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1. Use of virtual reality for the management of phantom limb pain: a systematic review

Author

Hali, Kalter, Manzo, Marc A., Koucheki, Robert, Wunder, Jay S., Jenkinson, Richard J., Mayo, Amanda L., Ferguson, Peter C., and Lex, Johnathan R.

Subjects
Rehabilitation
Abstract

To summarize the research on the effectiveness of virtual reality (VR) therapy for the management of phantom limb pain (PLP). Three databases (SCOPUS, Ovid Embase, and Ovid MEDLINE) were searched for studies investigating the use of VR therapy for the treatment of PLP. Original research articles fulfilling the following criteria were included: (i) patients 18 years and older; (ii) all etiologies of amputation; (iii) any level of amputation; (iv) use of immersive VR as a treatment modality for PLP; (v) self-reported objective measures of PLP before and after at least one VR session; (vi) written in English. A total of 15 studies were included for analysis. Fourteen studies reported decreases in objective pain scores following a single VR session or a VR intervention consisting of multiple sessions. Moreover, combining VR with tactile stimulation had a larger beneficial effect on PLP compared with VR alone. Based on the current literature, VR therapy has the potential to be an effective treatment modality for the management of PLP. However, the low quality of studies, heterogeneity in subject population and intervention type, and lack of data on long-term relief make it difficult to draw definitive conclusions.IMPLICATION FOR REHABILITATIONVirtual reality (VR) therapy has emerged as a new potential treatment option for phantom limb pain (PLP) that circumvents some limitations of mirror therapy.VR therapy was shown to decrease PLP following a single VR session as well as after an intervention consisting of multiple sessions.The addition of vibrotactile stimuli to VR therapy may lead to larger decreases in PLP scores compared with VR therapy alone. Virtual reality (VR) therapy has emerged as a new potential treatment option for phantom limb pain (PLP) that circumvents some limitations of mirror therapy. VR therapy was shown to decrease PLP following a single VR session as well as after an intervention consisting of multiple sessions. The addition of vibrotactile stimuli to VR therapy may lead to larger decreases in PLP scores compared with VR therapy alone.

Published
2023

2. Supplemental_material_revised_2 – Supplemental material for The relationship between intolerance of uncertainty and anxiety in autism: A systematic literature review and meta-analysis

Author

Jenkinson, Richard, Milne, Elizabeth, and Thompson, Andrew

Subjects
FOS: Psychology, FOS: Clinical medicine, mental disorders, 170199 Psychology not elsewhere classified, 111799 Public Health and Health Services not elsewhere classified, FOS: Educational sciences, 110319 Psychiatry (incl. Psychotherapy), FOS: Health sciences, behavioral disciplines and activities, humanities, 130312 Special Education and Disability, Education
Abstract

Supplemental material, Supplemental_material_revised_2 for The relationship between intolerance of uncertainty and anxiety in autism: A systematic literature review and meta-analysis by Richard Jenkinson, Elizabeth Milne and Andrew Thompson in Autism

Published
2020
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3. Scapula fractures: interobserver reliability of classification and treatment

Author

Neuhaus, Valentin, Bot, Arjan G. J., Guitton, Thierry G., Ring, David C., Abdel-Ghany, Mahmoud I., Abrams, Jeffrey, Abzug, Joshua M., Adolfsson, Lars E., Balfour, George W., Bamberger, H. Brent, Barquet, Antonio, Baskies, Michael, Batson, W. Arnold, Baxamusa, Taizoon, Bayne, Grant J., Begue, Thierry, Behrman, Michael, Beingessner, Daphne, Biert, Jan, Bishop, Julius, Alves, Mateus Borges Oliveira, Boyer, Martin, Brilej, Drago, Brink, Peter R. G., Brunton, Lance M., Buckley, Richard, Cagnone, Juan Carlos, Calfee, Ryan P., Campinhos, Luiz Augusto B., Cassidy, Charles, Catalano, Louis, Chivers, Karel, Choudhari, Pradeep, Cimerman, Matej, Conflitti, Joseph M., Costanzo, Ralph M., Crist, Brett D., Cross, Brian J., Dantuluri, Phani, Darowish, Michael, De Bedout, Ramon, Decoster, Thomas, Dennison, David G., Denoble, Peter H., Desilva, Gregory, Dienstknecht, Thomas, Duncan, Scott F., Duralde, Xavier A., Durchholz, Holger, Egol, Kenneth, Ekholm, Carl, Elias, Nelson, Erickson, John M., Esparza, J. Daniel Espinosa, Fernandes, C. H., Fischer, Thomas J., Fischmeister, Martin, Jaime, Forigua E., Getz, Charles L., Gilbert, Richard S., Giordano, Vincenzo, Glaser, David L., Gosens, Taco, Grafe, Michael W., Filho, Jose Eduardo Grandi Ribeiro, Gray, Robert R. L., Gulotta, Lawrence V., Gummerson, Nigel William, Hammerberg, Eric Mark, Harvey, Edward, Haverlag, R., Henry, Patrick D. G., Hobby, Jonathan L., Hofmeister, Eric P., Hughes, Thomas, Itamura, John, Jebson, Peter, Jenkinson, Richard, Jeray, Kyle, Jones, Christopher M., Jones, Jedediah, Jubel, Axel, Kaar, Scott G., Kabir, K., Kaplan, F. Thomas D., Kennedy, Stephen A., Kessler, Michael W., Kimball, Hervey L., Kloen, Peter, Klostermann, Cyrus, Kohut, Georges, Kraan, G. A., Kristan, Anze, Loebenberg, Mark I., Malone, Kevin J., Marsh, L., Martineau, Paul A., Mcauliffe, John, Mcgraw, Iain, Mehta, Samir, Merchant, Milind, Metzger, Charles, Meylaerts, S. A., Miller, Anna N., Wolf, Jennifer Moriatis, Murachovsky, Joel, Murthi, Anand, Nancollas, Michael, Nolan, Betsy M., Omara, Timothy, Omid, Reza, Ortiz, Jose A., Overbeck, Joachim P., Page, Richard S., Castillo, Alberto Pérez, Pesantez, Rodrigo, Polatsch, Daniel, Porcellini, G., Prayson, Michael, Quell, M., Ragsdell, Matthew M., Reid, James G., Reuver, J. M., Richard, Marc J., Richardson, Martin, Rizzo, Marco, Rowinski, Sergio, Rubio, Jorge, Guerrero, Carlos G. Sánchez, Satora, Wojciech, Schandelmaier, Peter, Scheer, Johan H., Schmidt, Andrew, Schubkegel, Todd A., Schulte, Leah M., Schumer, Evan D., Sears, Benjamin W., Shafritz, Adam B., Shortt, Nicholas L., Siff, Todd, Silva, Dario Mejia, Smith, Raymond Malcolm, Spruijt, Sander, Stein, Jason A., Pemovska, Emilija Stojkovska, Streubel, Philipp N., Swigart, Carrie, Swiontkowski, Marc, Thomas, George, Tolo, Eric T., Turina, Matthias, Tyllianakis, Minos, Van Den Bekerom, Michel P. J., Van Der Heide, Huub, Van De Sande, M. A. J., Van Eerten, P. V., Verbeek, DIederik O. F., Hoffmann, David Victoria, Vochteloo, A. J. H., Wagenmakers, Robert, Wall, Christopher J., Wallensten, Richard, Wascher, Daniel C., Weiss, Lawrence, Wiater, J. Michael, Wills, Brian P. D., Wint, Jeffrey, Wright, Thomas, Young, Jason P., Zalavras, Charalampos, Zura, Robert D., Zyto, Karol, Orthopedic Surgery and Sports Medicine, Other departments, Other Research, and Graduate School

