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Undisplaced FractureSENSENCT04075461

Arthroplasty Versus Internal Fixation for Undisplaced Femoral Neck Fracture

A study testing Arthroplasty and Internal fixation in people with Undisplaced Fracture and Femoral Neck Fractures, run by University of Southern Denmark at 19 sites in Denmark.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is the world's first national orthopedic randomized controlled trial (RCT) involving 19 out of 21 departments in Denmark. Each year, 7,000 patients suffer a hip fracture. This is a severe condition leading to 25% mortality after 1 year and 40% do not recover to the same functional level. Read more about this study

Who is it for?
Ages 65 years and older
What is being tested?
Arthroplasty and Internal fixation
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
330 participants
Where
19 sitesDenmark
Study dates
1 Feb 2020to 26 Jan 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 65 years and older
  • All sexes
  • No healthy volunteers
  • Older adult

Who may be able to join

  • Age ≥ 65 years old
  • Undisplaced femoral neck fracture
  • Posterior tilt (18) less than 20 degrees
  • NMS (13) = 5 and above, indicating an ability to walk
  • Cognitive intact in order to achieve informed consent

Who cannot join

  • The fracture is pathological
  • The patient does not speak Danish

Trial locations and contacts

19 sites in 1 country.

19 sites in 1 country

Denmark19 sites
  • Hospital of Southern Jutland

    Aabenraa

  • Aalborg University Hospital

    Aalborg

  • Aarhus University Hospital

    Aarhus

  • Bispebjerg Hospital

    Copenhagen

  • Herlev Hospital

    Copenhagen

  • Hvidovre Hospital

    Copenhagen

  • Regional Hospital West Jutland

    Gødstrup

  • Hospital of North Zealand

    Hillerød

  • North Denmark Regional Hospital

    Hjørring

  • Holbæk Hospital

    Holbæk

  • Randers Regional Hospital

    Horsens

  • Zealand University Hospital

    Køge

  • Lillebaelt Hospital

    Kolding, 6000

  • Nykøbing Falster Hospital

    Nykøbing Falster

  • Odense University Hospital

    Odense

  • Randers Regional Hospital

    Randers

  • Bornholm Hospital

    Rønne

  • Slagelse Hospital

    Slagelse, 4200

  • Viborg Regional Hospital

    Viborg

Other trials in Denmark

About this study

Official title: Is arthroplaSty bEtter Than interNal Fixation in the undiSplaced Femoral nEck Fracture? A National Pragmatical Randomized Controlled Trial - the SENSE Trial

This is the world's first national orthopedic randomized controlled trial (RCT) involving 19 out of 21 departments in Denmark. Each year, 7,000 patients suffer a hip fracture. This is a severe condition leading to 25% mortality after 1 year and 40% do not recover to the same functional level. The aim is to compare two surgical treatment methods (metal fixation versus artificial hip) in patients above 65 years with an undisplaced femoral neck fracture. The hypothesis is that even though an artificial hip is a larger surgical procedure than metal fixation of the broken bone, the artificial hip is more stable with less pain due the lack of a healing broken bone and therefore leads to a better and quicker mobilization after surgery. Better mobilization is one of the most important factors for decreasing mortality. We have chosen a pragmatic RCT design by using the local departmental implants. We hope that the knowledge from this study will therefore easily be implemented afterwards.

Read the detailed description

This is the world's first national orthopedic randomized controlled trial (RCT) involving 20 out of 21 departments in Denmark. The aim is to compare two surgical treatment methods (internal fixation (IF) versus arthroplasty) in patients above 65 years with an undisplaced femoral neck fracture (FNF).

Each year, 7,000 patients suffer a hip fracture. This is a severe condition leading to 25% mortality after 1 year and 40% do not recover to the same functional level. Undisplaced FNF is treated with internal fixation in order to aid in fracture healing. However, approximately 10% in Denmark will suffer a reoperation and two RCT's have demonstrated 20-21% reoperations. In comparison, the reoperation frequency was 5-7% for arthroplasty that also demonstrated slightly faster mobilization which is one of the most important factors for decreasing mortality. The hypothesis is therefore that even though arthroplasty is a larger surgery they benefit from the lack of fracture healing, less pain and faster mobilization.

