Cases: Two elderly women with significant medical comorbidities presented to a community hospital setting after new-onset generalized seizure activity while in bed without a history of trauma. Both were diagnosed by computed tomography scan with bilateral acetabular fractures. Owing to altered mental status from a postictal period, both were unable to be reliably assessed for pain, which resulted in a diagnostic delay. Conclusions: These cases highlight the importance of a proper secondary survey on mentally altered patients even without a history of significant trauma, a high index of suspicion for associated injuries in seizure patients, and the use of appropriate advanced imaging.

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Introduction: The supercapsular percutaneously assisted total hip (SuperPATH) approach and technique are a relatively new minimally invasive procedure for total hip replacement. The theoretical benefits include muscle sparing, no hip precautions, smaller incision, decrease in blood loss, and a relative familiar approach for joint surgeons. The aim of our study was to assess the early results and learning curve using the SuperPATH technique. Methods: A retrospective cohort analysis of the first 28 SuperPATH hip replacements by a single surgeon was performed. The learning curve was assessed by evaluating the results of 2 groups of 14 cases grouped in order in which they were performed. Group 1 was comprised of the first 14 cases, and group 2 of the last 14 cases. Primary measures included operative time and blood loss as surrogates of technical improvement. Secondary measures recorded were length of stay, acetabular component inclination angle, postoperative leg length discrepancy, and intraoperative complications. Descriptive statistics were used to describe the patient cohort, and comparative testing was performed to determine differences between the groups. Statistical significance was defined as p < 0.05. Results: The duration of the operative procedure between the first 14 cases and the last 14 cases was statistically significant (p = 0.045), 162.85 and 142.67 minutes, respectively. The length of stay was also statistically significant (p = 0.020) between the 2 groups, 3.5 and 2.5 days, respectively. There was no difference between the groups for blood loss, acetabular inclination angle, and leg length discrepancy. Conclusions: This study found a gradual decrease in operative time without plateau between the 2 groups, suggesting that operative time will continue to decrease in the future. Future research will include an extended follow-up of the study group to determine longer-term outcomes and complications. Furthermore, a larger sample size will be needed to determine when the learning curve levels off for this procedure. Level of Evidence: Level IV.