Subjects
Male, medicine.medical_specialty, Interobserver reliability, Radiography, Fleiss' kappa, Fractures, Bone, New International Classification for Scapular Fractures, OTA/AO fracture classification, reliability, scapula, Female, Humans, Imaging, Three-Dimensional, Observer Variation, Reproducibility of Results, Scapula, Tomography, X-Ray Computed, Surgery, Orthopedics and Sports Medicine, Reliability study, medicine, Ao classification, Reliability (statistics), Orthodontics, business.industry, General Medicine, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], business, Kappa
Abstract

Item does not contain fulltext OBJECTIVES: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. DESIGN: Web-based reliability study. SETTING: Independent orthopaedic surgeons from several countries were invited to classify scapular fractures in an online survey. PARTICIPANTS: One hundred three orthopaedic surgeons evaluated 35 movies of three-dimensional computerized tomography reconstruction of selected scapular fractures, representing a full spectrum of fracture patterns. MAIN OUTCOME MEASUREMENTS: Fleiss kappa (kappa) was used to assess the reliability of agreement between the surgeons. RESULTS: The overall agreement on the OTA/AO classification was moderate for the types (A, B, and C, kappa = 0.54) with a 71% proportion of rater agreement (PA) and for the 9 groups (A1 to C3, kappa = 0.47) with a 57% PA. For the New International Classification, the agreement about the intraarticular extension of the fracture (Fossa (F), kappa = 0.79) was substantial and the agreement about a fractured body (Body (B), kappa = 0.57) or process was moderate (Process (P), kappa = 0.53); however, PAs were more than 81%. The agreement on the treatment recommendation was moderate (kappa = 0.57) with a 73% PA. CONCLUSIONS: The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions. 01 maart 2014

Published
2014

4. Practice Patterns in the Care of Acute Achilles Tendon Ruptures

Author

Sheth, Ujash, Wasserstein, David, Moineddin, Rahim, Jenkinson, Richard, Kreder, Hans, and Jaglal, Susan

Subjects
Article
Abstract

Objectives: Over the last decade, there has been a growing body of level I evidence supporting non-operative management (focused on early range of motion and weight bearing) of acute Achilles tendon ruptures. Despite this emerging evidence, there have been very few studies evaluating its uptake. Our primary objective was to determine whether the findings from a landmark trial assessing the optimal management strategy for acute Achilles tendon ruptures influenced the practice patterns of orthopaedic surgeons in Ontario, Canada over a 12-year time period. As a second objective we examined whether patient and provider predictors of surgical repair utilization differed before and after dissemination of the landmark trial results. Methods: Using provincial health administrative databases, we identified Ontario residents ≥ 18 years of age with an acute Achilles tendon rupture from April 2002 to March 2014. The proportion of surgically repaired ruptures was calculated for each calendar quarter and year. A time series analysis using an interventional autoregressive integrated moving average (ARIMA) model was used to determine whether changes in the proportion of surgically repaired ruptures were chronologically related to the dissemination of results from a landmark trial by Willits et al. (first quarter, 2009). Spline regression was then used to independently identify critical time-points of change in the surgical repair rate to confirm our findings. A multivariate logistic regression model was used to assess for differences in patient (baseline demographics) and provider (hospital type) predictors of surgical repair utilization before and after the landmark trial. Results: In 2002, ˜19% of acute Achilles tendon ruptures in Ontario were surgically repaired, however, by 2014 only 6.5% were treated operatively. A statistically significant decrease in the rate of surgical repair (p < 0.001) was observed after the results from a landmark trial were presented at a major North American conference (February 2009). Prior to the dissemination of trial results, the odds of undergoing surgical repair at a teaching hospital were found to be significantly higher than if treated at a non-teaching hospital (odds ratio (OR), 1.52; 95% confidence interval (CI), 1.04-2.22; p = 0.03). However, after the landmark trial there was no significant difference in the odds of undergoing surgical repair between teaching and non-teaching hospitals (p = 0.46). All other predictors of surgical repair utilization remained unchanged in the before-and-after analysis. Conclusion: The current study demonstrates that large, well-designed randomized trials, such as the one conducted by Willits et al. can significantly change the practice patterns of orthopaedic surgeons. Moreover, the significant decline in surgical repair rate at both teaching and non-teaching hospitals after the landmark trial suggests both academic and non-academic surgeons readily incorporate high quality evidence in to their practice.

