A study of comparitive analysis of the outcome of Hardinge’s and Moore’s approach of hemi arthroplasty of hip
Keywords:Hardinge’s approach, Moore’s approach, Hemiarthroplasty of hip
Background: The posterior (Moore) approach is generally considered to be easy to perform and has less tissue dissection, which leads to shorter operation times and less blood loss. The lateral (Hardinge) approach can provide generous exposure of the acetabulum, which facilitates cup positioning results may decrease rates of hip dislocation.
Methods: In this study a prospective comparative study of outcome of Hardinge’s vs. Moore’s approach in hemi arthroplasty of hip done on 60 consecutive consenting cases who presented with a primary diagnosis of neck of femur fractures. The Selection of patients was randomized by selecting every alternate case of neck of femur fractures by Moore’s approach or Hardinge’s approach. Study recruited 30 cases in each group after the preoperative parameters like age, sex, side, mechanism of injury and the type of fracture.
Results: 30 cases underwent hemi - arthroplasty of hip by Hardinge’s approach vs. Moore’s technique and we found that there was difference in duration of hospital stay, the duration of healing and the rate of complications were much higher in the Moore’s technique. In our study there was no mortality.
Conclusions: Based on the findings of our study we recommend that between Hardinge’s and Moore’s approach, Hardinge’s approach is recommended as better than Moore’s approach due to number of complications is lower in Hardinge’s.
Aharonoff GB, Koval KJ, Skovron ML, Zuckerman JD. Hip fractures in the elderly: predictors of one year mortality. J Orthop Trauma. 1997;11:162-5.
Astrom J, Ahnqvist S, Beertema J, Jonsson B. Physical activity in women sustaining fracture of the neck of the femur, Bone Joint J. 1987;69:381-3
Khan M, Aleem IS, Poolman RW. Fixation versus primary replacement of displaced femoral neck fractures in the elderly. Indian J Orthop. 2011;45:23.
Pillai A, Eranki V, Shenoy R, Hadidi M. Age related incidence and early outcomes of hip fractures: a prospective cohort study of 1177 patients. J Orthop Surg Res. 2011;6:5.
Tandon S, Vijayvargiya M, Pathak A. Outcome Analysis Of Proximal Femoral Nail In Stable Intertrochanteric Femur Fractures. J Evol Med Dental Sci. 2015;4:2553-60.
Mukherjee DL, Puri HC. Early hemiarthroplasty for fresh fractures of the neck of the femur in geriatric patients. Indian J Surg. 1986;48:77-80.
Pawar ED, Agrawal SR, Patil AW, Pawar P, Choudhary S. A study of management of intertrochanteric fractures using external fixator. J Evol Med Dent Sci. 2014;3(21):5661-8.
Roy GK, Bandi M. Study of management of extracapsular fracture of neck of femur by dynamic hip screw. J Evol Med Dent Sci. 2014;1:306-12.
Schmalzried TP, Amstutz HC, Dorey FJ: Nerve palsy associated with total hip replacement. Risk factors and prognosis. J Bone Joint Surg Am. 1991;73:1074-80.
Barrett WP, Turner SE, Leopold JP. Prospective randomized study of direct anterior vs postero-lateral approach for total hip arthroplasty. J Arthroplasty. 2013;28:1634-8.
Moore AT. The self-locking metal hip prosthesis. J Bone Joint Surg Am. 1957, 39:811-827.
Stinchfield FE, Cooperman B, Shea Jr CE. Replacement of the femoral head by Judet or Austin Moore prosthesis. JBJS. 1957;39:1043-58.
Hinchey JJ, Day PL. Primary Prosthetic Replacement in Fresh Femoral-Neck Fractures: A review of 294 consecutive cases. JBJS. 1964;46:223-334.
Salvati EA, Artz T, Aglietti P, Asnis SE. Endoprostheses in the treatment of femoral neck fractures. Orthop Clin North Am. 1974;5:757-77.
Robinson CM, McQueen MM, Christie J. Hip Fractures in Adults Younger Than 50 Years of Age Epidemiology and Results. Clin Orthop Rel Res. 1995;312:238-46.