Clinical and Functional Outcomes of Lateral vs Posterior Hemiarthroplasty

Lower Dislocation But Higher Fracture Risk: Posterior vs. Lateral Approaches in Hemiarthroplasty for Femoral Neck Fractures

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.

Study Overview

• Status: Completed
• Conditions: Hemiarthroplasty; Hip Fractures; Femoral Neck Fractures
• Intervention / Treatment: Procedure: Lateral approach hemiarthroplasty; Procedure: Posterior approach hemiarthroplasty

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.

• Study Type: Interventional
• Enrollment (Actual): 225
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Umraniye
    • Istanbul, Umraniye, Turkey (Türkiye), 34764
      • Ümraniye Training and Research Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Lateral Approach Group; Patients underwent hemiarthroplasty using the direct lateral surgical approach.	Procedure: Lateral approach hemiarthroplasty; Hemiarthroplasty performed using the lateral surgical approach.
Experimental: Posterior Approach Group; Patients underwent hemiarthroplasty using the posterior surgical approach.	Procedure: Posterior approach hemiarthroplasty; Hemiarthroplasty performed using the posterior surgical approach.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Prosthetic dislocation rate	Incidence of postoperative prosthetic hip dislocation following hemiarthroplasty.	Within 12 months postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intraoperative periprosthetic femoral fracture rate	Incidence of intraoperative femoral fractures occurring during hemiarthroplasty.	During surgery
Harris Hip Score (HHS)	The Harris Hip Score is a clinician-based outcome measure ranging from 0 to 100 points, where higher scores indicate better hip function.	Preoperative baseline and final follow-up at minimum 12 months postoperatively
Parker and Palmer Mobility Score (PPMS) change	The Parker and Palmer Mobility Score is a validated mobility assessment scale ranging from 0 to 9 points, where higher scores indicate better mobility.	Preoperative baseline and final follow-up at minimum 12 months postoperatively
One-year mortality	All-cause mortality within one year after surgery.	Within 12 months postoperatively

Collaborators and Investigators

• Sponsor: Umraniye Education and Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2016
• Primary Completion (Actual): March 30, 2019
• Study Completion (Actual): March 30, 2019

Study Registration Dates

• First Submitted: December 23, 2025
• First Submitted That Met QC Criteria: January 8, 2026
• First Posted (Actual): January 15, 2026

Study Record Updates

• Last Update Posted (Actual): January 15, 2026
• Last Update Submitted That Met QC Criteria: January 8, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: Functional Outcome; Harris Hip Score; Lateral Hemiarthroplasty; Posterior Hemiarthroplasty; Surgical Approach; Parker and Palmer Mobility Score
• Additional Relevant MeSH Terms: Wounds and Injuries; Leg Injuries; Fractures, Bone; Femoral Fractures; Hip Injuries; Hip Fractures; Femoral Neck Fractures
• Other Study ID Numbers: B.10.1.TKH.4.34.H.GP.0.01/91

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No