[One-year morbidity and mortality in total hip arthroplasty for fracture: comparison between direct anterior approach and lateral approach].

INTRODUCTION: hip fracture is one of the most common conditions in the professional practice of an orthopedic surgeon. The early mortality of primary total hip arthroplasty (THA) for osteoarthritis is 0.35% with an incidence of complications of 3.9%. This increases considerably (3.1%) when THA is performed as the treatment of a hip fracture. The main objective of this study is to determine if the surgical approach has an effect on the mortality of patients who are treated with THA in the context of a fracture. MATERIAL AND METHODS: we carried out a retrospective and observational study that included patients with intracapsular hip fractures who had been treated with THA, performed through an anterior or lateral approach, by the same team in a single center between 2007 and 2021. RESULTS: the anterior approach is independently associated with a lower risk of bleeding with an OR = 0.15 (95% CI = 0.051-0.48, p = 0.001) versus the lateral approach. Overall mortality in the anterior approach was 6.7 versus 15.2% in the lateral approach (p = 0.25). CONCLUSIONS: this study demonstrates in a statistically significant way that patients who undergo arthroplasty through a lateral approach have a higher risk of bleeding. The anterior approach in the hands of a trained surgical team is a safe option for performing THA in patients with hip fractures and has the potential to reduce some of the risks associated with the procedure.