Published
2016

5. Potential discrepancy between plain films and CT scans in Brooker classification of heterotopic ossification

Author

Probyn Linda, Tsao May, Poon Michael, Chow Edward, Tao Mary Jiayi, Barnes Elizabeth, Kreder Hans, Jenkinson Richard, Nousiainen Markku, and Wan Bo Angela

Subjects
medicine.medical_specialty, Radiography, Connective tissue, Lamellar bone, Pelvis, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Retrospective Studies, Retrospective review, Full Paper, business.industry, Ossification, Heterotopic, X-Rays, General Medicine, medicine.disease, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Hip Joint, Heterotopic ossification, Radiology, Tomography, X-Ray Computed, business, Pelvic radiotherapy
Abstract

The Brooker classification is a commonly used tool to characterize the extent of heterotopic ossification (HTO), which is the dystrophic formation of mature lamellar bone in non-osseous tissues such as muscles, connective tissue or nerves. We aim to provide illustrative cases to describe the limitations and challenges of this system.A retrospective review was conducted in all patients who had retrieved hip and/or pelvic radiotherapy for HTO prophylaxis at Sunnybrook Health Sciences Centre between July 1998 and August 2016. An independent musculoskeletal radiologist who was blinded to the condition of the patient and the clinical outcome evaluated the imaging studies based on the Brooker classification.22 patients were identified for analysis. Three patient cases were presented to illustrate the discrepancies between the Brooker classification and radiographic images, CT images and different radiographical projections. Two patient cases were presented to demonstrate the inability of the Brooker classification to account for volumetric differences in HTO and arthroplasty lengths.Although the Brooker classification for HTO is a widely used quantitative and qualitative assessment tool given its simplicity and familiarity, it possesses several limitations. Utilization of other radiographic modalities, such as CT, and orthogonal projections may reduce ambiguities from using the HTO system. Development of a classification method that can appropriately correspond to the clinical outcomes such as functional capabilities to further HTO development is warranted. Advances in knowledge: The present study critically evaluated the Brooker classification system, and identified areas in which improvement is warranted on characterizing HTO. This is important in further research that aims to improve the accuracy of HTO classification guidelines.

