Comparison The Early Clinical Efficacy of SuperPath Approach Versus The Modified Hardinge Approach In Total Hip Arthroplasty For Femoral Neck Fractures In Elderly: A Randomized Controlled Trial

Abstract Purpose: Femoral neck fracture is a common form of hip fracture in the elderly. Minimally invasive surgery is very popular in recent years. This study was to investigate the clinical efficacy and advantages of the SuperPath approach to total hip arthroplasty in the treatment of femoral neck fractures in the elderly. Methods: From February 2018 to March 2019, 120 patients were random divided into two groups with 60 patients each: the SuperPath group and conventional group. The results evaluated the general operation situation, Serum markers, blood loss, pain score, hip function and prosthesis location analysis. Results: There was no difference demographically between two groups. Compared with the conventional group, the SuperPath group had a shorter operation time (78.4 vs 93.0 min), smaller incision length (5.8 vs 12.5 cm), less intraoperative blood loss (121.5 vs 178.8 ml), shorter hospitalization time (8.0 vs 10.8 day) and less drainage volume (77.8 vs 141.2 ml). The creatine kinase (CK) in the SuperPath group was significantly lower, while there was no difference in the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). The visual analog scale (VAS) was lower in one month and Harris Hip Score (HHS) were higher in three months in the SuperPath group. There was no difference in the cup abduction angle and anteversion angle of the two groups. Conclusion: We found the better clinical efficacy after the SuperPath approach with less muscle damage, less postoperative pain and better postoperative function compared with the modified Hardinge approach. Trial registration: Retrospectively registered. The randomized clinical trial was retrospective registered at Chinese Clinical Trial Registry on December 31, 2020 (ChiCTR-2000041583, http://www.chictr.org.cn/showproj.aspx?proj=57008).