Electronic Thesis and Dissertation Repository

Thesis Format



Master of Science


Health and Rehabilitation Sciences


Hunter, Susan


This thesis evaluated the functional and psychological outcomes in older adults with a periprosthetic femoral fracture (PPF) after total hip arthroplasty. The first study was a retrospective chart review of 130 people who had PPF surgery to evaluate the functional and psychological outcomes and mortality rate at one-year post-PPF surgery. The second study assessed falls, mobility, balance, and lower extremity strength in ten people at 6-months to 4-years after PPF surgery. In Study 1, people had low scores on function and psychological well-being and the one-year mortality was 15.4%. Participants in Study 2 demonstrated slower gait, reduced mobility, balance and leg strength compared to age and sex-matched normative values, social isolation, a lack of falls awareness and a falls occurrence of 50.0%. These indicate that the evaluation of rehabilitation protocols for functional and psychological recovery is warranted to achieve better outcomes in this population.

Summary for Lay Audience

A fall in an older adult after hip replacement surgery can cause a fracture around the new hip. These fractures usually require surgery to fix and few studies have evaluated the physical and mental health of patients after successful repair of the fracture. Importantly, no research has looked at new falls and awareness of falls prevention after the repair surgery. The purpose of these two studies was to increase our understanding of the physical and mental health outcomes of older adults after their fracture repair surgery. In the first study, medical charts of 130 people were reviewed to evaluate the physical and mental health status and the number of people who died at one-year after the surgery for the fracture. In the second study, ten people with this kind of fracture were assessed for falls occurrences and knowledge of falls. In addition, walking speed, mobility, balance, and leg strength were evaluated at 6-months to 4-years after the surgery for the fracture. We found poor physical and mental health at one-year after their repair surgery. We found 15.4% of people who had the surgery to repair the fracture had died in the first year. People in Study 2 walked slower and had reduced leg strength, balance, and mobility compared to healthy older adults and reported social isolation after their repair surgery. Half of the people fell after their repair surgery for the fracture and lacked the knowledge to prevent falls. Our findings demonstrate that the evaluation of the rehabilitation protocols is needed to ensure better mental and physical health status in older adults after this fracture.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.