Published
2017

6. 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

Author

McCormack, Robert, Apostle, Kelly, Moon, Raely, Bielby, Shea A., Switzer, Julie A., Cole, Peter A., Anderson, Sarah A., Lafferty, Paul M., Li, Mengnai, Ly, Thuan V., Marston, Scott B., Foley, Amy L., Vang, Sandy, Oatt, Amber, Wright, David M., Marcantonio, Andrew J., Kain, Michael S. H., Iorio, Richard, Specht, Lawrence M., Tilzey, John F., Lobo, Margaret J., Garfi, John S., Vallier, Heather A., Dolenc, Andrea, Buckley, Richard E., Robinson, Chalitha, Prayson, Michael J., Laughlin, Richard, Rubino, L. Joseph, May, Jedediah, Rieser, Geoffrey Ryan, Dulaney-Cripe, Liz, Gayton, Chris, Shaer, James, Schrickel, Tyson, Duffy, Paul, Hileman, Barbara, Gorczyca, John T., Gross, Jonathan M., Humphrey, Catherine A., Kates, Stephen, Noble, Krista, McIntyre, Allison W., Pecorella, Kaili, Davis, Craig A., Weinerman, Stewart, Korley, Robert, Weingarten, Peter, Stull, Philip, Lindenbaum, Stephen, Hewitt, Michael, Schwappach, John, Baker, Janell K., Rutherford, Tori, Newman, Heike, Lieberman, Shane, Finn, Erin, Puloski, Shannon, Robbins, Kristin, Hurley, Meghan, Lyle, Lindsey, Mitchell, Khalis, Browner, Kieran, Whatley, Erica, Payton, Krystal, Reeves, Christina, Cannada, Lisa K., Karges, David, Johnston, Kelly, Hill, Leslie, Mehta, Samir, Esterhai, John, Ahn, Jaimo, Horan, Annamarie D., McGinnis, Kelly, Kaminski, Christine A., Kowalski, Brynn N., Keeve, Jonathan P., Anderson, Christopher G., Powell, James, McDonald, Michael D., Hoffman, Jodi M., Tarkin, Ivan, Siska, Peter, Gruen, Gary, Evans, Andrew, Farrell, Dana J., Irrgang, James, Luther, Arlene, Cross III., William W., Carcary, Kimberly, Cass, Joseph R., Sems, Stephen A., Torchia, Michael E., Scrabeck, Tyson, Jenkins, Mark, Dumais, Jules, Romero, Amanda W., Sagebien, Carlos A., Butler, Mark S., Monica, James T., Sanders, David, Seuffert, Patricia, Hsu, Joseph R., Ficke, James, Charlton, Michael, Napierala, Matthew, Fan, Mary, Tornetta III., Paul, Tannoury, Chadi, Carlisle, Hope, Silva, Heather, Boyer, Dory, Lawendy, Abdel, Archdeacon, Michael, Finnan, Ryan, Le, Toan, Wyrick, John, Hess, Shelley, Brennan, Michael L., Probe, Robert, Kile, Evelyn, Mills, Kelli, Clipper, Lydia, Tieszer, Christina, Yu, Michelle, Erwin, Katie, Horwitz, Daniel, Strohecker, Kent, Swenson, Teresa K., Aurang, Kamran, Zohman, Gary, Peterson, Brett, Huff, Roger B., Baele, Joseph, Stephen, David, Weber, Timothy, Edison, Matt, McBeth, Jessica, Shively, Karl, Ertl, Janos P., Mullis, Brian, Parr, J. Andrew, Worman, Ripley, Frizzell, Valda, Moore, Molly M., Kreder, Hans, Tobias, Erin, Thomas, Emily, DePaolo, Charles J., Alosky, Rachel, Shell, Leslie E., Hampton, Lynne, Shepard, Stephanie, Nanney, Tracy, Cuento, Claudine, Cantu, Robert V., Jenkinson, Richard, Henderson, Eric R., Eickhoff, Linda S., Hammerberg, E. Mark, Stahel, Philip, Hak, David, Mauffrey, Cyril, Gibula, Douglas, Gissel, Hannah, Henderson, Corey, Zamorano, David P., Nousiainen, Markku, Tynan, Martin C., Pourmand, Deeba, Lawson, Deanna, Della Rocca, Gregory J., Crist, Brett D., Murtha, Yvonne M., Anderson, Linda K., Linehan, Colleen, Pilling, Lindsey, Lewis, Courtland G., Axelrod, Terry, Caminiti, Stephanie, Sullivan, Raymond J., Roper, Elizabeth, Obremskey, William, Kregor, Philip, Richards, Justin E., Stringfellow, Kenya, Dohm, Michael P., Zellar, Abby, Segers, Michiel J. M., Murnaghan, John, Zijl, Jacco A. C., Verhoeven, Bart, Smits, Anke B., de Vries, Jean Paul P. M., Fioole, Bram, van der Hoeven, Henk, Theunissen, Evert B. M., de Vries Reilingh, Tammo S., Govaert, Lonneke, Wittich, Philippe, Nam, Diane, de Brauw, Maurits, Wille, Jan, Go, Peter M. N. Y. M., Ritchie, Ewan D., Wessel, Ronald N., Hammacher, Eric R., Heetveld, Martin J., Visser, Gijs A., Stockmann, Heyn, Silvis, Rob, Wadey, Veronica, Snellen, Jaap P., Rijbroek, Bram, Scheepers, Joris J. G., Vermeulen, Erik G. J., Siroen, Michiel P. C., Vuylsteke, Ronald, Brom, Hans L. F., Rijna, Herman, de Rijcke, Piet A. R., Koppert, Cees L., Moola, Farhad, Yee, Albert, Buijk, Steven E., Groenendijk, Richard P. R., Dawson, Imro, Tetteroo, Geert W. M., Bruijninckx, Milko M. M., Doornebosch, Pascal G., de Graaf, Eelco J. R., van der Elst, Maarten, van der Pol, Carmen C., van 't Riet, Martijne, Milner, Katrine, Karsten, Tom M., de Vries, Mark R., Stassen, Laurents P. S., Schep, Niels W. L., Schmidt, G. Ben, Hoffman, W. H., Poolman, Rudolf W., Simons, Maarten P., van der Heijden, Frank H. W. M., Willems, W. Jaap, Kunz, Monica, de Meulemeester, Frank R. A. J., van der Hart, Cor P., Turckan, Kahn, Festen, Sebastiaan, de Nies, Frank, Haverlag, Robert, Out, Nico J. M., Bosma, Jan, van Kampen, Albert, Biert, Jan, Schemitsch, Emil