcomes for femoral neck fractures: A meta-analysis. J Arthroplasty 2018;33(5):1617-27.e9. https://doi.org/10.1016/j.arth.2017.12.029
9. Parker MJ. Lateral versus posterior approach for insertion of hemiarthroplasties for hip fractures: A randomized trial of 216 patients. Injury 2015;46(6):1023-7. https://doi.org/10.1016/j.injury.2015.02.020
10. Mukka S, Mahmood S, Kadum B, Sköldenberg O, Sayed-Noor A. Direct lateral vs posterolateral approach to hemiarthroplasty for femoral neck fractures. Orthop Traumatol Surg Res 2016;102(8):1049-54. https://doi.org/10.1016/j.otsr.2016.08.017
11. Enocson A, Tidermark J, Tornkvist H, Lapidus LJ. Dislocation of hemiarthroplasty after femoral neck fracture: better outcome after the anterolateral approach in a prospective cohort study on 739 consecutive hips. Acta Orthop 2008;79(2):211-7. https://doi.org/10.1080/17453670710014996
12. Guzon-Illescas O, Perez Fernandez E, Crespí Villarias N, Quirós Donate FJ, Peña M, Alonso-Blas C, et al. Mortality after osteoporotic hip fracture: incidence, trends, and associated factors. J Orthop Surg Res 2019;14(1):203. https://doi.org/10.1186/s13018-019-1226-6
13. Omsland TK, Emaus N, Tell GS, Magnus JH, Ahmed LA, Holvik K, et al. Mortality following the first hip fracture in Norwegian women and men (1999-2008). A NOREPOS study. Bone 2014;63:81-6. https://doi.org/10.1016/j.bone.2014.02.016
14. Chang W, Lv H, Feng C, Yuwen P, Wei N, Chen W, et al. Preventable risk factors of mortality after hip fracture surgery: Systematic review and meta-analysis. Int J Surg 2018;52:320-8. https://doi.org/10.1016/j.ijsu.2018.02.061
15. Rae HC, Harris IA, McEvoy L, Todorova T. Delay to surgery and mortality after hip fracture. ANZ J Surg 2007;77(10):889-91. https://doi.org/10.1111/j.1445-2197.2007.04267.x
16. Hedlundh U, Ahnfelt L, Hybbinette CH, Weckstrom J, Fredin H. Surgical experience related to dislocations after total hip arthroplasty. J Bone Joint Surg Br 1996;78(2):206-9. PMID: 8666625