- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00761813
Using Alternative Implants for the Surgical Treatment of Hip Fractures (The FAITH Study)
Fixation Using Alternative Implants for the Treatment of Hip Fractures: A Multi-Centre Randomized Trial Comparing Sliding Hip Screws and Cancellous Screws on Revision Surgery Rates and Quality of Life in the Treatment of Femoral Neck Fractures
Study Overview
Status
Conditions
Detailed Description
One type of hip fracture, called a femoral neck fracture, involves a break in the narrow part of the femur bone where the head of the femur is joined to the main shaft. The break can be either undisplaced, which involves very little separation at the fracture site, or displaced, in which there is substantial separation. Surgeons agree that the best surgical procedure for an undisplaced fracture is internal fixation, in which a mechanical implant reconnects the two separated segments of bone. For displaced fractures, surgeons usually choose between internal fixation and a hip joint replacement.
There is more than one way to perform internal fixation. The majority of orthopaedic surgeons currently favor the use of multiple small diameter cancellous screws. However, an alternative method that uses a single large diameter screw attached to a sideplate, called a sliding hip screw, has been gaining popularity and might reduce post-surgical complications and the need for revision surgery. Which surgical method is best for the patient is unknown. This study will compare the use of multiple small diameter cancellous screws versus a single sliding hip screw on rates of revision surgery 2 years after patients sustain femoral neck fractures and undergo internal fixation. The study will also compare the impact of the two different surgical procedures on the overall health, function, and quality of life of patients. Results from this study may impact current orthopaedic practice.
Participation in this study will last 2 years. Before surgery, participants will complete a baseline assessment that will include x-rays, a medical history review, and a physical examination. Participants will then be randomly assigned to undergo one of two types of internal fixation surgeries for repairing their hip fractures. In one group of participants, surgeons will use at least two small cancellous threaded screws that have a diameter of at least 6.5 mm. In the other group of participants, surgeons will use a single large diameter screw that is partially threaded. This screw, called a sliding hip screw, will be affixed to the femur bone with a sideplate, and there will be no other fixations. All surgeons, who will need to meet certain criteria to partake in the study, will follow the manufacturers' technique guidelines for using either type of screw. Specific aspects of both the pre-operative and post-operative care, such as the use of antibiotics and calcium supplementation, will be standardized for all participants.
Follow-up assessments will be completed either by phone or in-person at the hospital or clinic. They will occur 1, 2, and 10 weeks after surgery and 6, 9, 12, 18, and 24 months after surgery. All assessments will include questionnaires and interviews on health status, hip function, pain, and revision surgery. Some of the in-person assessments will also include x-rays.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Alabama
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Birmingham, Alabama, United States, 35294
- University of Alabama @ Birmingham
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California
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Irvine, California, United States, 92618
- Kamran Aurang, MD
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Orange, California, United States, 92868
- University of Califnornia-Irvine
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San Jose, California, United States, 95128
- Santa Clara Valley Medical Center
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Colorado
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Denver, Colorado, United States, 80204
- Mark Hammerberg
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Grand Junction, Colorado, United States, 81505
- Rocky Mountain Orthopaedic/Western Slope Study Group
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Indiana
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Indianapolis, Indiana, United States, 46202
- OrthoIndy
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Indianapolis, Indiana, United States, 46202
- Indiana University-Wishard Hlth Serv.
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Massachusetts
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Boston, Massachusetts, United States, 02118
- Boston Medical Center
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Burlington, Massachusetts, United States, 01805
- Lahey Clinic
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Michigan
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Grand Rapids, Michigan, United States, 49503
- Orthopaedic Associates of Grand Rapids
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Saginaw, Michigan, United States, 48602
- Colleen Linehan, MD
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Minnesota
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Minneapolis, Minnesota, United States, 55441
- Hennepin County Medical Center
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Saint Paul, Minnesota, United States, 55101
- University of Minnesota-Regions Hospital
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Missouri
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Columbia, Missouri, United States, 65201
- Columbia Orthopaedic Group
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Saint Louis, Missouri, United States, 63110
- St. Louis University
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New Jersey
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New Brunswick, New Jersey, United States, 08901
- Robert Wood Johnson University
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New York
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Rochester, New York, United States, 14642
- University of Rochester Med. Ctr.
