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Morbimortalidad a un año en artroplastía total de cadera por fractura: comparación entre abordaje anterior directo y abordaje lateral.

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Title: Morbimortalidad a un año en artroplastía total de cadera por fractura: comparación entre abordaje anterior directo y abordaje lateral.
Alternate Title: One-year morbidity and mortality in total hip arthroplasty for fracture: comparison between direct anterior approach and lateral approach.
Authors: Vanegas-Medellín, M.1,2 vanegasmedellin@gmail.com, Castillo-Vázquez, F. G.1,2, Fernández-Palomo, L. J.1,3
Source: Acta Ortopédica Mexicana. Nov/Dec2025, Vol. 39 Issue 6, p372-379. 8p.
Subjects: HIP fractures, MORTALITY, HEMORRHAGE, OPERATIVE surgery, TOTAL hip replacement, COMORBIDITY
Abstract (English): Introduction: hip fracture is one of the most common conditions in the professional practice of an orthopedic surgeon. The early mortality of primary total hip arthroplasty (THA) for osteoarthritis is 0.35% with an incidence of complications of 3.9%. This increases considerably (3.1%) when THA is performed as the treatment of a hip fracture. The main objective of this study is to determine if the surgical approach has an effect on the mortality of patients who are treated with THA in the context of a fracture. Material and methods: we carried out a retrospective and observational study that included patients with intracapsular hip fractures who had been treated with THA, performed through an anterior or lateral approach, by the same team in a single center between 2007 and 2021. Results: the anterior approach is independently associated with a lower risk of bleeding with an OR = 0.15 (95% CI = 0.0510.48, p = 0.001) versus the lateral approach. Overall mortality in the anterior approach was 6.7 versus 15.2% in the lateral approach (p = 0.25). Conclusions: this study demonstrates in a statistically significant way that patients who undergo arthroplasty through a lateral approach have a higher risk of bleeding. The anterior approach in the hands of a trained surgical team is a safe option for performing THA in patients with hip fractures and has the potential to reduce some of the risks associated with the procedure. [ABSTRACT FROM AUTHOR]
Abstract (Spanish): Introducción: la fractura de cadera es uno de los padecimientos más comunes en la práctica profesional de un ortopedista. La mortalidad temprana de la artroplastía total de cadera (ATC) primaria por artrosis es de 0.35% con una incidencia de complicaciones de 3.9%. Esto aumenta de forma considerable (3.1%) cuando la ATC se realiza secundaria a fractura. El objetivo principal de este estudio fue determinar si el tipo de abordaje quirúrgico tiene efecto en la mortalidad de los pacientes que son tratados con ATC en el contexto de una fractura. Material y métodos: estudio retrospectivo y observacional en el que se incluyó a los pacientes con fracturas intracapsulares de cadera que hayan sido tratados mediante ATC, realizada por abordaje anterior o lateral, por un mismo equipo en un solo centro entre 2007 y 2021. Resultados: el abordaje anterior se asocia de forma independiente a un menor riesgo de sangrado con OR = 0.15 (IC95% = 0.0510.48, p = 0.001) contra el abordaje lateral. La mortalidad global en el abordaje anterior fue de 6.7% frente a 15.2% del abordaje lateral (p = 0.25). Conclusiones: este estudio demuestra de forma estadísticamente significativa que los pacientes en quienes se realiza una artroplastía por abordaje lateral tienen mayor riesgo de sangrado. El abordaje anterior en manos de un equipo quirúrgico capacitado es una opción segura para realizar una ATC en pacientes con fracturas de cadera y tiene el potencial de disminuir algunos de los riesgos asociados al procedimiento. [ABSTRACT FROM AUTHOR]
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Database: MedicLatina
Description
Abstract:Introduction: hip fracture is one of the most common conditions in the professional practice of an orthopedic surgeon. The early mortality of primary total hip arthroplasty (THA) for osteoarthritis is 0.35% with an incidence of complications of 3.9%. This increases considerably (3.1%) when THA is performed as the treatment of a hip fracture. The main objective of this study is to determine if the surgical approach has an effect on the mortality of patients who are treated with THA in the context of a fracture. Material and methods: we carried out a retrospective and observational study that included patients with intracapsular hip fractures who had been treated with THA, performed through an anterior or lateral approach, by the same team in a single center between 2007 and 2021. Results: the anterior approach is independently associated with a lower risk of bleeding with an OR = 0.15 (95% CI = 0.0510.48, p = 0.001) versus the lateral approach. Overall mortality in the anterior approach was 6.7 versus 15.2% in the lateral approach (p = 0.25). Conclusions: this study demonstrates in a statistically significant way that patients who undergo arthroplasty through a lateral approach have a higher risk of bleeding. The anterior approach in the hands of a trained surgical team is a safe option for performing THA in patients with hip fractures and has the potential to reduce some of the risks associated with the procedure. [ABSTRACT FROM AUTHOR]
ISSN:23064102
DOI:10.35366/121816