Femoral Neck Fracture Clinical Trial
Official title:
Porous Tantalum Rods Improve the Hip Joint Function of Patients With Avascular Necrosis of the Femoral Head After Femoral Neck Fracture Surgery: a Randomized Controlled Trial
To confirm 1) whether, compared with core decompression alone, core decompression with porous tantalum rod implantation improves the hip joint function of patients with avascular necrosis of the femoral head after femoral neck fracture surgery, 2) whether porous tantalum rod shows favorable biocompatibility with the human body, and 3) whether this treatment method is feasible for treating avascular necrosis of the femoral head after femoral neck fracture surgery.
History and current status of related studies: Femoral neck fracture can render the blood
supply to the femoral head insufficient, leading to avascular necrosis of the femoral head.
This often increases treatment difficulty and can have a strong influence on the recovery of
hip joint function. Although core decompression for treatment of avascular necrosis of the
femoral head has been largely used in clinical settings, the mid-term therapeutic effects
are not satisfactory in some patients.
Biocompatibility is defined as the ability of a biomaterial, prosthesis, or medical device
to perform with an appropriate host response. The biocompatibility of a bone implant and
host influences the therapeutic effects. Therefore, biomaterials that are less likely to
induce negative host responses may increase the therapeutic effects of such treatments for
orthopedic diseases. A porous tantalum rod is a bone trabecula-like metal implant that is
used to support weight-bearing areas of necrotic bone, preventing further collapse of the
necrotic area. This implant has exhibited favorable effects in the early treatment of
avascular necrosis of the femoral head. Although previous reports have focused on porous
tantalum rod implantation for clinical treatment of avascular necrosis of the femoral head
after fermoral neck fracture, few have assessed the long-term therapeutic effects or
biocompatibility of porous tantalum rods.
Adverse events Possible adverse events include any expected or unexpected symptoms. If
severe adverse events occur, information including the date of occurrence and measures taken
related to the treatment of the adverse events will be reported to the principal
investigator and the institutional review board within 24 hours.
Data collection, management, analysis, and open access Data collection: Case report forms
with demographic data, disease diagnosis, accompanying diseases, drug allergy history, and
adverse events will be collected , processed using Epidata software, collated, and then
electrically recorded using a double-data entry strategy by data managers.
Data management: The locked electronic database will not be altered in any way, and will
only be available to the project manager. Paper and electronic data regarding screening,
informed consent, and clinical outcomes will be preserved at the Affiliated Hospital of
Nantong University, China.
Data analysis: The electronic database will be made available to a professional statistician
for statistical analysis. An outcome analysis report will be made by the statistician and
submitted to the lead researchers. An independent data monitoring committee will supervise
and manage the trial data with the goal of ensuring a scientific and stringent trial
process, resulting in accurate and complete data.
Data open access: Anonymized trial data will be published at http://www.figshare.com.
Statistical analysis Statistical analysis will be performed by a statistician using SPSS
19.0 software and will follow the intention-to-treat principle. Normally distributed
measurement data will be expressed as a mean, standard deviation, min, and max. Non-normally
distributed measurement data will be expressed as a lower quartile (q1), median, and upper
quartile (q3). McNemar's test will be used to compare the percentage of patients with
excellent hip joint function as per Harris hip scores 12 months after surgery, the
percentage of patients presenting with femoral head collapse, prosthesis loosening,
peri-prosthesis infection, and incidence of complications 6 and 12 months after surgery. The
Mann-Whitney U test will be used to compare the VAS score prior to and 1, 6, and 12 months
after surgery. Statistical significance will be accepted when α = 0.05.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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