Patients are included in the emergency department and are electronically randomized to either IF or arthroplasty before the surgery. The design is a pragmatic RCT using the implants which are available in the departments. Furthermore, the postoperative treatment protocol is "business as usual" thereby investigating the precise effect of the intervention in real clinical conditions. In addition to a great external validity this allows for easy implemented after study results. The primary outcome is a validated functional score 1 year after surgery and the sample size is calculated to 330 patients. Secondary outcome measures are additional functional assessments and questionnaires, health related quality of life and pain assessment.

We have set up a steering committee consisting of researchers and senior surgeons with a representative from each region. In addition, all but 1 hospital has a representative in project group. The project is therefore anchored in the entire Denmark.

Being tested
Arthroplasty, Internal fixation
Medical subject headings
Femoral Neck Fractures

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • ArthroplastyProcedure or surgery

    Arthroplasty is commonly used for a displaced femoral neck fracture.

  • Internal fixationProcedure or surgery

    Internal fixation is commonly used for undisplaced femoral neck fracture

Study groups in NCT04075461
Study groupRoleWhat they receive
Undisplaced FNF + ArthroplastyExperimentalArthroplasty is the typical surgery for a displaced femoral neck fracture
Receives: Procedure: Arthroplasty
Undisplaced FNF + Internal fixationActive comparatorInternal fixation is the typical surgery for an undisplaced femoral neck fracture
Receives: Procedure: Internal fixation

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. New Mobility Score (NMS)

    NMS score the level of function with a score from 0-9 points. The best score is 9 points.

    Measured: 12 months

Secondary outcomes (6)
  1. EuroQol 5 domain 5 level (EQ-5D-5L)

    Health related quality of life assessment with a score from 0-1 point. The best score is 1 point

    Measured: Admission, 3 months, 6 months and 12 months.

  2. Oxford Hip Score (OHS)

    Specific hip function questionnaire with a score from 0-48 points. The best score is 48 points.

    Measured: Admission, 3 months, 6 months and 12 months.

  3. Reoperation

    New surgery in relation to the primary surgery

    Measured: Within 1 year after surgery

  4. Mortality

    Mortality

    Measured: Within 1 year after surgery

  5. New Mobility Score (NMS)

    NMS score the level of function with a score from 0-9 points. The best score is 9 points.

    Measured: Admission, 3 and 6 months

  6. Pain Verbal Rating Scale (VRS)

    Patient reported outcome of pain assessment

    Measured: Admission, 2 and 6 weeks, 3, 6, and 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Aug 2019
  2. Study start1 Feb 2020
  3. Primary completion26 Jan 2024
  4. Study completion26 Jan 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
The study is designed as a national pragmatical RCT including all patients with an undisplaced FNF and a NMS score of 5 and above. The standard treatment in Denmark is internal fixation and the patients are randomized to arthroplasty or IF. The steering group have assessed the pragmatic attitude of the design and the study reaches 5 points in 7 of the 9 domains (Figure 1) (9). Reporting is performed accordingly to the extension of the CONSORT statements for pragmatical RCT (17). Using the PRECIS-2 we scored the study to 43 points out of 45 possible.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
330 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04075461
Sponsor's protocol ID
S-20180036
Acronym
SENSE
Status last verified
Mar 2025
First submitted
22 Aug 2019
Last updated
25 Mar 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Due to Danish regulation direct data sharing is not possible.

Publications

  • National Institute for Health and Care Excellence. Hip fracture: mangement. Clinical guideline [CG124]. National Institute for Health and Care Excellence; 2011, updated 2017.

  • Roberts KC, Brox WT, Jevsevar DS, Sevarino K. Management of hip fractures in the elderly. J Am Acad Orthop Surg. 2015 Feb;23(2):131-7. doi: 10.5435/JAAOS-D-14-00432.

    PubMed 25624365
  • Lu Q, Tang G, Zhao X, Guo S, Cai B, Li Q. Hemiarthroplasty versus internal fixation in super-aged patients with undisplaced femoral neck fractures: a 5-year follow-up of randomized controlled trial. Arch Orthop Trauma Surg. 2017 Jan;137(1):27-35. doi: 10.1007/s00402-016-2591-9. Epub 2016 Nov 11.

