Anterolateral Minimally Invasive Total Hip Arthroplasty: Pitfalls During the Learning Curve and Clinical Outcomes.

Introduction:To report outcomes and complications from a modified anterolateral minimal invasive surgery (ALMIS) approach for total hip arthroplasty (THA). Patients and methods: All patients undergoing THA through ALMIS approach during a seven-year period were retrospectively evaluated. Results:One hundred fifty-four patients with a mean follow-up of 4.6 years were studied. The mean Harris hip score was found to be 91.1. A number of complications were recorded, including two cases (1.3%) of greater avulsion trochanter, one case (0.6%) of femur fractures, 12 (7.8%) cases of Trendelenburg sign and 12 cases of heterotopic ossification. Conclusions: This approach offers good visualization during acetabulum and femur preparation and excellent clinical results during mid-term follow-up.

The Effect of Quarantine Due to COVID-19 Pandemic in Surgically Treated Fractures in Greece: a Two-Center Study.

Objectives: Many countries have implemented quarantines to control the Coronavirus (COVID-19) pandemic spread. The quarantine effects on surgically-treated fractures, operated during this period (March 9th - May 4th) in two public Greek institutions, the "Venizeleion" General Hospital of Crete (VGH) and the "251" Hellenic Air Force General Hospital of Athens ("251" HAFGH) were evaluated and compared with those of the same period of 2019. Materials and methods: This is a retrospective study of a prospectively collected database. Evaluated data included gender, age, and trauma mechanism. Outcomes: A total of 103 patients who had suffered fractures were surgically treated in both institutions during the quarantine period of 2020 compared to 179 during the same period of 2019, showing a reduction of 43% in surgical cases. The mean age of patients treated in 2020 was 72.2 (SD=19.9), as compared to 65.3 (SD=21.5; p-value=0.008) in 2019. There were 70 (68%) elderly patients (>65 years) in 2020 and 103 (57.6%) in 2019. Of all treated fractures, 31% were caused by high energy mechanisms during the explored period of 2020, as compared to 45% in 2019 (p-value=0.019). Conclusions: This is the first study in Europe evaluating the effect of COVID-19 quarantine on surgically treated fractures. The findings showed a significant decline in surgically treated fractures, particularly high-energy fractures, along with a significantly higher mean age of patients in 2020 compared to 2019. Low-energy fractures in elderly during quarantine emphasizes the need of prevention measures to minimize their incidence, especially in a time when the health personnel and resources are engaged in the battle against COVID-19.