Acetabular Fracture

Researchers are investigating the effects of a categorized physical therapy program on people with non-arthritic hip and groin pain. This study addresses a gap in current research, which has mostly focused on osteoarthritis of the hip, by exploring how a standardized physical therapy approach can help those without arthritis-related hip problems. The trial is randomized and aims to better understand treatment options for hip and groin pain. Participants will be assigned to one of two groups one receiving standard-of-care physical therapy, and the other receiving matrix-based physical therapy in addition to the standard care. Matrix-based therapy involves tailoring stretches and strengthening exercises based on the patients hip mobility and strength. Both approaches will be monitored over the course of the study. Throughout the study, participants will be evaluated using the International Hip Outcome Tool-12 iHOT-12 for up to 6 months to measure hip function and health. Pain levels will be assessed with a numerical rating scale, and adherence to home exercise programs will be tracked. The study includes double-masked procedures to reduce bias and will provide detailed monitoring of participants progress and response to therapy.

Researchers are evaluating a new endoscopic surgical technique to treat acetabulum fractures, which are breaks in the socket of the hip bone. These fractures can result from falls in older adults or high-energy accidents in younger people. Traditional surgery involves open procedures, but this study aims to develop a less invasive method using endoscopy to improve safety and patient outcomes. The study involves three parts first developing the endoscopic surgical method using cadavers, then testing it prospectively in patients, and finally conducting a randomized controlled trial comparing the new endoscopic technique with the current standard open surgery called the modified Stoppa approach. The endoscopic method involves operating through small incisions using an extraperitoneal approach similar to hernia repair surgeries. Participants will be monitored for operation time, major and minor complications within three months, and patient satisfaction over about one year using health questionnaires. The study will include adults with anterior acetabular fractures suitable for the endoscopic method. Those with previous lower abdominal surgery or under 18 years old will be excluded. The trial will help determine if the new technique reduces surgery time, blood loss, and improves recovery compared to traditional surgery.

Greater Trochanteric Pain Syndrome GTPS is a condition causing pain on the outer side of the hip, often affecting middle-aged women. This trial evaluates a simple exercise timing approach to see if following a prescribed hip exercise programme early in the day helps improve adherence. Researchers compare whether timing guidance, with or without reminders, is easier and more acceptable than usual care for adults diagnosed with GTPS. Participants are randomly assigned to one of three groups one group receives information about exercising early in the morning plus weekly digital reminders another group receives only the information without reminders and the third group follows their usual prescribed exercises without any timing guidance or reminders. All participants follow the same hip-strengthening exercises prescribed by their healthcare provider over a 28-day intervention period. During the study, participants complete a short daily survey about their exercise for 28 days and fill out online questionnaires on hip pain, movement, and exercise at five points over about three months. Some participants will join online group discussions at the end to share their experiences. Researchers monitor recruitment, retention, questionnaire completion, and participant feedback to assess the feasibility of this approach and inform future larger trials.

Researchers are studying the management of acetabular hip fractures in adults aged 60 years and older, focusing on the challenges posed by pre-existing medical conditions, osteoporosis, and increased mortality risk. The study compares two surgical options open reduction internal fixation ORIF alone versus ORIF combined with acute primary total hip arthroplasty THA. This observational cohort study involves multiple Canadian academic institutions affiliated with the Canadian Orthopaedic Trauma Society COTS. Participants will receive either ORIF alone or ORIF combined with THA, based on surgeon discretion. These treatments are part of their standard surgical care following an acetabular fracture, which is an acute, displaced fracture requiring surgery. After surgery, patients will be followed for up to 24 months, with assessments at 6 weeks, 3, 6, 12, and 24 months. During follow-up, patients will complete questionnaires such as the Oxford Hip Score to measure pain and function, the EQ-5D to assess quality of life, and undergo the Timed Up & Go test to evaluate mobility and fall risk. Additional outcomes include pain levels, morphine usage, hospital stay length, discharge location, time to weight-bearing, return to work or daily activities, and hospital readmission rates. Data collected will help assess recovery and physical function after these surgical treatments.

Researchers are evaluating the feasibility of two live video-based pain management programs for adults with chronic hip-related pain that is not caused by arthritis. This randomized controlled trial aims to compare two interventions, HIPS-1 and HIPS-2, focusing on feasibility, credibility, and acceptability. The study will help optimize recruitment, protocols, and materials in preparation for a future trial testing efficacy. Both programs include six weekly 30-minute sessions delivered by trained physical therapists via live video. HIPS-1 is a mind-body intervention teaching relaxation, coping skills, and pain education, while HIPS-2 focuses on healthy lifestyle education including physical activity, sleep, and nutrition. Participants in both groups also continue their usual prescribed physical therapy and complete weekly check-in surveys. Sessions are audio-recorded for quality checks. Participants complete a baseline digital survey before randomization, followed by six intervention sessions over about six weeks. Additional assessments occur immediately after the program and at a six-month follow-up. Researchers will monitor participant satisfaction, program completion rates, symptom changes, and adverse events. Various pain and physical function questionnaires are collected throughout the study to evaluate outcomes and intervention fidelity.