H., van Vugt, Arie B., Edwards, Michael J. R., Blokhuis, Taco J., Frolke, Jan Paul M., Geeraedts, Leo M. G., Gardeniers, Jean W. M., Tan, Edward T. C. H., Poelhekke, Lodewijk M. S. J., de Waal Malefijt, Maarten C., Schreurs, Bart, Ahn, Henry, Roukema, Gert R., Josaputra, Hong A., Keller, Paul, de Rooij, Peter D., Kuiken, Hans, Boxma, Han, Cleffken, Berry I., Liem, Ronald, Rhemrev, Steven J., Bosman, Coks H. R., Hall, Jeremy A., de Mol van Otterloo, Alexander, Hoogendoorn, Jochem, de Vries, Alexander C., Meylaerts, Sven A. G., Verhofstad, Michiel H. J., Meijer, Joost, van Egmond, Teun, van der Brand, Igor, Patka, Peter, McKee, Michael D., Eversdijk, Martin G., Peters, Rolf, Den Hartog, Dennis, Van Waes, Oscar J. F., Oprel, Pim, van der Vis, Harm M., Campo, Martin, Verhagen, Ronald, Albers, G. H. Robert, Zurcher, Arthur W., Whelan, Daniel B., Simmermacher, Rogier K. J., van Mulken, Jeroen, van Wessem, Karlijn, van Gaalen, Steven M., Leenen, Luke, Bronkhorst, Maarten W. G. A., Guicherit, Onno R., Goslings, J. Carel, Nauth, Aaron, Ponsen, Kees Jan, Bhatia, Mahesh, Arora, Vinod, Tyagi, Vivek, Liew, Susan, Bedi, Harvinder, Carr, Ashley, Curry, Hamish, Chia, Andrew, Csongvay, Steve, Vicente, Milena R., Donohue, Craig, Doig, Stephen, Edwards, Elton, Etherington, Greg, Esser, Max, Gong, Andrew, Jain, Arvind, Li, Doug, Miller, Russell, Moaveni, Ash, Perey, Bertrand, Wild, Lisa M., Russ, Matthias, Ton, Lu, Wang, Otis, Dowrick, Adam, Murdoch, Zoe, Sage, Claire, Frihagen, Frede, Clarke-Jenssen, John, Hjorthaug, Geir, Ianssen, Torben, Khan, Ryan M., Amundsen, Asgeir, Brattgjerd, Jan Egil, Borch, Tor, Boe, Berthe, Flatoy, Bernhard, Hasselund, Sondre, Haug, Knut Jorgen, Hemlock, Kim, Hoseth, Tor Magne, Jomaas, Geir, Hidy, Jennifer T., Kibsgard, Thomas, Lona, Tarjei, Moatshe, Gilbert, Muller, Oliver, Molund, Marius, Nicolaisen, Tor, Nilsen, Fredrik, Rydinge, Jonas, Smedsrud, Morten, Stodle, Are, Coles, Chad, Trommer, Axel, Ugland, Stein, Karlsten, Anders, Ekas, Guri, Vesterhus, Elise Berg, Brekke, Anne Christine, Gupta, Ajay, Jain, Neeraj, Khan, Farah, Sharma, Ateet, Leighton, Ross, Sanghavi, Amir, Trivedi, Mittal, Rai, Anil, Subash, Rai, Kamal, Yadav, Vineet, Singh, Sanjay, Tetsworth, Kevin, Donald, Geoff, Biddulph, Michael, Weinrauch, Patrick, Pincus, Paul, Yang, Steven, Halliday, Brett, Gervais, Trevor, Holt, Michael, Flynn, Annette, Prasad, Amal Shankar, Mishra, Vimlesh, Sundaresh, D. C., Johnston, David, Khanna, Angshuman, Cherian, Joe Joseph, Olakkengil, Davy J., Sharma, Gaurav, Pirpiris, Marinis, Love, David, Bucknill, Andrew, Farrugia, Richard J., Pape, Hans-Christoph, Knobe, Matthias, Glazebrook, Mark, Pfeifer, Roman, Hull, Peter, Lewis, Sophie, Evans, Simone, Nanda, Rajesh, Logishetty, Rajanikanth, Anand, Sanjeev, Bowler, Carol, Dadi, Akhil, Palla, Naveen, Alexander, David, Ganguly, Utsav, Rai, B. Sachidananda, Rajakumar, Janakiraman, Jennings, Andrew, Chuter, Graham, Rose, Glynis, Horner, Gillian, Clark, Callum, Eke, Kate, Reed, Mike, Coady, Cathy, Herriott, Chris, Dobb, Christine, Bhandari, Mohit, Swiontkowski, Marc, Devereaux, Pj, Jeray, Kyle, Thabane, Lehana, Stone, Trevor, Dunbar, Michael, Walter, Stephen, Sprague, Sheila, Scott, Taryn, Guyatt, Gordon, Amirault, David, Viveiros, Helena, McKay, Paula, Swinton, Marilyn, Gross, Michael, Truong, Victoria, Koo, Kaitlin, Heels-Ansdell, Diane, Zhou, Qi, Buckingham, Lisa, Duraikannan, Aravin, Maddock, Deborah, Simunovic, Nicole, Agel, Julie, Oxner, William, Van Lieshout, Esther M. M., Zielinski, Stephanie M., Rangan, Amar, Hanusch, Birgit C., Kottam, Lucksy, Clarkson, Rachel, Reardon, Gerald, Slobogean, Gerard, Katz, Jeffrey, Gillespie, Brenda, Greendale, Gail A., Guy, Pierre, Hartman, Curtis, Rubin, Craig, Waddell, James, FAITH Investigators, Richardson, Glen, Trenholm, Andrew, Wong, Ivan, Trask, Kelly, MacDonald, Shelley, Viskontas, Darius, Dobbin, Gwen, Bicknell, Ryan, Yach, Jeff, Bardana, Davide, Wood, Gavin, Harrison, Mark, Yen, David, Lambert, Sue, Howells, Fiona, Ward, Angela, Lemke, H. Michael, Zalzal, Paul, Brien, Heather, Naumetz, V., Weening, Brad, Wai, Eugene K., Papp, Steve, Gofton, Wade T., Liew, Allen, Kingwell, Stephen P., Zomar, Mauri, Johnson, Garth, O'Neil, Joseph, Roffey, Darren M., Borsella, Vivian, Avram, Victoria, Oliver, Todd M., Jones, Vicki, Jones, Clifford B., Ringler, James R., Endres, Terrence J., Moon, Karyn, Sietsema, Debra L., Jeray, Kyle J., Broderick, J. Scott, Goetz, David R., Pace, Thomas B., Schaller, Thomas M., Porter, Scott E., Tanner, Stephanie L., Snider, Rebecca G., Nastoff, Lauren A., Surgery, Emergency Medicine, Obstetrics and Gynaecology, Other Research, Other departments, Graduate School, and AMS - Amsterdam Movement Sciences

