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Study of surgical approach in hip fracture

Project managers
Postdoctoral fellow
PhD fellow


The most common operation for hip fractures is to replace the entire hip socket with a cemented hemiprosthesis. After such an injury and operation, there are many patients who never achieve the same level of function as before the injury, and this is a great burden for the patients, but also for their relatives and for the nursing and care sector.

A new surgical method, the so-called SPAIRE approach, preserves many of the anatomical structures that are usually cut during a hemiprosthetic operation.

In the randomized controlled HIFSAT study, it will be investigated whether patients operated with the SPAIRE method have better function and mobility after surgery, compared to patients who are operated with the current standard method (so-called lateral access). This can have an impact on hip fracture treatment both nationally and internationally.


Patients over the age of 50, who are admitted to a teaching hospital with an acute femoral neck fracture, will be eligible for participation. The researchers plan to include 406 patients. The inclusion started on 30 April 2024.  

Half of the study patients will be randomized to surgery with a SPAIRE approach and half will be operated with a lateral approach. The patients are to be checked 4, 12 and 24 months after the operation, to measure function and pain.  

The patients are included on bed rest before the operation.

Patients who cannot come to an outpatient check-up must be checked at an institution or at home.


In HIFSAT (The Hip Fracture Surgical Approach Trial), the standard surgical approach (Direct Lateral Approach, where one loosens the gluteus medius to enter the hip joint) is compared with a new muscle-saving posterior approach, SPAIRE (Saving Piriformis and Internus, Repair Eksternus).

The study is a collaborative project with Ahus and Ullevål, OUS.

The study can potentially improve function and pain in a very vulnerable patient group, and the study could also be of great importance internationally.

The main outcome measure is the Harris Hip score, after 4 months, which measures both function and pain in patients who have undergone hip surgery.

In the study, the researchers will also investigate a number of other outcome measures, such as quality of life, length of hospital stay and prosthesis placement etc.