Hemiarthroplasty of the hip--the anterior or posterior approach? A comparison of surgical approaches.

A series of 531 patients presenting with a displaced subcapital femoral fracture treated by hemiarthroplasty, were studied prospectively to determine the optimal approach for surgery. A total of 302 prostheses were inserted by an anterolateral approach and 229 by a posterolateral approach. Complications in these two broadly comparable groups are discussed. Dislocation and thrombosis were more common after a posterior approach. Operative time, blood loss, and infection, were greater after an anterior approach. There was no significant difference in the length of hospital stay or mortality. Our findings suggest that favoured approach should be that at which the surgeon feels more competent.