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North Carolina
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Asheville, North Carolina, United States, 28801
- Mission Hospital Res. Unit
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Ohio
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Cincinnati, Ohio, United States, 45267
- Univ. of Cincinnati Med Ctr
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Cleveland, Ohio, United States, 44109
- MetroHealth Medical Center
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Dayton, Ohio, United States, 45409
- Miami Valley Hospital
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Youngstown, Ohio, United States, 44501
- Humility of Mary Health Partners/St. Elizabeth Hlth Ctr
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- University of Pennsylvania
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Pittsburgh, Pennsylvania, United States, 15213
- University of Pittsburgh
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South Carolina
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Greenville, South Carolina, United States, 29605
- Greenville Hospital System
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Tennessee
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Nashville, Tennessee, United States, 37232
- Vanderbilt University Orthopaedic Instititute
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Texas
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Fort Sam Houston, Texas, United States, 78234
- US Army Institute of Surgical Research
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Lubbock, Texas, United States, 79430
- Texas Tech Univ. Hlth Sci. Ctr.
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San Antonio, Texas, United States, 78229-3900
- University of Texas HSC (San Antonio)
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Temple, Texas, United States, 76508
- Scott & White Hospital
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Washington
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Spokane, Washington, United States, 99216
- Northwest Orthopaedic Specialists
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Fracture of femoral neck
- Operative treatment within 4 days for displaced fractures
- Operative treatment within 7 days for nondisplaced fractures
- Ambulatory before the injury
- Low energy trauma, such as falls from a sitting or standing position
- No other major trauma
Exclusion Criteria:
- Unsuited for both surgical treatments
- Associated major injuries of the lower extremities
- Retained hardware around the hip
- Infection around the hip
- Bone metabolic disorder (except for osteoporosis)
- Moderate or severe cognitive impairment
- Parkinson's disease or dementia
- Unable to complete the 2-year follow-up
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Single Sliding Hip Screw
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The ORIF will be performed using a single large diameter partially threaded screw that is affixed to the proximal femur with a side plate (with a minimum of two holes and a maximum of four holes) and no supplemental fixations.
Surgeons will use any commercially available sliding hip screw implant and will insert implants as per the manufacturers' technical guides.
Other surgical factors will be based on surgeon preference and noted.
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Experimental: Multiple Cancellous Screws
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ORIF will be performed using multiple small diameter threaded screws (with a minimum of two screws and a minimum diameter of 6.5 mm).
Surgeons will use any threaded screw or hook pin and will follow the manufacturers' technical guides.
Other surgical factors will be based on surgeon preference and noted.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Revision Surgery
Time Frame: Measured 2 years after original surgery
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Additional Surgery on the affected hip
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Measured 2 years after original surgery
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Quality of Life
Time Frame: Measured 2 years after original surgery
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The SF-12 PCS is the short form - 12 Health Survey Physical component summary - 0 is bad and 100 is good The WOMAC is Western Ontario and McMaster Universities Osteoarthritis Index 0 is good and 100 is bad The EQ-5D is EuroQol5D 1 is good and 5 is bad
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Measured 2 years after original surgery
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Complications, Including Avascular Necrosis, Nonunion, and Infection
Time Frame: Measured 2 years after original surgery
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Measured 2 years after original surgery
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Marc Swiontkowski, MD, University of Minnesota
Publications and helpful links
General Publications
- van de Kuit A, Oosterhoff JHF, Dijkstra H, Sprague S, Bzovsky S, Bhandari M, Swiontkowski M, Schemitsch EH, IJpma FFA, Poolman RW, Doornberg JN, Hendrickx LAM; , the Machine Learning Consortium and FAITH Investigators. Patients with Femoral Neck Fractures Are at Risk for Conversion to Arthroplasty After Internal Fixation: A Machine-Learning Algorithm. Clin Orthop Relat Res. 2022 Jun 21;480(12):2350-60. doi: 10.1097/CORR.0000000000002283. Online ahead of print.
- Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) Investigators. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial. Lancet. 2017 Apr 15;389(10078):1519-1527. doi: 10.1016/S0140-6736(17)30066-1. Epub 2017 Mar 3.
- FAITH Investigators. Fixation using alternative implants for the treatment of hip fractures (FAITH): design and rationale for a multi-centre randomized trial comparing sliding hip screws and cancellous screws on revision surgery rates and quality of life in the treatment of femoral neck fractures. BMC Musculoskelet Disord. 2014 Jun 26;15:219. doi: 10.1186/1471-2474-15-219.
- Zielinski SM, Viveiros H, Heetveld MJ, Swiontkowski MF, Bhandari M, Patka P, Van Lieshout EM; FAITH trial investigators. Central coordination as an alternative for local coordination in a multicenter randomized controlled trial: the FAITH trial experience. Trials. 2012 Jan 8;13:5. doi: 10.1186/1745-6215-13-5.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- R01AR055267 (U.S. NIH Grant/Contract)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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