A new approach to hip surgery in the elderly

Femoral neck fractures, often caused by falls, pose a significant challenge for elderly individuals, impacting their mobility and autonomy. Total hip arthroplasty (THA), involving the replacement of the damaged hip joint with a prosthesis, is currently the gold standard treatment. However, this surgery is risky for this fragile population, with a high rate of postoperative complications and prolonged recovery, emphasizing the importance of identifying less invasive techniques to promote faster recovery and reduce risks.

This study was initiated to evaluate the efficacy and safety of a new surgical approach, SuperPATH (Supercapsular Percutaneously Assisted Total Hip Arthroplasty), for hip surgery in elderly patients with femoral neck fractures.

SuperPATH: a promising alternative for elderly patients?

This meta-analysis is based on data from 26 studies involving a total of 2,236 patients who underwent hip arthroplasty for femoral neck fractures. Two surgical approaches were compared:

• The SuperPATH approach, a percutaneous supercapsular technique that preserves surrounding musculature and limits incisions.
• A standard posterior approach, a more invasive method requiring the opening of the joint capsule and external rotator muscles.

The primary evaluation criteria for these two approaches were: operative time, blood loss, incision length, length of hospital stay, hip function evaluation (Harris score), and visual analog scale (VAS) pain score.

The study’s results indicated that:

• The SuperPATH approach significantly reduces intraoperative blood loss, incision length, hospital stay, and improves Harris scores compared to the standard posterior approach.
• Although operative time is longer with the SuperPATH approach, this difference is not correlated with a significant increase in postoperative complications.
• Patients in the SuperPATH group reported less postoperative pain than those in the standard group, particularly one week and three months after surgery.

SuperPATH: a preferred approach for the elderly

This meta-analysis suggests that the SuperPATH approach is a promising alternative for hip surgery in elderly patients with femoral neck fractures. By minimizing surgical trauma, this technique reduces postoperative complications, accelerates recovery, and decreases pain, although it requires slightly longer operative time. These findings highlight the importance of developing approaches tailored to elderly patients, for whom preserving autonomy and achieving a swift recovery are essential. Further research will help confirm these results and optimize postoperative rehabilitation protocols to broaden the application of the SuperPATH technique in various clinical settings.