BACKGROUND AND PURPOSE Hemiarthroplasty is a common treatment in patients with displaced femoral neck fracture. Due to positive claims of less pain, earlier mobilisation and favourable functional outcome, the anterior approaches to the joint are gaining in popularity. This randomised controlled trial investigated if component placement and heterotopic ossification differed between a muscle sparing anterior approach and a direct lateral approach. PATIENTS AND METHODS 150 patients operated with an uncemented hemiarthroplasty, were randomised to anterolateral or direct lateral approach and assessed postoperatively radiologically. Measurements included leg-length discrepancy, femoral offset, femoral stem position, canal fill ratio and the presence of heterotopic ossification after 12 months. RESULTS There was an increased risk of high-grade heterotopic ossification in the direct lateral approach (p < 0.05). We found no statistically significant differences in leg-length discrepancy, femoral stem position or femoral offset. CONCLUSIONS Hemiarthroplasty performed in the direct lateral approach resulted in a higher incidence of Brooker grade 3 heterotopic ossification. Our results support equal geometrical restoration and similar component placement with both approaches. CLINICAL TRIAL REGISTRY ClinicalTrials.gov Identifier: NCT03974698Uncemented Hemiarthroplasty, Radiological Features Comparing Lateral Versus Anterolateral Approach https://www.clinicaltrials.gov/ct2/show/NCT03974698?term=raymond+tellefsen…draw=2…rank=1.

中文翻译：

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使用直接外侧入路与保留肌肉的前外侧入路相比，髋部高度异位骨化的风险增加：对接受半髋关节置换术治疗的股骨颈骨折患者进行的随机试验的放射学结果。

背景和目的半髋关节置换术是移位股骨颈骨折患者的常见治疗方法。由于疼痛减轻、活动更早和功能效果良好，关节前入路越来越受欢迎。这项随机对照试验调查了保留肌肉的前路入路和直接侧向入路之间的组件放置和异位骨化是否存在差异。患者和方法 150 名接受非骨水泥半髋关节置换术的患者被随机分配至前外侧入路或直接侧向入路，并进行术后放射学评估。测量包括腿长差异、股骨偏移、股骨柄位置、管充盈率以及 12 个月后是否存在异位骨化。结果 直接外侧入路中高度异位骨化的风险增加（p < 0.05）。我们发现腿长差异、股骨柄位置或股骨偏移量没有统计学上的显着差异。结论 采用直接外侧入路进行的半髋关节置换术导致 Brooker 3 级异位骨化的发生率较高。我们的结果支持两种方法具有相同的几何恢复和相似的组件放置。临床试验注册处 ClinicalTrials.gov 标识符：NCT03974698非骨水泥半关节置换术，比较外侧入路与前外侧入路的放射学特征 https://www.clinicaltrials.gov/ct2/show/NCT03974698?term=raymond+tellefsen…draw=2…rank=1。我们发现腿长差异、股骨柄位置或股骨偏移量没有统计学上的显着差异。结论 采用直接外侧入路进行的半髋关节置换术导致 Brooker 3 级异位骨化的发生率较高。我们的结果支持两种方法具有相同的几何恢复和相似的组件放置。临床试验注册处 ClinicalTrials.gov 标识符：NCT03974698非骨水泥半关节置换术，比较外侧入路与前外侧入路的放射学特征 https://www.clinicaltrials.gov/ct2/show/NCT03974698?term=raymond+tellefsen…draw=2…rank=1。我们发现腿长差异、股骨柄位置或股骨偏移量没有统计学上的显着差异。结论 采用直接外侧入路进行的半髋关节置换术导致 Brooker 3 级异位骨化的发生率较高。我们的结果支持两种方法具有相同的几何恢复和相似的组件放置。临床试验注册处 ClinicalTrials.gov 标识符：NCT03974698非骨水泥半关节置换术，比较外侧入路与前外侧入路的放射学特征 https://www.clinicaltrials.gov/ct2/show/NCT03974698?term=raymond+tellefsen…draw=2…rank=1。我们的结果支持两种方法具有相同的几何恢复和相似的组件放置。临床试验注册处 ClinicalTrials.gov 标识符：NCT03974698非骨水泥半关节置换术，比较外侧入路与前外侧入路的放射学特征 https://www.clinicaltrials.gov/ct2/show/NCT03974698?term=raymond+tellefsen…draw=2…rank=1。我们的结果支持两种方法具有相同的几何恢复和相似的组件放置。临床试验注册处 ClinicalTrials.gov 标识符：NCT03974698非骨水泥半关节置换术，比较外侧入路与前外侧入路的放射学特征 https://www.clinicaltrials.gov/ct2/show/NCT03974698?term=raymond+tellefsen…draw=2…rank=1。