Surgical Approach of Hemiarthroplasty After Femoral Neck Fracture: Posterolateral or Direct Lateral

NCT ID: NCT04438226

Last Updated: 2022-12-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

555 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-12-01

Study Completion Date

2022-07-07

Brief Summary

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Rationale: In the Netherlands the two main surgical approaches for hemiarthroplasty are the posterolateral and the direct lateral approach. Currently there is no conclusive evidence which of these two approaches results in better patient outcomes.

Objective: Assessing the patient outcome comparing the posterolateral with the direct lateral approach in patients being treated with cemented hemiarthroplasty after femoral neck fractures.

Study design: A randomised controlled multi-center superiority trial and natural experiment with an economic evaluation alongside.

Study population: All patients older than 18 years with a femoral neck fracture whereby treatment with cemented hemiarthroplasty is recommended according the national guidelines.

Intervention: Treatment with cemented hemiarthroplasty using the posterolateral approach.

Standard intervention to be compared to: Treatment with cemented hemiarthroplasty using the direct lateral approach.

Main study parameters/endpoints: The primary outcome is the patient-rated quality of life (EQ-5D-5L) at 6 months after surgery.

Secondary outcomes are: ADL functionality (KATZ), Balance test (SPPB), Tendency to Fall (FES-I), Pain (NRS), Re-interventions, Mobility, Discharge destination, Complications, and cost-effectiveness.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness: The different approaches in the two treatment arms of the randomised controlled trial are widely used techniques in the Netherlands and many of the outcome measures are part of the standard clinical follow-up after hip fracture. Therefore, there is no extra risk or burden for participating patients, except for the time to complete some additional follow-up measurements. The primary outcome measurement and secondary outcomes, will be assessed through questionnaires online, by hardcopy or by phone at baseline, 4 weeks, 3 and 6 months postoperatively. The assessment of the Short Physical Performance Battery (SPPB) balance test, will be performed by one of the study researchers or nurse practitioner to protect continuity and feasibility.

Detailed Description

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Conditions

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Hip Fractures Surgical Approach Hemiarthroplasty Posterolateral Direct Lateral

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Posterolateral

Patients treated with a hemiarthroplasty using the posterolateral approach

Group Type EXPERIMENTAL

Surgical approach

Intervention Type PROCEDURE

The surgical approach of hemiarthroplasty after femoral neck fracture

Direct lateral

Patients treated with a hemiarthroplasty using the direct lateral approach

Group Type EXPERIMENTAL

Surgical approach

Intervention Type PROCEDURE

The surgical approach of hemiarthroplasty after femoral neck fracture

Interventions

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Surgical approach

The surgical approach of hemiarthroplasty after femoral neck fracture

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* ≥ 18 years at time of trauma
* Acute hip fracture
* Hemiarthroplasty as recommended treatment according the national guidelines
* Dutch or English fluency and literacy
* Informed consent or by proxy in patients with mental impairment

Exclusion Criteria

* Multi-trauma-patient (ISS \> 15)
* Secondary surgery after failed internal fixation
* Patients with a known metastatic disease and a confirmed pathological fracture of the hip
* Fracture \> 7 days at time of surgery
* High risk of non-compliance/adherence to study procedures (e.g. no Dutch residency during follow-up period, or other factors that impair follow-up data collection)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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JointResearch

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Onze Lieve Vrouwe Gasthuis

Amsterdam, North Holland, Netherlands

Site Status

Countries

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Netherlands

References

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Tol MCJM, Willigenburg NW, Rasker AJ, Willems HC, Gosens T, Heetveld MJ, Schotanus MGM, Eggen B, Kormos M, van der Pas SL, van der Vaart AW, Goslings JC, Poolman RW; APOLLO Research Group. Posterolateral or Direct Lateral Surgical Approach for Hemiarthroplasty After a Hip Fracture: A Randomized Clinical Trial Alongside a Natural Experiment. JAMA Netw Open. 2024 Jan 2;7(1):e2350765. doi: 10.1001/jamanetworkopen.2023.50765.

Reference Type DERIVED
PMID: 38206628 (View on PubMed)

Other Identifiers

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NL63378.100.17

Identifier Type: -

Identifier Source: org_study_id