Subjects
Time Factors, Sports medicine, medicine.medical_treatment, Bone Screws, Dentistry, Femoral Neck Fractures, law.invention, Fracture Fixation, Internal, Study Protocol, Postoperative Complications, 0302 clinical medicine, Clinical Protocols, Randomized controlled trial, law, Fracture fixation, Orthopedics and Sports Medicine, 030212 general & internal medicine, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries), Likelihood Functions, 030222 orthopedics, Femoral neck fractures, 3. Good health, Europe, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], Treatment Outcome, Research Design, Hip fractures, Sliding hip screw, Reoperation, medicine.medical_specialty, Asia, Prosthesis Design, 03 medical and health sciences, Fixation (surgical), Rheumatology, medicine, Humans, Internal fixation, Proportional Hazards Models, business.industry, Australia, Arthroplasty, Surgery, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], North America, Orthopedic surgery, Quality of Life, Cancellous screws, business
Abstract

Hip fractures are a common type of fragility fracture that afflict 293,000 Americans (over 5,000 per week) and 35,000 Canadians (over 670 per week) annually. Despite the large population impact the optimal fixation technique for low energy femoral neck fractures remains controversial. The primary objective of the FAITH study is to assess the impact of cancellous screw fixation versus sliding hip screws on rates of revision surgery at 24 months in individuals with femoral neck fractures. The secondary objective is to determine the impact on health-related quality of life, functional outcomes, health state utilities, fracture healing, mortality and fracture-related adverse events. FAITH is a multi-centre, multi-national randomized controlled trial utilizing minimization to determine patient allocation. Surgeons in North America, Europe, Australia, and Asia will recruit a total of at least 1,000 patients with low-energy femoral neck fractures. Using central randomization, patients will be allocated to receive surgical treatment with cancellous screws or a sliding hip screw. Patient outcomes will be assessed at one week (baseline), 10 weeks, 6, 12, 18, and 24 months post initial fixation. We will independently adjudicate revision surgery and complications within 24 months of the initial fixation. Outcome analysis will be performed using a Cox proportional hazards model and likelihood ratio test. This study represents major international efforts to definitively resolve the treatment of low-energy femoral neck fractures. This trial will not only change current Orthopaedic practice, but will also set a benchmark for the conduct of future Orthopaedic trials. The FAITH trial is registered at ClinicalTrials.gov (Identifier NCT00761813 ).

Published
2014

7. Mortality and complications following stabilization of femoral metastatic lesions: a population-based study of regional variation and outcome

Author

Ristevski, Bill, Jenkinson, Richard J., Stephen, David J.G., Finkelstein, Joel, Schemitsch, Emil H., McKee, Michael D., and Kreder, Hans J.

Subjects
Research
Abstract

BACKGROUND: It is considered that patients at risk for spontaneous fracture due to metastatic lesions should undergo surgical stabilization before fracture occurs; however, prophylactic stabilization is associated with surgical morbidity and mortality. We sought to compare pathological fracture fixation versus prophylactic stabilization of diaphyseal femoral lesions for patients with femoral metastases and assess the rate of prophylactic surgery completed in all regions of Ontario. METHODS: Using population data sets, we identified all patients who had undergone femoral stabilization, either for pathological femoral fractures or for prophylactic fixation of femoral metastases before pathological fractures, between 1992 and 1997 in Ontario. We compared the rates of survival, serious medical and surgical complications and length of stay in hospital between the 2 groups. RESULTS: A total of 624 patients underwent surgical stabilization for femoral metastases. The most common sites of primary metastases were the lungs (26%), breasts (16%), kidneys (6%) and prostate (6%); 46% of patients had other or multiple primary metastases. Overall, 37% of lesions were fixed prophylactically, with wide variation by region (17.6%-72.2%). Patients who underwent prophylactic stabilization had better overall survival at all postoperative time points. This held true after adjusting for age, sex, comorbidities and type of cancer (p0.001). CONCLUSION: These data demonstrate a survival advantage with prophylactic fixation of metastatic femoral lesions combined with a relatively low perioperative risk excluding concomitant bilateral procedures. Ontario regional rates of prophylactic fixation vary enormously, with most patients not receiving prophylactic treatment.

