Medindia LOGIN REGISTER
Medindia
Advertisement

Clinical Trial Aims to Improve Hip Fracture Care for Older Adults

by Colleen Fleiss on Feb 8 2025 11:54 PM
Listen to this article
0:00/0:00

Hip fractures in older adults can lead to severe complications, reduced mobility, and increased mortality risk.

Clinical Trial Aims to Improve Hip Fracture Care for Older Adults
Hip fractures in older adults can cause serious complications. Traditionally, surgeons used screws and plates to repair minimally displaced femoral neck fractures, but many now opt for hip replacement. A $10.8M multicenter trial, co-led by Dr. Gerard Slobogean of UMSOM, will compare hip arthroplasty with traditional internal fixation in patients 60 and older (1 Trusted Source
UM School of Medicine Surgeon-Scientist to Co-Lead Large International Clinical Trial to Determine Most Effective Treatment for Common Hip Fracture in Older Adults

Go to source
).
“Our goal is to improve patient outcomes after often debilitating hip fractures, especially among older adults,” said Dr. Slobogean who is also an orthopedic trauma surgeon at the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center (UMMC). “Hip fractures are a major public health concern, and we anticipate that the results of this trial will definitively inform clinical practice, regardless of the result.”

The Burden of Hip Fractures: A Global Health Issue

Each year, more than 5 million older adults around the world sustain hip fractures. Femoral neck fractures are very common, and one in five of those fractures are considered minimally displaced, with a small gap between the edges of the broken bone. About 14 percent of those who receive internal fixation surgery ultimately need to have another surgery, such as a hip replacement.

“We want to answer the question, ‘When an older adult has this type of broken hip, does fixing the fracture or replacing the hip best reduce death, maintain their ability to walk, increase their time at home and improve their overall health?’” Dr. Slobogean said. “Currently, we have limited clinical research to help patients, caregivers and orthopedic surgeons choose the best treatment for each patient.”

Researchers expect to open the randomized controlled clinical trial in the fall. They plan to enroll 600 patients age 60 or older who need surgery for minimally displaced femoral neck fractures, at 32 tertiary care and community hospitals in the United States, Canada, the United Kingdom, Spain, the Netherlands and Norway. The R Adams Cowley Shock Trauma Center – the highest-level trauma center in Maryland – will be one of the sites. Patients will be randomly selected to receive either internal fixation or hip replacement surgery and investigators will follow them for 12 months.

The “FASTER-Hip trial” is funded by a $10.8 million grant from the Patient-Centered Outcomes Research Institute (PCORI) awarded to the University of Southern California (USC). UMSOM researchers will receive $2.5 million from this funding. PCORI is an independent nonprofit organization that funds comparative clinical effectiveness research to help patients and clinicians make better-informed healthcare decisions.

Joseph Patterson, MD, an orthopedic surgeon specializing in fracture care, Director of Orthopaedic Trauma research in the Department of Orthopedic Surgery and Assistant Professor at the Keck School of Medicine at USC, is the principal investigator. Dr. Slobogean and Sheila Sprague, PhD, Research Director in the Department of Surgery at McMaster University in Ontario, Canada, are co-principal investigators.

Advertisement
"Evidence from head-to-head clinical trials will help surgeons advise patients on whether to choose an immediate hip replacement, which is more time-consuming and involves more blood loss, or an internal fixation procedure that may require another surgery later," said Mark T. Gladwin, MD, the John Z. and Akiko K. Bowers Distinguished Professor and Dean of UMSOM, and Vice President for Medical Affairs at University of Maryland, Baltimore.

UMSOM researchers were instrumental in developing the clinical trial with the help of a National Institutes of Health (NIH) R 34 planning grant (R34AR082550) awarded to Dr. Slobogean. This will be the first clinical trial designed as a Musculoskeletal Adaptive Platform Trial (MAPT) utilizing a model developed by the University of Maryland’s Center of Orthopaedic Injury Research and Innovation with NIH funding (R34AR084718), according to Nathan O’Hara, PhD, MHA, an Associate Professor of Orthopaedics at UMSOM who serves as COIRI’s co-director with Dr. Slobogean.

A platform trial is a type of clinical trial that allows multiple treatments to be tested simultaneously within a single trial structure – an approach that reduces costs, speeds up the evaluation process and improves decision-making in assessing therapies.

The trial was designed and will be conducted with input from orthopaedic trauma patients, caregivers and families, orthopaedic surgeons, physical therapists, geriatric medicine doctors, nurses and other healthcare providers as well as professional organizations, a peer support network and a large Medicare advantage plan.

UMSOM orthopaedic researchers have considerable experience developing and leading large multicenter international trials. The PREP-IT trials, conducted by Drs. Slobogean and O’Hara, found that skin antisepsis with iodine povacrylex in alcohol reduced the risk of surgical site infections for routine orthopaedic fracture surgery. Similarly, the PREVENT CLOT trial led by Robert V. O’Toole, MD, the Hansjörg Wyss Medical Foundation Endowed Professor in Orthopaedic Trauma at UMSOM and Chief of Orthopaedics at the R Adams Cowley Shock Trauma Center, found aspirin as effective as blood thinner injections in preventing life-threatening blood clots in patients hospitalized with bone fractures.

Reference:
  1. UM School of Medicine Surgeon-Scientist to Co-Lead Large International Clinical Trial to Determine Most Effective Treatment for Common Hip Fracture in Older Adults - (https://www.medschool.umaryland.edu/news/2025/um-school-of-medicine-surgeon-scientist-to-co-lead-large-international-clinical-trial-to-determine-most-effective-treatment-for-common-hip-fracture-in-older-adults.html)
Source-Eurekalert



Home

Consult

e-Book

Articles

News

Calculators

Drugs

Directories

Education

Consumer

Professional