Fixation Using Alternative Implants for the Treatment of Hip Fractures: The feasibility of a multicenter 2 × 2 factorial randomized controlled trial evaluating surgical treatment and vitamin D supplementation in young femoral neck fracture patients.

clinical protocols femoral neck fractures fracture fixation internal randomized controlled trial vitamin D

Journal

OTA international : the open access journal of orthopaedic trauma
ISSN: 2574-2167
Titre abrégé: OTA Int
Pays: United States
ID NLM: 101770383

Informations de publication

Date de publication:
Jun 2020
Historique:
received: 06 08 2019
accepted: 15 12 2019
entrez: 3 5 2021
pubmed: 4 5 2021
medline: 4 5 2021
Statut: epublish

Résumé

To conduct a pilot trial for the Fixation using Alternative Implants for the Treatment of Hip Fractures (FAITH-2) protocol to assess feasibility of a definitive trial. Pilot trial. Twenty-five clinical sites across North America and Australia were initiated, but enrolment occurred in only 15 North American sites. Ninety-one randomized adults aged 18 to 60 years with a femoral neck fracture requiring surgical fixation. Eligible patients were randomized to receive surgical treatment (sliding hip screw or cancellous screws) AND nutritional supplementation (4000 IU of vitamin D or placebo) for 6 months postfracture. Feasibility outcomes included: clinical site initiation, participant enrolment rate, proportion of participants with complete 12-month follow-up, level of data quality, and rate of protocol adherence (number of randomization errors, crossovers between treatment groups, and daily supplementation adherence). Eighty-six of 91 participants randomized into the pilot trial from 15 North American hospitals were deemed eligible. Four of five primary feasibility criteria were not achieved as we were unable to initiate clinical sites outside of North America and Australia due to feasibility constraints, slow participant enrolment (60 participants recruited over 36 mo), low adherence with daily nutritional supplementation at the 6-week (72.1%), 3-month (60.5%), and 6-month (54.7%) follow-up visits, and a high loss to follow-up rate of 22.1% at 12 months. Despite not meeting key feasibility criteria, we increased our knowledge on the logistics and anticipated barriers when conducting vitamin D supplementation trials in this trauma population, which can be used to inform the design and conduct of future trials on this topic.

Identifiants

pubmed: 33937697
doi: 10.1097/OI9.0000000000000066
pii: OTAI-D-19-00042
pmc: PMC8022909
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e066

Informations de copyright

Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Orthopaedic Trauma Association.

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Auteurs

Sheila Sprague (S)

Division of Orthopaedic Surgery, Department of Surgery.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Mohit Bhandari (M)

Division of Orthopaedic Surgery, Department of Surgery.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Sofia Bzovsky (S)

Division of Orthopaedic Surgery, Department of Surgery.

Taryn Scott (T)

Division of Orthopaedic Surgery, Department of Surgery.

Lehana Thabane (L)

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Diane Heels-Ansdell (D)

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Robert V O'Toole (RV)

R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.

Andrea Howe (A)

R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.

Greg E Gaski (GE)

Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN.

Lauren C Hill (LC)

Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN.

Krista M Brown (KM)

Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN.

Darius Viskontas (D)

Department of Orthopaedics, University of British Columbia.

Mauri Zomar (M)

Division of Orthopaedics, Fraser Health Authority, New Westminster, British Columbia, Canada.

Gregory J Della Rocca (GJ)

Department of Orthopaedic Surgery, University of Missouri, Columbia, MO.

Gerard P Slobogean (GP)

R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.

Classifications MeSH