Internal Fixation Versus Hip Replacement in Older Adults with a Garden I/II Femoral Neck Fracture: Physical Function and Pain in Elderly Patients - a Substudy of the Hipsther Trial

What this Trial Is About

Researchers are evaluating the impact of two surgical treatments—internal fixation versus hip arthroplasty—on physical function and pain in elderly patients aged 75 and older who have an undisplaced or minimally displaced femoral neck fracture (Garden I or II). This substudy is part of a larger ongoing nationwide randomized controlled trial called HipSTHeR, aiming to recruit 340 patients eligible for either surgical option. The goal is to understand differences in recovery related to these two treatments over time. Participants are randomly assigned to receive either internal fixation, which involves using screws, pins, or similar devices, or hip arthroplasty, which includes cemented total or hemiarthroplasty. The specific type of arthroplasty or osteosynthesis is determined by the surgeon. After surgery, patients included in this substudy are contacted a few weeks later by letter and telephone to provide consent and participate in follow-ups conducted at 4 and 12 months via phone and mail. During follow-ups, participants answer questions about their functional abilities and pain. Researchers evaluate outcomes using the New Mobility Score as the primary measure, assessing indoor and outdoor walking and shopping ability. Additional assessments include the WOMAC scale for hip-specific symptoms, the Katz ADL index for daily living activities, cognitive status using ALFI-MMSE, depression symptoms with the Geriatric Depression Scale (GDS-15), and morale using the Philadelphia Geriatric Center Morale Scale (PGCMS). Data on fracture and treatment are collected from national registries, and the study will continue until 2027, monitoring outcomes at specified intervals.

Functional Outcome After ORIF or Arthroplasty for Femoral Neck Fracture