565 The SPAIRE Technique for Hip Hemiarthroplasty - an Alternative Approach to the Hip

Abstract

Abstract Aim Over 20,000 hip hemiarthroplasties for hip fractures are performed annually in the UK. NICE currently recommends performing these via the anterolateral approach, to reduce the risk of dislocation, with the potential expense of reducing function and mobility post-operatively. To address these issues, muscle-sparing approaches have been utilised and "SPAIRE" (Sparing Piriformis and Internus Repairing Externus) is one of them. Method Retrospective analysis of prospectively collected data over a 10-month period was performed at a single centre. All hip fracture patients who had hip hemiarthroplasty as their primary treatment were included. We collected demographic data, pre- and post- operative mobility status, and time to reach that, surgical approach, duration of surgery and complications. Our primary outcome was the dislocation rate and secondary outcomes were post-operative time to mobilisation and duration of surgery. Results Between October 2021 and August 2022, we identified 194 cases, divided into three groups based on the surgical approach used: SPAIRE = 43, Anterolateral = 97, Posterior = 54. All groups had similar demographics and a minimum two-month follow-up. There were no dislocations in the SPAIRE group, compared to 2 (2%) in the Anterolateral and 2 (3.7%) in the Posterior groups. The mean return to mobility was 1.4 days for "SPAIRE" patients, compared to 2 and 2.6 days for patients in other groups. All three groups had similar mean surgical times (74min, 79min, and 71min respectively). Conclusions The "SPAIRE" approach seems to be lowering the risk of dislocation, and reducing the time to mobilisation, potentially improving function for patients undergoing hip hemiarthroplasty.