Published
2009

8. 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

Author

McCormack, Robert, Apostle, Kelly, Boyer, Dory, Moola, Farhad, Perey, Bertrand, Stone, Trevor, Viskontas, Darius, Lemke, H. Michael, Zomar, Mauri, Moon, Karyn, Moon, Raely, Oatt, Amber, Buckley, Richard E., Duffy, Paul, Korley, Robert, Puloski, Shannon, Johnston, Kelly, Powell, James, Carcary, Kimberly, Sanders, David, Lawendy, Abdel, Tieszer, Christina, Stephen, David, Kreder, Hans, Jenkinson, Richard, Nousiainen, Markku, Axelrod, Terry, Murnaghan, John, Nam, Diane, Wadey, Veronica, Yee, Albert, Milner, Katrine, Kunz, Monica, Schemitsch, Emil H., Ahn, Henry, Hall, Jeremy A., McKee, Michael D., Whelan, Daniel B., Nauth, Aaron, Vicente, Milena R., Wild, Lisa M., Khan, Ryan M., Hidy, Jennifer T., Coles, Chad, Leighton, Ross, Biddulph, Michael, Johnston, David, Glazebrook, Mark, Alexander, David, Coady, Cathy, Dunbar, Michael, Amirault, David, Gross, Michael, Oxner, William, Reardon, Gerald, Richardson, Glen, Trenholm, Andrew, Wong, Ivan, Trask, Kelly, MacDonald, Shelley, Dobbin, Gwen, Bicknell, Ryan, Yach, Jeff, Bardana, Davide, Wood, Gavin, Harrison, Mark, Yen, David, Lambert, Sue, Howells, Fiona, Ward, Angela, Zalzal, Paul, Brien, Heather, Naumetz, V., Weening, Brad, Simunovic, Nicole, Wai, Eugene K., Papp, Steve, Gofton, Wade T., Liew, Allen, Kingwell, Stephen P., Johnson, Garth, O'Neil, Joseph, Roffey, Darren M., Borsella, Vivian, Avram, Victoria, Oliver, Todd M., Jones, Vicki, Jones, Clifford B., Ringler, James R., Endres, Terrence J., Sietsema, Debra L., Jeray, Kyle J., Broderick, J. Scott, Goetz, David R., Pace, Thomas B., Schaller, Thomas M., Porter, Scott E., Tanner, Stephanie L., Snider, Rebecca G., Nastoff, Lauren A., Bielby, Shea A., Switzer, Julie A., Cole, Peter A., Anderson, Sarah A., Lafferty, Paul M., Li, Mengnai, Ly, Thuan V., Marston, Scott B., Foley, Amy L., Vang, Sandy, Wright, David M., Marcantonio, Andrew J., Kain, Michael S. H., Iorio, Richard, Specht, Lawrence M., Tilzey, John F., Lobo, Margaret J., Garfi, John S., Vallier, Heather A., Dolenc, Andrea, Robinson, Chalitha, Prayson, Michael J., Laughlin, Richard, Rubino, L. Joseph, May, Jedediah, Rieser, Geoffrey Ryan, Dulaney-Cripe, Liz, Gayton, Chris, Shaer, James, Schrickel, Tyson, Hileman, Barbara, Gorczyca, John T., Gross, Jonathan M., Humphrey, Catherine A., Kates, Stephen, Noble, Krista, McIntyre, Allison W., Pecorella, Kaili, Davis, Craig A., Weinerman, Stewart, Weingarten, Peter, Stull, Philip, Lindenbaum, Stephen, Hewitt, Michael, Schwappach, John, Baker, Janell K., Rutherford, Tori, Newman, Heike, Lieberman, Shane, Finn, Erin, Robbins, Kristin, Hurley, Meghan, Lyle, Lindsey, Mitchell, Khalis, Browner, Kieran, Whatley, Erica, Payton, Krystal, Reeves, Christina, Cannada, Lisa K., Karges, David, Hill, Leslie, Mehta, Samir, Esterhai, John, Ahn, Jaimo, Horan, Annamarie D., McGinnis, Kelly, Kaminski, Christine A., Kowalski, Brynn N., Keeve, Jonathan P., Anderson, Christopher G., McDonald, Michael D., Hoffman, Jodi M., Tarkin, Ivan, Siska, Peter, Gruen, Gary, Evans, Andrew, Farrell, Dana J., Irrgang, James, Luther, Arlene, Cross III., William W., Cass, Joseph R., Sems, Stephen A., Torchia, Michael E., Scrabeck, Tyson, Jenkins, Mark, Dumais, Jules, Romero, Amanda W., Sagebien, Carlos A., Butler, Mark S., Monica, James T., Seuffert, Patricia, Hsu, Joseph R., Ficke, James, Charlton, Michael, Napierala, Matthew, Fan, Mary, Tornetta III., Paul, Tannoury, Chadi, Carlisle, Hope, Silva, Heather, Archdeacon, Michael, Finnan, Ryan, Le, Toan, Wyrick, John, Hess, Shelley, Brennan, Michael L., Probe, Robert, Kile, Evelyn, Mills, Kelli, Clipper, Lydia, Yu, Michelle, Erwin, Katie, Horwitz, Daniel, Strohecker, Kent, Swenson, Teresa K., Aurang, Kamran, Zohman, Gary, Peterson, Brett, Huff, Roger B., Baele, Joseph, Weber, Timothy, Edison, Matt, McBeth, Jessica, Shively, Karl, Ertl, Janos P., Mullis, Brian, Parr, J. Andrew, Worman, Ripley, Frizzell, Valda, Moore, Molly M., Tobias, Erin, Thomas, Emily, DePaolo, Charles J., Alosky, Rachel, Shell, Leslie E., Hampton, Lynne, Shepard, Stephanie, Nanney, Tracy, Cuento, Claudine, Cantu, Robert V., Henderson, Eric R., Eickhoff, Linda S., Hammerberg, E. Mark, Stahel, Philip, Hak, David, Mauffrey, Cyril, Gibula, Douglas, Gissel, Hannah, Henderson, Corey, Zamorano, David P., Tynan, Martin C., Pourmand, Deeba, Lawson, Deanna, Della Rocca, Gregory J., Crist, Brett D., Murtha, Yvonne M., Anderson, Linda K., Linehan, Colleen, Pilling, Lindsey, Lewis, Courtland G., Caminiti, Stephanie, Sullivan, Raymond J., Roper, Elizabeth, Obremskey, William, Kregor, Philip, Richards, Justin E., Stringfellow, Kenya, Dohm, Michael P., Zellar, Abby, Segers, Michiel J. M., Zijl, Jacco A. C., Verhoeven, Bart, Smits, Anke B., De Vries, Jean Paul P. M., Fioole, Bram, Van Der Hoeven, Henk, Theunissen, Evert B. M., De Vries Reilingh, Tammo S., Govaert, Lonneke, Wittich, Philippe, De Brauw, Maurits, Wille, Jan, Go, Peter M. N. Y. M., Ritchie, Ewan D., Wessel, Ronald N., Hammacher, Eric R., Heetveld, Martin J., Visser, Gijs A., Stockmann, Heyn, Silvis, Rob, Snellen, Jaap P., Rijbroek, Bram, Scheepers, Joris J. G., Vermeulen, Erik G. J., Siroen, Michiel P. C., Vuylsteke, Ronald, Brom, Hans L. F., Rijna, Herman, De Rijcke, Piet A. R., Koppert, Cees L., Buijk, Steven E., Groenendijk, Richard P. R., Dawson, Imro, Tetteroo, Geert W. M., Bruijninckx, Milko M. M., Doornebosch, Pascal G., De Graaf, Eelco J. R., Van Der Elst, Maarten, Van Der Pol, Carmen C., Van 'T Riet, Martijne, Karsten, Tom M., De Vries, Mark R., Stassen, Laurents P. S., Schep, Niels W. L., Ben Schmidt, G., Hoffman, W. H., Poolman, Rudolf W., Simons, Maarten P., Van Der Heijden, Frank H. W. M., Willems, W. Jaap, De Meulemeester, Frank R. A. J., Van Der Hart, Cor P., Turckan, Kahn, Festen, Sebastiaan, De Nies, Frank, Haverlag, Robert, Out, Nico J. M., Bosma, Jan, Van Kampen, Albert, Biert, Jan, Van Vugt, Arie B., Edwards, Michael J. R., Blokhuis, Taco J., Frolke, Jan Paul M., Geeraedts, Leo M. G., Gardeniers, Jean W. M., Tan, Edward T. C. H., Poelhekke, Lodewijk M. S. J., De Waal Malefijt, Maarten C., Schreurs, Bart, Roukema, Gert R., Josaputra, Hong A., Keller, Paul, De Rooij, Peter D., Kuiken, Hans, Boxma, Han, Cleffken, Berry I., Liem, Ronald, Rhemrev, Steven J., Bosman, Coks H. R., De Mol Van Otterloo, Alexander, Hoogendoorn, Jochem, De Vries, Alexander C., Meylaerts, Sven A. G., Verhofstad, Michiel H. J., Meijer, Joost, Van Egmond, Teun, Van Der Brand, Igor, Patka, Peter, Eversdijk, Martin G., Peters, Rolf, Den Hartog, Dennis, Van Waes, Oscar J. F., Oprel, Pim, Van Der Vis, Harm M., Campo, Martin, Verhagen, Ronald, Albers, G. H. Robert, Zurcher, Arthur W., Simmermacher, Rogier K. J., Van Mulken, Jeroen, Van Wessem, Karlijn, Van Gaalen, Steven M., Leenen, Luke, Bronkhorst, Maarten W. G. A., Guicherit, Onno R., Goslings, J. Carel, Ponsen, Kees Jan, Bhatia, Mahesh, Arora, Vinod, Tyagi, Vivek, Liew, Susan, Bedi, Harvinder, Carr, Ashley, Curry, Hamish, Chia, Andrew, Csongvay, Steve, Donohue, Craig, Doig, Stephen, Edwards, Elton, Etherington, Greg, Esser, Max, Gong, Andrew, Jain, Arvind, Li, Doug, Miller, Russell, Moaveni, Ash, Russ, Matthias, Ton, Lu, Wang, Otis, Dowrick, Adam, Murdoch, Zoe, Sage, Claire, Frihagen, Frede, Clarke-Jenssen, John, Hjorthaug, Geir, Ianssen, Torben, Amundsen, Asgeir, Brattgjerd, Jan Egil, Borch, Tor, Boe, Berthe, Flatoy, Bernhard, Hasselund, Sondre, Haug, Knut Jorgen, Hemlock, Kim, Hoseth, Tor Magne, Jomaas, Geir, Kibsgard, Thomas, Lona, Tarjei, Moatshe, Gilbert, Muller, Oliver, Molund, Marius, Nicolaisen, Tor, Nilsen, Fredrik, Rydinge, Jonas, Smedsrud, Morten, Stodle, Are, Trommer, Axel, Ugland, Stein, Karlsten, Anders, Ekas, Guri, Vesterhus, Elise Berg, Brekke, Anne Christine, Gupta, Ajay, Jain, Neeraj, Khan, Farah, Sharma, Ateet, Sanghavi, Amir, Trivedi, Mittal, Rai, Anil, Subash, Rai, Kamal, Yadav, Vineet, Singh, Sanjay, Tetsworth, Kevin, Donald, Geoff, Weinrauch, Patrick, Pincus, Paul, Yang, Steven, Halliday, Brett, Gervais, Trevor, Holt, Michael, Flynn, Annette, Prasad, Amal Shankar, Mishra, Vimlesh, Sundaresh, D. C., Khanna, Angshuman, Cherian, Joe Joseph, Olakkengil, Davy J., Sharma, Gaurav, Pirpiris, Marinis, Love, David, Bucknill, Andrew, Farrugia, Richard J., Pape, Hans-Christoph, Knobe, Matthias, Pfeifer, Roman, Hull, Peter, Lewis, Sophie, Evans, Simone, Nanda, Rajesh, Logishetty, Rajanikanth, Anand, Sanjeev, Bowler, Carol, Dadi, Akhil, Palla, Naveen, Ganguly, Utsav, Rai, B. Sachidananda, Rajakumar, Janakiraman, Jennings, Andrew, Chuter, Graham, Rose, Glynis, Horner, Gillian, Clark, Callum, Eke, Kate, Reed, Mike, Herriott, Chris, Dobb, Christine, Bhandari, Mohit, Swiontkowski, Marc, Devereaux, Pj, Jeray, Kyle, Thabane, Lehana, Walter, Stephen, Sprague, Sheila, Scott, Taryn, Guyatt, Gordon, Viveiros, Helena, McKay, Paula, Swinton, Marilyn, Truong, Victoria, Koo, Kaitlin, Heels-Ansdell, Diane, Zhou, Qi, Buckingham, Lisa, Duraikannan, Aravin, Maddock, Deborah, Agel, Julie, Van Lieshout, Esther M. M., Zielinski, Stephanie M., Rangan, Amar, Hanusch, Birgit C., Kottam, Lucksy, Clarkson, Rachel, Slobogean, Gerard, Katz, Jeffrey, Gillespie, Brenda, Greendale, Gail A., Guy, Pierre, Hartman, Curtis, Rubin, Craig, Waddell, James, and FAITH Investigators

