100 elderly patients with fresh femoral neck fractures (Garden Grade III-IV) were randomized to receive a hemi-arthroplasty via a SuperPath approach (with the associated prostheses) or a traditional posterior approach. Outcomes of interest included pain on a Visual Analog Scale (VAS), the Harris Hip Score and the Barthel Index. Peri-operative outcomes were additionally reported. Follow up was performed at 1 week, 3 months and 2 years post-operation. Results revealed significantly favourable VAS pain scores, Harris Hip Scores and Barthel Index scores at 1 week in the SuperPath group compared to the posterior approach group. Furthermore, Barthel Index scores at 3 months were significantly in favour of the SuperPath group. Peri-operatively, blood loss, transfusion rate, incision length and the days until weight bearing were all significantly in favour of the SuperPath group.