Evidence map›Paper›PMID 40410877›Full record

Observational studyJournal of orthopaedic surgery and research2025

Direct anterior approach enhances early recovery outcomes in total hip arthroplasty among elderly individuals with femoral neck fractures: a propensity-matched cohort study.

Yansong Wang, Jianwei Hou, Jun Feng, Hongbin Li, Xiaodong Wang

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Yansong WangDepartment of Orthopedics, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, 226006, Jiangsu Province, China.
Jianwei HouDepartment of Orthopedics, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, 226006, Jiangsu Province, China.
Jun FengDepartment of Orthopedics, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, 226006, Jiangsu Province, China.
Hongbin LiDepartment of Orthopedics, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, 226006, Jiangsu Province, China.
Xiaodong WangDepartment of Orthopedics, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong, 226006, Jiangsu Province, China. stonewys@ntu.edu.cn.

Funding

Scientific research project of Nantong Health and Health Commission MSZ2022044
6 · The paper itself

Abstract

Objective Enhanced recovery after surgery protocols have been increasingly adopted to optimize postoperative functional restoration. This propensity score-matched cohort study quantified the impact of the direct anterior approach during THA on ERAS efficacy in patients with femoral neck fractures and analyzed outcomes such as functional recovery acceleration and perioperative complications. Methods The consecutive cohort comprised 231 patients who underwent primary arthroplasty for femoral neck fractures and were stratified by surgical approach: direct anterior (DAA, n = 59) versus posterolateral (PLA, n = 172). The clinical outcomes, such as patient statistics, details of perioperative management, length of stay, pain, Harris hip score, and in-hospital complications, were recorded. This retrospective observational study mitigated the risk of confounding bias by applying propensity score matching. Results With PSM, 51 pairs of well-matched patients were generated for comparison between the DAA group and the PLA group. The incision length decreased to 10.7 ± 1.4 cm in the DAA group, whereas it was 13.1 ± 1.3 cm in the PLA group. Compared with the PLA cohort, the DAA cohort had a significantly shorter postoperative length of stay (P = 0.001) but superior limb-length discrepancy control (P < 0.001). Compared with the PLA group, the DAA group demonstrated superior early pain control (VAS score reduction: 3/7/14 days, P < 0.05) and accelerated functional gains (HHS improvement: 7/14 days/1 month, P < 0.05), although the 6-month outcomes were similar between groups (P = 0.675). The DAA group exhibited superior 1-month outcomes in terms of pain control, device independence, and ambulation (P < 0.05), but there were similar complication profiles between the groups. Conclusions Compared with the posterolateral approach, DAA enhances early recovery outcomes in THA among elderly patients with femoral neck fractures undergoing ERAS protocols. DAA demonstrated superior short-term functional gains and similar long-term outcomes compared with the posterolateral approach. These findings support the strategic use of DAA for optimizing early recovery for this patient population.

Indexed as

Arthroplasty, Replacement, HipFemoral Neck FracturesPropensity ScoreRecovery of FunctionAgedAged, 80 and overCohort StudiesFemaleHumansLength of StayMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesTreatment OutcomeDirect anterior approachEnhanced recovery after surgeryFemoral neck fracturesPropensity score matchingTotal hip arthroplasty

Identifiers

PMID40410877
PMCPMC12102940

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.