A Randomized Trial to Assess Patient Quality of Life and Function After Alternative Surgeries for Pathologic Fractures of the Femur
A Randomized Trial to Assess Patient Quality of Life and Function After Alternative Surgeries for Pathologic Fractures of
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Michigan
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Grand Rapids, Michigan, United States, 49503
- Spectrum Health Medical Group
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New York
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New York, New York, United States, 10065
- Memorial Sloan Kettering Cancer Center 1275 York Avenue
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Rochester, New York, United States
- University of Rochester Medical Center
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Syracuse, New York, United States, 13210
- SUNY Upstate Medical University
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The Bronx, New York, United States, 10467
- Montefiore Medical Center
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North Carolina
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Durham, North Carolina, United States, 27708
- Duke University
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Surgeon's estimated survival ≥ 1 month
- Patients presenting for orthopaedic evaluation with a painful impending pathologic femur fracture or displaced pathologic femur fracture in the intertrochanteric, pertrochanteric, or subtrochanteric region of the proximal femur. The anatomic region of interest is defined by a line drawn from the base of the femoral neck to 5 cm below the base of the lesser trochanter or 2 diaphyseal shaft widths, whichever is greater.
- Patients with an impending fracture who have had bevacizumab are eligible provided there will be a 3-week window between their last infusion and surgery.
- Diagnosis of widespread visceral and/or osseous metastatic disease based on clinical and radiographic evidence. (Patients may continue on study if surgery shows a non-malignant process.)
- All cancer diagnoses, except lymphoma, will be eligible
Exclusion Criteria:
- Estimated survival <1 month
- A large soft tissue mass or other disease involving an area outside of the defined pertrochanteric anatomic region described above. (Patients excluded based on intraoperative findings will be replaced on the study.)
- Prior surgical treatment of the area (i.e., revision cases). A biopsy does not constitute prior surgical treatment.
- Radiographic evidence of an intramedullary occlusion by blastic metastases that would necessitate an alternative method of treatment, such as a plate/screw construct.
- Diagnosis of lymphoma
- Age < 18 years
- Patients with advanced hip arthritis on radiographic imaging
- Previous randomization for a contralateral procedure as part of this study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Active Comparator: long-stem cemented hemiarthroplasty (LSCH)
(LSCH), "Hip, Ball, Rod and Cement" Replace the ball of the hip joint with a metal ball and a rod that is placed inside the thigh bone with cement to keep the implant in place.
The study participation period for each patient is 360 days from the date of surgery and includes 5 defined timepoints that include the suture removal visit at 3 weeks and follow-up clinical visits for radiographs and rehabilitation progress checks at 6 weeks, 12 weeks, 6 months, and 12 months after surgery.
At each follow-up visit, a combination of questionnaires and physical tests will be administered to assess physical function, general health status, disability level, and pain control.
Some patients may be in a rehabilitation center or on hospice care and will miss their follow-up appointments.
To collect data for the primary endpoint, the 6 week and/or 12 week TESS can be done over phone if necessary.
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Active Comparator: intramedullary nailing (IMN)
Intramedullary nailing (IMN), "Rod and Screws" A metal rod is placed inside your thigh bone and secured in place by metal screws just below the hip and above the knee.
The study participation period for each patient is 360 days from the date of surgery and includes 5 defined timepoints that include the suture removal visit at 3 weeks and follow-up clinical visits for radiographs and rehabilitation progress checks at 6 weeks, 12 weeks, 6 months, and 12 months after surgery.
At each follow-up visit, a combination of questionnaires and physical tests will be administered to assess physical function, general health status, disability level, and pain control.
Some patients may be in a rehabilitation center or on hospice care and will miss their follow-up appointments.
To collect data for the primary endpoint, the 6 week and/or 12 week TESS can be done over phone if necessary.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Toronto Extremity Salvage Score (TESS)
Time Frame: 12 weeks post-op
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Implant-specific differences in postoperative functional outcomes will be determined throughout the study period using Toronto Extremity Salvage Score (TESS); the primary outcome assessment will take place at the 12-week follow-up visit.
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12 weeks post-op
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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Pain VAS score
Time Frame: 12 weeks post-op
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12 weeks post-op
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Narcotic usage cumulative
Time Frame: 12 weeks post-op
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12 weeks post-op
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Timed get up and go test
Time Frame: 12 weeks post-op
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12 weeks post-op
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Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
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Infections
Time Frame: 12 weeks post-op
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12 weeks post-op
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Blood loss
Time Frame: 12 weeks post-op
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12 weeks post-op
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: John Healey, MD, Memorial Sloan Kettering Cancer Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Wounds and Injuries
- Fractures, Bone
- Fractures, Spontaneous
- Health Care Quality, Access, and Evaluation
- Investigative Techniques
- Epidemiologic Methods
- Therapeutics
- Surgical Procedures, Operative
- Data Collection
- Health Care Evaluation Mechanisms
- Quality of Health Care
- Public Health
- Environment and Public Health
- Orthopedic Procedures
- Fracture Fixation
- Fracture Fixation, Internal
- Surveys and Questionnaires
- Fracture Fixation, Intramedullary
Other Study ID Numbers
Other Study ID Numbers
- 12-287
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