Pelvic fragility fractures in elderly patients often lead to serious health problems and high death rates. Currently, treatment approaches vary widely due to the lack of a standard protocol. This trial evaluates a new clinical pathway based on evidence and expert experience, aiming to improve outcomes for this vulnerable group who face multiple risks for poor recovery. The study compares the usual care with an evidence-based clinical pathway designed to guide diagnosis and treatment strategies. Patients will be randomly assigned to either continue with standard care or follow this best-practice clinical pathway. The pathway focuses on early diagnosis and minimally invasive treatments tailored for fragile patients. Participants will be monitored over time to assess their mobility, daily function, quality of life, pain levels, medication use, complication rates, and mortality. Assessments use tools like the Parker mobility score, Elderly mobility scale, Katz Index, EuroQol quality of life questionnaire, and pain rating scales. Follow-ups occur at multiple intervals up to two years, with careful tracking of recovery and any additional injuries or complications.

Researchers are comparing two types of surgeries for patients aged 65 and older who have unstable trochanteric hip fractures, a serious injury common in older adults that often leads to pain, decreased mobility, and increased risk of death. The study aims to see if hip arthroplasty improves mobility, overall health, quality of life, and reduces the need for additional surgeries compared to the traditional intramedullary nail treatment. This trial will help determine the best approach to treat these complex fractures, which currently have high complication and re-operation rates. Participants will be randomly assigned to receive either an intramedullary nail or hip arthroplasty. The intramedullary nail group will have a procedure involving a long nail inserted into the femur and may include additional fixation methods if needed. The hip arthroplasty group will undergo either hemiarthroplasty or total hip arthroplasty using specific prosthetic components, with surgery performed by experienced orthopedic surgeons. Both techniques follow detailed surgical protocols to ensure proper treatment of the unstable fractures. Throughout the study, patients will be followed up at 2, 6, and 12 months after surgery to assess their recovery. Evaluations include patient-reported outcome measures, physical tests such as the timed up and go test and Trendelenburg test, clinical assessments of leg length difference, and hip X-rays to monitor implant positioning and bone healing. The research team will collect data on complications, reoperations, and mortality to compare the effectiveness and safety of each treatment over time.

Researchers are comparing two regional anesthesia techniques to manage postoperative pain in patients undergoing total hip replacement surgery using the direct anterior approach. This surgery is commonly done for conditions like degenerative osteoarthritis, osteonecrosis, congenital disorders such as dysplasia, and inflammatory arthritis. The direct anterior approach aims to spare hip muscles, reduce dislocation risk, limit soft tissue damage, and support quicker recovery, but patients can experience moderate to severe pain and opioid-related side effects after surgery. The study compares the Suprainguinal Fascia Iliaca SIFI block and the lumbar Erector Spinae Plane ESP block, both involving infiltration of local anesthetics Ropivacaine 0.375, 40 mL in specific nerve or fascial areas. Participants receive one of these two blocks during surgery. The primary focus is on nerve block incidence 8 hours post-surgery. Secondary goals include measuring recovery time for lower limb movement, opioid use, pain levels, sensory block extent, hospital discharge timing, and rates of chronic pain and complications up to 90 days after surgery. Participants will be monitored through physical assessments evaluating nerve function, pain using the Numeric Rating Scale, opioid consumption, and sensory nerve block at 8, 24, and 48 hours post-surgery. Researchers will also track postoperative complications, hospital discharge timing, and persistent pain at 30 and 90 days. The total involvement includes surgery, immediate postoperative monitoring, and follow-up visits to assess recovery and side effects.

Researchers are investigating whether a new care concept called gero-ERAT, which combines two structured care approaches CGA and ERAS, can improve recovery for elderly patients who have experienced physical trauma. This project aims to reduce complications, shorten hospital stays, decrease readmissions, and help more patients return to normal life, benefiting both patients and society. The research will include qualitative interviews and prospective cohort studies to better understand patient experiences and the impact of the new care model. The study compares conventional care with the gero-ERAT care pathway at a university hospital trauma unit. The gero-ERAT intervention involves a standardized care plan based on evidence for elderly trauma patients and includes patient participation and feedback. Data collection will occur at baseline, six months, and one year after hospital discharge, with patients completing several surveys and questionnaires related to quality of life, symptom assessment, daily activities, and recovery. Participants will be involved through interviews and survey completion, with data gathered from medical records and patient responses. Researchers will measure hospital length of stay, complications, readmissions, mortality, and various health and recovery scales over one year. The project also includes health economic evaluations and subgroup analyses based on age and frailty. The total study duration is up to eight years, with ongoing data analysis and publication plans.

This research aims to understand how patients recover in terms of function and self-reported outcomes after experiencing pelvic or acetabular fractures. It includes patients treated with surgery or without surgery and seeks to answer important questions about these treatments by capturing data over time. Patients in the study are grouped based on having either pelvic ring fractures or acetabular fractures. The study collects information regardless of whether the treatment was operative surgical or nonoperative nonsurgical. Various performance and patient-reported outcome measures, including the NIH PROMIS tool, are used to monitor recovery. Participants will be followed for up to 24 months after their injury. During this time, researchers will assess their return to work and daily activities, track fracture healing and complications, and evaluate physical performance through tests like the 10 meter walk, Five Time Sit to Stand, and Timed Up and Go. Patient feedback is collected at multiple time points to understand their health status and function over time.