Subjects
3. Good health
Abstract

BMC musculoskeletal disorders 15, 219 (2014). doi:10.1186/1471-2474-15-219, Published by BioMed Central, London

9. Rationale and design of the HIP fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) Trial : a protocol for an international randomised controlled trial evaluating early surgery for hip fracture patients

Author

Benjamin Deheshi, Gavin C A Wood, Aamer Nabi Nur, Maria Tiboni, Leslie Gauthier, Ekaterine Popova, Masood Umer, Patrice Forget, Parag Sancheti, Flávia Kessler Borges, Alben Sigamani, Philip J. Devereaux, Iain K. Moppett, Mitchell Winemaker, Wojciech Szczeklik, Mohit Bhandari, Abdel-Rahman Lawendy, Richard Kolesar, Vikas Tandon, Mariano Balaguer-Castro, Paweł Ślęczka, Shirley Pettit, Jordi Teixidor-Serra, Victoria Avram, Michael McGillion, Giovanni Landoni, Valerie Harvey, Ernesto Guerra-Farfán, Chew Yin Wang, Bobby John, Jordi Tomas-Hernandez, Ameen Patel, Anthony Adili, John Neary, Robert J. Feibel, Justin de Beer, Mmampapatla Thomas Ramokgopa, Richard Jenkinson, Bruce M Biccard, Jessica Vincent, Kim Alvarado, Harsha Shanthanna, Institut Català de la Salut, [Borges FK] Department of Perioperative Medicine, Population Health Research Institute, Hamilton, Ontario, Canada. [Bhandari M, Avram V] Department of Surgery, McMaster University, Hamilton, Ontario, Canada. [Patel A] Department of Medicine, McMaster University, Hamilton, Ontario, Canada. [Guerra-Farfán E, Teixidor-Serra J, Tomas-Hernandez J] Servei de Cirurgia Ortopèdica i Traumatologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain. [Sigamani A] Department of Clinical Research, Narayana Health, Bangalore, India., Vall d'Hebron Barcelona Hospital Campus, Supporting clinical sciences, Anesthesiology, Borges, Flavia K, Bhandari, Mohit, Patel, Ameen, Avram, Victoria, Guerra-Farfán, Ernesto, Sigamani, Alben, Umer, Masood, Tiboni, Maria, Adili, Anthony, Neary, John, Tandon, Vika, Sancheti, Parag K, Lawendy, Abdelrahman, Jenkinson, Richard, Ramokgopa, Mmampapatla, Biccard, Bruce M, Szczeklik, Wojciech, Wang, Chew Yin, Landoni, Giovanni, Forget, Patrice, Popova, Ekaterine, Wood, Gavin, Nabi Nur, Aamer, John, Bobby, Ślęczka, Paweł, Feibel, Robert J, Balaguer-Castro, Mariano, Deheshi, Benjamin, Winemaker, Mitchell, de Beer, Justin, Kolesar, Richard, Teixidor-Serra, Jordi, Tomas-Hernandez, Jordi, Mcgillion, Michael, Shanthanna, Harsha, Moppett, Iain, Vincent, Jessica, Pettit, Shirley, Harvey, Valerie, Gauthier, Leslie, Alvarado, Kim, and Devereaux, P J

Subjects
Male, Time Factors, accelerated surgery, law.invention, 0302 clinical medicine, Postoperative Complications, Randomized controlled trial, law, Informed consent, Protocol, 030212 general & internal medicine, Stroke, Medicine(all), Hip fracture, Mortality rate, Wounds and Injuries::Fractures, Bone::Femoral Fractures::Hip Fractures [DISEASES], General Medicine, Middle Aged, Other subheadings::Other subheadings::/surgery [Other subheadings], 3. Good health, Pulmonary embolism, Research Design, hip fracture, randomised control trial, Female, medicine.medical_specialty, heridas y lesiones::fracturas óseas::fracturas del fémur::fracturas de cadera [ENFERMEDADES], 03 medical and health sciences, Health Care Facilities, Manpower, and Services::Health Services::Preventive Health Services::Early Medical Intervention [HEALTH CARE], medicine, Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Epidemiologic Study Characteristics::Clinical Protocols::Clinical Trial Protocols as Topic [HEALTH CARE], Humans, Articulació coxofemoral - Cirurgia, Aged, business.industry, Hip Fractures, Otros calificadores::Otros calificadores::/cirugía [Otros calificadores], Perioperative, medicine.disease, calidad, acceso y evaluación de la atención sanitaria::calidad de la atención sanitaria::mecanismos de evaluación de la atención sanitaria::características de los estudios epidemiológicos::protocolos clínicos::protocolos de ensayos clínicos como asunto [ATENCIÓN DE SALUD], Physical therapy, instalaciones, servicios y personal de asistencia sanitaria::servicios de salud::servicios preventivos de salud::intervención médica temprana [ATENCIÓN DE SALUD], Observational study, Surgery, business, 030217 neurology & neurosurgery, Assaigs clínics
Abstract

IntroductionAnnually, millions of adults suffer hip fractures. The mortality rate post a hip fracture is 7%–10% at 30 days and 10%–20% at 90 days. Observational data suggest that early surgery can improve these outcomes in hip fracture patients. We designed a clinical trial—HIP fracture Accelerated surgical TreaTment And Care tracK (HIP ATTACK) to determine the effect of accelerated surgery compared with standard care on the 90-day risk of all-cause mortality and major perioperative complications.Methods and analysisHIP ATTACK is a multicentre, international, parallel group randomised controlled trial (RCT) that will include patients ≥45 years of age and diagnosed with a hip fracture from a low-energy mechanism requiring surgery. Patients are randomised to accelerated medical assessment and surgical repair (goal within 6 h) or standard care. The co-primary outcomes are (1) all-cause mortality and (2) a composite of major perioperative complications (ie, mortality and non-fatal myocardial infarction, pulmonary embolism, pneumonia, sepsis, stroke, and life-threatening and major bleeding) at 90 days after randomisation. All patients will be followed up for a period of 1 year. We will enrol 3000 patients.Ethics and disseminationAll centres had ethics approval before randomising patients. Written informed consent is required for all patients before randomisation. HIP ATTACK is the first large international trial designed to examine whether accelerated surgery can improve outcomes in patients with a hip fracture. The dissemination plan includes publishing the results in a policy-influencing journal, conference presentations, engagement of influential medical organisations, and providing public awareness through multimedia resources.Trial registration numberNCT02027896; Pre-results.

Published
2019

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