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髋关节前外侧入路相比，高级别异位骨化的风险增加：来自接受半关节置换术治疗的股骨颈骨折患者的随机试验的放射学结果

背景与目的：半髋关节置换术是移位股骨颈骨折患者常用的治疗方法。由于疼痛更小、活动更早和功能结果良好的积极主张，关节的前路方法越来越受欢迎。这项随机对照试验调查了保留肌肉前入路和直接外侧入路之间的组件放置和异位骨化是否不同。患者和方法：150 名接受非骨水泥半关节成形术的患者被随机分配到前外侧入路或直接外侧入路，并在术后进行放射学评估。测量包括腿长差异、股骨偏移、股骨柄位置、管填充率和 12 个月后异位骨化的存在。结果：p  < 0.05)。我们发现在腿长差异、股骨柄位置或股骨偏移方面没有统计学上的显着差异。结论：在直接外侧入路进行的半关节成形术导致 Brooker 3 级异位骨化的发生率更高。我们的结果支持使用这两种方法进行相同的几何修复和类似的组件放置。临床试验注册：ClinicalTrials.gov 标识符：NCT03974698Uncemented Hemiarthroplasty，放射学特征比较外侧与前外侧方法 https://www.clinicaltrials.gov/ct2/show/NCT03974698?term =raymond+tellefsen...draw=2...rank=1