    PubMed 27837321
  • Dolatowski FC, Frihagen F, Bartels S, Opland V, Saltyte Benth J, Talsnes O, Hoelsbrekken SE, Utvag SE. Screw Fixation Versus Hemiarthroplasty for Nondisplaced Femoral Neck Fractures in Elderly Patients: A Multicenter Randomized Controlled Trial. J Bone Joint Surg Am. 2019 Jan 16;101(2):136-144. doi: 10.2106/JBJS.18.00316.

    PubMed 30653043
  • Wamper KE, Sierevelt IN, Poolman RW, Bhandari M, Haverkamp D. The Harris hip score: Do ceiling effects limit its usefulness in orthopedics? Acta Orthop. 2010 Dec;81(6):703-7. doi: 10.3109/17453674.2010.537808.

    PubMed 21110703
  • Gjertsen JE, Fevang JM, Matre K, Vinje T, Engesaeter LB. Clinical outcome after undisplaced femoral neck fractures. Acta Orthop. 2011 Jun;82(3):268-74. doi: 10.3109/17453674.2011.588857.

    PubMed 21619501
  • Zlowodzki M, Brink O, Switzer J, Wingerter S, Woodall J Jr, Petrisor BA, Kregor PJ, Bruinsma DR, Bhandari M. The effect of shortening and varus collapse of the femoral neck on function after fixation of intracapsular fracture of the hip: a multi-centre cohort study. J Bone Joint Surg Br. 2008 Nov;90(11):1487-94. doi: 10.1302/0301-620X.90B11.20582.

    PubMed 18978271
  • Sikand M, Wenn R, Moran CG. Mortality following surgery for undisplaced intracapsular hip fractures. Injury. 2004 Oct;35(10):1015-9. doi: 10.1016/j.injury.2004.01.004.

    PubMed 15351669
  • Loudon K, Treweek S, Sullivan F, Donnan P, Thorpe KE, Zwarenstein M. The PRECIS-2 tool: designing trials that are fit for purpose. BMJ. 2015 May 8;350:h2147. doi: 10.1136/bmj.h2147. No abstract available.

    PubMed 25956159
  • Kristensen PK, Thillemann TM, Soballe K, Johnsen SP. Are process performance measures associated with clinical outcomes among patients with hip fractures? A population-based cohort study. Int J Qual Health Care. 2016 Dec 1;28(6):698-708. doi: 10.1093/intqhc/mzw093.

    PubMed 27591269
  • de Morton NA, Harding KE, Taylor NF, Harrison G. Validity of the de Morton Mobility Index (DEMMI) for measuring the mobility of patients with hip fracture during rehabilitation. Disabil Rehabil. 2013 Feb;35(4):325-33. doi: 10.3109/09638288.2012.705220. Epub 2012 Aug 16.

    PubMed 22897700
  • de Morton NA, Berlowitz DJ, Keating JL. A systematic review of mobility instruments and their measurement properties for older acute medical patients. Health Qual Life Outcomes. 2008 Jun 5;6:44. doi: 10.1186/1477-7525-6-44.

    PubMed 18533045
  • Parker MJ, Palmer CR. A new mobility score for predicting mortality after hip fracture. J Bone Joint Surg Br. 1993 Sep;75(5):797-8. doi: 10.1302/0301-620X.75B5.8376443.

    PubMed 8376443
  • Kristensen MT, Foss NB, Kehlet H. [Timed Up and Go and New Mobility Score as predictors of function six months after hip fracture]. Ugeskr Laeger. 2005 Aug 29;167(35):3297-300. Danish.

    PubMed 16138973
  • Kristensen MT, Bandholm T, Foss NB, Ekdahl C, Kehlet H. High inter-tester reliability of the new mobility score in patients with hip fracture. J Rehabil Med. 2008 Jul;40(7):589-91. doi: 10.2340/16501977-0217.

    PubMed 18758678

Questions about this trial

What is this clinical trial studying?

A study testing Arthroplasty and Internal fixation in people with Undisplaced Fracture and Femoral Neck Fractures, run by University of Southern Denmark at 19 sites in Denmark.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 25 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 19 sites in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

New Mobility Score (NMS) (time frame: 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04075461, which also lists 23 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 Mar 2025.

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