Biomarkers of muscle damage increased in anterolateral compared to direct lateral approach to the hip in hemiarthroplasty: no correlation with clinical outcome

• Published in: Osteoporosis international 2018-08, Vol.29 (8), p.1853-1860
• Main Authors: Ugland, T O, Haugeberg, G, Svenningsen, S, Ugland, S H, Berg, Ø H, Pripp, A H, Nordsletten, L
• Format: Article
• Language: English
• Subjects: Biomarkers; Clinical outcomes; Correlation analysis; Creatine; Creatine kinase; Femur; Fractures; Hip; Pain; Patient satisfaction
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-018-4557-y

SummaryIn this study, we found elevated levels of serum CK in the anterolateral approach to the hip compared to the direct lateral approach in patients with a displaced femoral neck fracture. No correlation was found between levels of CK and functional outcomes.IntroductionTo compare increase in serum creatine kinase (CK) and its association with functional outcome between the muscle-sparing anterolateral approach and the direct lateral approach to the hip in patients with displaced femoral neck fracture (FNF).MethodsIn this randomized trial, we enrolled eligible patients between 70 and 90 years of age with FNF. Patients were allocated to an uncemented hemiarthroplasty inserted through a direct lateral or an anterolateral approach. The primary endpoints were pain and patient satisfaction assessed by the Visual Analogue Scale (VAS). Among secondary endpoints was increase in CK at 24 and 48 h compared to baseline and its association with surgical parameters, Timed up and Go Test (TUG), Harris Hip Score (HHS), and the presence of a Trendelenburg sign using correlation analysis. This paper reports on increase in serum CK and its association with functional outcome.ResultsAt 24 h, there was a mean increase from baseline in total CK of 228 U/L (95% CI 187 to 269; P