{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T13:25:34Z","timestamp":1766064334608,"version":"3.48.0"},"reference-count":26,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ActaO"],"abstract":"<jats:p>Background and purpose:\u00a0The 2 most common surgical approaches in hemiarthroplasty for hip fracture treatment are the posterolateral and the direct lateral approach. We aimed to estimate the relative cost-effectiveness of these approaches.Methods:\u00a0We conducted an economic evaluation alongside a randomized controlled superiority trial for 6 months. The trial included 555 patients over 18 years of age with an acute femoral neck fracture. The effectiveness outcome used was quality-adjusted life years (QALYs), assessed using the EQ-5D-5L. Costs were measured through self-reported questionnaires administered at baseline, after 3 months, and after 6 months. We dealt with missing data through multiple imputation and analyzed the imputed datasets by comparing group means in costs and QALYs. A secondary analysis included adjustment for baseline imbalances through linear regression.Results:\u00a0The estimated average treatment effect on the QALYs was 0.02 (95% confidence interval [CI] \u20130.006 to 0.046). From the healthcare and societal perspective, we found a non-significant average treatment effect on costs of 1,508 (CI \u20131,744 to 4,760) and 1,583 (CI \u20131,972 to 5,137), respectively. The probability of cost-effectiveness was 10% at a willingness-to-pay of zero, and then slowly increased to around 50% for higher willingness-to-pay values.Conclusion:\u00a0We found no conclusive evidence of any differences between the surgical approaches with respect to costs, QALYs, and cost-effectiveness. We therefore suggest that, from an economic viewpoint, the 2 surgical approaches should be treated as interchangeable.<\/jats:p>","DOI":"10.2340\/17453674.2025.45056","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T13:22:07Z","timestamp":1766064127000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparing the posterolateral and the direct lateral approach for cemented hemiarthroplasty after femoral neck fracture: a cost-effectiveness analysis"],"prefix":"10.2340","volume":"96","author":[{"given":"Jonas L","family":"Esser","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria C J M","family":"Tol","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nienke W","family":"Willigenburg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1257-3012","authenticated-orcid":false,"given":"Ariena J","family":"Rasker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5805-3138","authenticated-orcid":false,"given":"Taco","family":"Gosens","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3975-6337","authenticated-orcid":false,"given":"Martijn G M","family":"Schotanus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3166-6951","authenticated-orcid":false,"given":"Hanna C","family":"Willems","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin J","family":"Heetveld","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J Carel","family":"Goslings","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna M","family":"Van Dongen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3178-2247","authenticated-orcid":false,"given":"Rudolf W","family":"Poolman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2025,12,18]]},"reference":[{"key":"136526","doi-asserted-by":"crossref","unstructured":"Sing C W, Lin T C, Bartholomew S, Bell J S, Bennett C, Beyene K, et al. Global epidemiology of hip fractures: secular trends in incidence rate, post-fracture treatment, and all-cause mortality. J Bone Miner Res 2023; 38(8): 1064-75. doi: 10.1002\/jbmr.4821.","DOI":"10.1002\/jbmr.4821"},{"key":"136527","doi-asserted-by":"crossref","unstructured":"Kanters T, Van De Ree C, De Jongh M, Gosens T, Hakkaart-van Roijen L. Burden of illness of hip fractures in elderly Dutch patients. Arch Osteoporos 2020; 15(1): 1-7. doi: 10.1007\/s11657-019-0678-y","DOI":"10.1007\/s11657-019-0678-y"},{"key":"136528","doi-asserted-by":"crossref","unstructured":"Williamson S, Landeiro F, McConnell T, Fulford-Smith L, Javaid MK, Judge A, et al. Costs of fragility hip fractures globally: a systematic review and meta-regression analysis. Osteoporos Int 2017; 28(10): 2791-800. doi: 10.1007\/s00198-017-4153-6.","DOI":"10.1007\/s00198-017-4153-6"},{"key":"136529","doi-asserted-by":"crossref","unstructured":"Burgers P, Hoogendoorn M, Van Woensel E, Poolman R, Bhandari M, Patka P, et al. Total medical costs of treating femoral neck fracture patients with hemi- or total hip arthroplasty: a cost analysis of a multicenter prospective study. Osteoporos Int 2016; 27(6): 1999-2008. doi: 10.1007\/s00198-016-3484-z.","DOI":"10.1007\/s00198-016-3484-z"},{"key":"136530","doi-asserted-by":"crossref","unstructured":"Chechik O, Khashan M, Lador R, Salai M, Amar E. Surgical approach and prosthesis fixation in hip arthroplasty world wide. Arch Orthop Trauma Surg 2013; 133(11): 1595-600. doi: 10.1007\/s00402-013-1828-0.","DOI":"10.1007\/s00402-013-1828-0"},{"key":"136531","doi-asserted-by":"crossref","unstructured":"Kristensen T B, Vinje T, Havelin L I, Enges\u00e6ter L B, Gjertsen J-E. Posterior approach compared to direct lateral approach resulted in better patient-reported outcome after hemiarthroplasty for femoral neck fracture: 20,908 patients from the Norwegian hip fracture register. Acta Orthop 2017; 88(1): 29-34. doi: 10.1080\/17453674.2016.1251566.","DOI":"10.1080\/17453674.2016.1250480"},{"key":"136532","doi-asserted-by":"crossref","unstructured":"Leonardsson O, Rolfson O, Rogmark C. The surgical approach for hemiarthroplasty does not influence patient-reported outcome: a national survey of 2118 patients with one-year follow-up. Bone Joint J 2016; 98(4): 542-7. doi: 10.1302\/0301-620X.98B4.35612.","DOI":"10.1302\/0301-620X.98B4.36626"},{"key":"136533","doi-asserted-by":"crossref","unstructured":"Tol M C, van Beers L W, Willigenburg N W, Gosens T, Heetveld M J, Willems H C, et al. Posterolateral or direct lateral approach for hemiarthroplasty after femoral neck fractures: a systematic review. Hip Int 2021; 31(2): 154-65. doi: 10.1177\/1120700021999152.","DOI":"10.1177\/1120700020931766"},{"key":"136534","doi-asserted-by":"crossref","unstructured":"van der Sijp M P L, van Delft D, Krijnen P, Niggebrugge A H P, Schipper I B. Surgical approaches and hemiarthroplasty outcomes for femoral neck fractures: a meta-analysis. J Arthroplasty 2018; 33(5): 1617-27. e9 doi: 10.1016\/j.arth.2018.06.002.","DOI":"10.1016\/j.arth.2017.12.029"},{"key":"136535","doi-asserted-by":"crossref","unstructured":"Tol M C, Willigenburg N W, Rasker A J, Willems H C, Gosens T, Heetveld M J, et al. Posterolateral or direct lateral surgical approach for hemiarthroplasty after a hip fracture: a randomized clinical trial alongside a natural experiment. JAMA Network Open 2024; 7(1): e2350765-e. doi: 10.1001\/jamanetworkopen.2023.50765.","DOI":"10.1001\/jamanetworkopen.2023.50765"},{"key":"136536","doi-asserted-by":"crossref","unstructured":"Tiihonen R, Alaranta R, Helkamaa T, Nurmi-L\u00fcthje I, Kaukonen J-P, L\u00fcthje P. A 10-year retrospective study of 490 hip fracture patients: reoperations, direct medical costs, and survival. 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