2023 OTA Annual Meeting : Posterolateral or Direct Lateral Surgical Approach for Hemiarthroplasty After a Hip Fracture

843 patients were included in this study consisting of a randomized trial (n=555) and natural experiment (n=288), aiming to compare posterolateral and direct lateral hemiarthroplasty approaches for the treatment of hip fracture. The primary outcome of interest was health-related quality of life at 6 months, measured with the EuroQol 5-Dimensions (EQ-5D-5L) questionnaire. Secondary outcomes of interest included dislocation, fear of falling, activities of daily living, pain, and re-operation. Data from the randomized trial and natural experiment were fused, and pooled effects were reported. The pooled results showed a significantly higher odds of dislocation with the posterolateral approach compared to the direct lateral approach (OR 12.31 [95%CI 2.77, 54.7]). No difference in quality of life scores were observed between the two groups. The rate of re-operation was lower in the direct lateral group (n=18) than the posterolateral group (n=35).