Femoral Neck Fractures, Hemiarthroplasty, Hip Fractures
Conditions
Keywords
Lateral Hemiarthroplasty, Posterior Hemiarthroplasty, Surgical Approach, Functional Outcome, Harris Hip Score, Parker and Palmer Mobility Score
Brief summary
This prospective, single-center, randomized clinical trial compared the clinical and functional outcomes of hemiarthroplasty performed via lateral versus posterior surgical approaches in elderly patients with displaced intracapsular femoral neck fractures. The primary objective was to compare prosthetic dislocation and intraoperative femoral fracture rates between the two approaches. Secondary outcomes included functional scores, radiological parameters, complications, and mortality.
Detailed description
This study is a prospective, single-center, randomized clinical trial designed to compare the clinical, functional, and radiological outcomes of hemiarthroplasty performed via lateral and posterior surgical approaches in elderly patients with displaced intracapsular femoral neck fractures. Between March 2016 and June 2019, eligible patients were randomized in a 1:1 ratio to undergo hemiarthroplasty using either the lateral or posterior approach. Randomization was performed using a computer-generated sequence. All procedures were performed or supervised by experienced orthopedic surgeons following standardized surgical and postoperative protocols. Clinical parameters, perioperative data, and radiological indices including cortical index, Singh index, and Dorr classification were recorded. Functional outcomes were assessed using the Parker and Palmer Mobility Score (PPMS) and the Harris Hip Score (HHS). Patients were followed for a minimum of 12 months. The primary outcome measure was the prosthetic dislocation rate within 12 months postoperatively. Secondary outcomes included intraoperative periprosthetic femoral fracture rate, functional scores, complications, and mortality. The study was conducted in accordance with the principles of the Declaration of Helsinki, with approval obtained from the local ethics committee, and written informed consent was obtained from all participants or their legal representatives.
Interventions
PROCEDUREPosterior approach hemiarthroplasty
Hemiarthroplasty performed using the posterior surgical approach.
PROCEDURELateral approach hemiarthroplasty
Hemiarthroplasty performed using the lateral surgical approach.
Sponsors
Umraniye Education and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
This study was conducted as an open-label trial. Due to the nature of the surgical interventions, blinding of surgeons and participants was not feasible.
Intervention model description
Participants were randomly assigned in a 1:1 ratio to one of two parallel groups to undergo hemiarthroplasty using either the lateral or the posterior surgical approach. Each participant received only the assigned intervention.
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 60 years or older * Displaced intracapsular femoral neck fracture * Treated with hemiarthroplasty * Ability to provide informed consent by the patient or a legal representative
Exclusion criteria
* Pathological femoral neck fractures * Previous surgery on the affected hip * Polytrauma patients * Periprosthetic fractures
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Prosthetic dislocation rate | Within 12 months postoperatively | Incidence of postoperative prosthetic hip dislocation following hemiarthroplasty. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intraoperative periprosthetic femoral fracture rate | During surgery | Incidence of intraoperative femoral fractures occurring during hemiarthroplasty. |
| Harris Hip Score (HHS) | Preoperative baseline and final follow-up at minimum 12 months postoperatively | The Harris Hip Score is a clinician-based outcome measure ranging from 0 to 100 points, where higher scores indicate better hip function. |
| Parker and Palmer Mobility Score (PPMS) change | Preoperative baseline and final follow-up at minimum 12 months postoperatively | The Parker and Palmer Mobility Score is a validated mobility assessment scale ranging from 0 to 9 points, where higher scores indicate better mobility. |
| One-year mortality | Within 12 months postoperatively | All-cause mortality within one year after surgery. |
Countries
Turkey (Türkiye)
Outcome results
None listed