Prospective comparison of the anterior and lateral approach in hemiarthroplasty for hip fractures: a study protocol

Sijp, Max P.L. van der; Schipper, Inger B.; Keizer, Stefan B.; Krijnen, Pieta; Niggebrugge, Arthur H.P.

doi:10.1186/s12891-017-1724-9

Cited by 10 publications

(6 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Definitions of the complications, treatment aspects, and data collection have been presented previously in more detail by van der Sijp et al ( 16 ). Applicable definitions for this study are a follows:…”

Section: Methodsmentioning

confidence: 99%

Intrathecal Morphine Is Associated with Less Delirium Following Hip Fracture Surgery: A Register Study

et al. 2020

View full text Add to dashboard Cite

Background: Delirium is a common complication after proximal femoral fracture surgery, with pain and opioid consumption as the contributing factors. The administration of intrathecal morphine may decrease these factors postoperatively and potentially reduce delirium. Objectives: This research aimed to study the association between the use of intrathecal morphine and the occurrence of delirium. Methods: A retrospective analysis of a prospective register kept in a non-academic hospital in the Netherlands was performed. The register contained data of all patients with proximal femur fractures that were surgically treated with osteosynthesis or prosthesis. Patients receiving spinal anesthesia (SA group) were compared with patients receiving spinal anesthesia with the addition of intrathecal morphine (SIM group). The administration of either SA or SIM was based on the preference of the anesthesiologist. The primary outcome was the incidence of delirium, as defined by the DSM-V classification. The follow-up lasted until hospital discharge. Both univariate and multivariate analyses were performed. Results: The SA group consisted of 451 patients, and the SIM group included 34 patients. Delirium occurred in 19.7% in the SA group versus 5.9% in the SIM group (P = 0.046). This association remained significant after correction in multivariate analysis (OR of delirium in the SA group, 95% CI: 1.062 - 21.006, P = 0.041). Additionally, multivariate analysis revealed that age, gender, preoperative cognitive impairment, and fracture treatment (osteosynthesis or prosthesis) were independently associated with delirium. Conclusions: This retrospective study found an independent association between the use of intrathecal morphine and a lower incidence of delirium. This clinically relevant decrease in delirium should be studied in a prospective randomized study.

show abstract

Section: Methodsmentioning

confidence: 99%

Intrathecal Morphine Is Associated with Less Delirium Following Hip Fracture Surgery: A Register Study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Details of the routine data collection and outcomes have been published previously and apply to all patients with a proximal femoral fracture. 18 The methodology of data collection and of any subsequent observational studies was approved by the institutional Medical Research Ethics Committee and the study hospital's board of directors without the need for individual patient consent.…”

Section: Methodsmentioning

confidence: 99%

Prognostic Factors for Short-term Recovery of Independence in a Multistate Model for Patients With a Hip Fracture

Sijp

Eijk

Niggebrugge

et al. 2021

Journal of the American Medical Directors Association

Self Cite

View full text Add to dashboard Cite

Objectives: This study investigates the transitions of community-dwelling patients with a proximal femoral fracture towards recovery of independence using multistate modeling. The prognostic value of factors affecting the short-term rate of recovery of independence in activities of daily living was assessed for the resilient portion of the population. Design: An inception cohort was recruited between 2016 and 2019. Setting and Participants: Only community-dwelling older patients admitted with a proximal femoral fracture were included. Measures: Follow-up was performed at 6 weeks and 3 months, when the patients' living situation and level of independence were recorded. Multistate modeling was used to study the transition rates of the population through prespecified states of the recovery process. Using this model, prognostic factors for the recovery of independence were identified for resilient patients (defined as those patients who managed to return home at any point in the follow-up after discharge). Results: A total of 558 patients were included, and 218 (40.9%) recovered to prefracture levels of independence. Of the resilient patients, 20.7% were discharged home directly, and 79.3% via a rehabilitation home. In this patient group, a more favorable American Society of Anesthesiologists classification, better prefracture mobility, and the absence of a prefracture fear of falling were statistically significantly associated with a successful recovery. A low level of prefracture independence was inversely associated, meaning that patients with a low level of prefracture independence had a higher chance of successful recovery. Conclusions and Implications: This study identified 4 factors with an independent prognostic value for the recovery of independence in resilient patients after a proximal femoral fracture. These factors could be used to construct clinical profiles that contribute to the assessment of the patient's post-acute care needs and recovery capacity. In addition, multistate modeling has been shown to be an effective and versatile tool in the study of recovery prognostics.

show abstract

“…Data were prospectively collected by the treating physicians and nurses. The Hip Fracture Unit is part of a multicentre level 1 trauma teaching hospital, treating approximately 500 proximal femoral fractures annually [ 23 ]. All data were handled in agreement with the ‘Code of Conduct for Health Research’ of the Council of the Federation of Medical Scientific Societies.…”

Section: Methodsmentioning

confidence: 99%

High risks of failure observed for A1 trochanteric femoral fractures treated with a DHS compared to the PFNA in a prospective observational cohort study

Sijp

Groot

Meylaerts

et al. 2021

Arch Orthop Trauma Surg

Self Cite

View full text Add to dashboard Cite

Introduction Both the DHS and the PFNA are common and well-studied treatment options for stable trochanteric fractures. The aim of the current study was to compare the implant failure rates of these two implants in 31A1 type trochanteric femoral fractures. Materials and methods A single-centre observational cohort study was conducted in the Hip Fracture Unit of a multicentre level 1 trauma teaching hospital between December 2016 and October 2018. Patients with an AO/OTA type 31A1 fracture were included. Pathological fractures, bilateral fractures, high-energy traumas and patients younger than 18 years of age were excluded. Surgery was performed using either a DHS or PFNA. Both were used routinely for stable trochanteric fractures, and allocation was decided by the surgeon performing the operation. The primary outcome of this study was the implant failure rate in the first postoperative year. Secondary outcomes included the reoperation rate, functional recovery, pain and morphine use. Results Data were available from 126 patients treated with a DHS (n = 32, 25.4%) or PFNA (n = 95, 74.6%). Minor differences were observed in the patient characteristics including the prevalence of cognitive impairment (18.8% vs 40.2%; P = 0.028), prefracture independence in activities of daily living (87.1% vs 67.4%; P = 0.034) and prefracture mobility (independently without aides: 61.3% vs 40.4%; P = 0.033). Fractures treated with a DHS showed 25% implant failures, compared to 1.1% for fractures treated with a PFNA (P = 0.004). No differences were observed in any of the secondary outcomes. Conclusions Significantly more implant failures were observed for the DHS compared the PFNA within 1 year after surgery. Despite the fact that this did not result in differences in revision surgery, we conclude that the PFNA, considering the minimal number of implant-related fractures is a viable implant for A1 type trochanteric fractures.

show abstract

Prospective comparison of the anterior and lateral approach in hemiarthroplasty for hip fractures: a study protocol

Cited by 10 publications

References 22 publications

Intrathecal Morphine Is Associated with Less Delirium Following Hip Fracture Surgery: A Register Study

Intrathecal Morphine Is Associated with Less Delirium Following Hip Fracture Surgery: A Register Study

Prognostic Factors for Short-term Recovery of Independence in a Multistate Model for Patients With a Hip Fracture

High risks of failure observed for A1 trochanteric femoral fractures treated with a DHS compared to the PFNA in a prospective observational cohort study

Contact Info

Product

Resources

About