{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:00:01Z","timestamp":1792018801927,"version":"4.4.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To compare 90-day and 1-year outcomes, including mortality, of femoral neck fracture patients undergoing total hip arthroplasty (THA) by direct anterior approach (DAA) versus posterior approach (PA).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective cohort.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Level I Trauma Center.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients:<\/jats:title>\n            <jats:p>One hundred forty-three consecutive intracapsular femoral neck fractures treated with THA from 2010 to 2018. The minimum follow-up was 12 months, and the average follow-up was 14.6 months (12\u201372 months).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measures:<\/jats:title>\n            <jats:p>Postoperative outcomes, including discharge ambulation, dislocation, periprosthetic joint infection, revision THA, and mortality at 90 days and 1 year after THA.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Of the 143 THA included, 44 (30.7%) were performed by DAA while 99 (69.3%) were performed by PA. In-hospital outcomes were similar between the cohorts. Compared with DAA patients, PA patients were more likely to ambulate without assistance preinjury (88.9% vs. 72.7%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.025) and be nonambulatory at the time of discharge (27.3% vs. 11.4%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.049). There were no significant differences in 90-day and 1-year postoperative outcomes between the DAA and PA groups, including dislocation, periprosthetic joint infection, periprosthetic fracture, mechanical complications, and revision surgery. Although there was no difference in mortality rate at 90 days, at 1-year follow-up the mortality rate was lower in the DAA group (0% vs. 11.1%, <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.018).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Performing THA by DAA provides similar benefits in regards to medical and surgical outcomes compared with the PA for displaced femoral neck fracture. However, the DAA may lead to decreased 1-year mortality rates, possibly, because of improved early ambulation capacity that is an important predictor of long-term mortality.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000001883","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T03:01:40Z","timestamp":1593745300000},"page":"41-48","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":26,"title":["Comparison Between the Direct Anterior and Posterior Approaches for Total Hip Arthroplasty Performed for Femoral Neck Fracture"],"prefix":"10.1097","volume":"35","author":[{"given":"Kyle H.","family":"Cichos","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott E.","family":"Mabry","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clay A.","family":"Spitler","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"McGwin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, UAB School of Public Health, Birmingham, AL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan H.","family":"Quade","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elie S.","family":"Ghanem","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1007\/s00198-016-3484-z","article-title":"Total medical costs of treating femoral neck fracture patients with hemi- or total hip arthroplasty: a cost analysis of a multicenter prospective study","volume":"27","author":"Burgers","year":"2016","journal-title":"Osteoporos Int."},{"key":"R2-20250614","doi-asserted-by":"crossref","first-page":"54","DOI":"10.3109\/17453674.2013.878831","article-title":"Similar mortality rates in hip fracture patients over the past 31 years","volume":"85","author":"Mundi","year":"2014","journal-title":"Acta Orthop."},{"key":"R3-20250614","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s11999-016-4868-2","article-title":"The Frank Stinchfield Award: total hip arthroplasty for femoral neck fracture is not a typical DRG 470: a propensity-matched cohort study","volume":"475","author":"Schairer","year":"2017","journal-title":"Clin Orthop Relat Res."},{"key":"R4-20250614","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1016\/j.arth.2018.01.014","article-title":"Early failure of primary total hip arthroplasty: is surgical approach a risk factor?","volume":"33","author":"Angerame","year":"2018","journal-title":"J Arthroplasty."},{"key":"R5-20250614","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1016\/j.arth.2017.11.011","article-title":"Does surgical approach affect outcomes in total hip arthroplasty through 90 Days of follow-up? 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