Actively Recruiting
pDIFFIR: Geriatric Periprosthetic DIstal Femur: FIxation Versus Replacement
Led by Unity Health Toronto · Updated on 2025-12-18
148
Participants Needed
1
Research Sites
373 weeks
Total Duration
On this page
Sponsors
U
Unity Health Toronto
Lead Sponsor
M
Mount Sinai Hospital, Canada
Collaborating Sponsor
AI-Summary
What this Trial Is About
Periprosthetic distal femur fractures are a significant source of morbidity and mortality for elderly patients. One treatment option involved a surgical fixation with plates or nails, screws and cables/wires along the side of your fractured bone. The second method consists in replacing your knee joint with an artificial knee prosthesis (artificial knee joint). The primary objective is to determine if acute distal femur replacement improves knee pain and functional outcomes compared to surgical fixation. Secondary outcomes are mortality, reoperation, complications, post-operative pain and quality of life. A health economic analysis will be conducted to assess the cost-effectiveness of both treatments. A total of 148 patients (74/group) will be enrolled in the study.
CONDITIONS
Official Title
pDIFFIR: Geriatric Periprosthetic DIstal Femur: FIxation Versus Replacement
Who Can Participate
Eligibility Criteria
You may qualify if you...
- 65 years and older
- Isolated periprosthetic fracture of the distal femur around a stable primary total knee arthroplasty (Lewis and Rorabeck Type 1-2)
- Fracture is acute (within 1 week from time of injury)
- Patient was ambulatory (with or without walking aids) in the community and at home prior to the injury
- Independent or moderately frail with score of 3 to 6 on the validated Clinical Frailty Scale
- Patient is able to read and understand the consent form document, or an interpreter is available to the patient at the time of consent and follow-up
- Patient or substitute decision maker is able to provide written informed consent to participate in the study
You will not qualify if you...
- Active infection around the fracture (soft tissue or bone)
- Open fracture
- Bilateral femur fractures
- Major neuro-vascular injury requiring intervention, compartment syndrome and major neurologic injuries
- Pathological fracture excluding osteoporosis
- Ipsilateral total knee arthroplasty using revision components (varus/valgus constraint, stemmed femoral components)
- Periprosthetic distal femur fracture around a loose or failing primary total knee arthroplasty (Lewis and Rorabeck Type III)
- Ipsilateral primary partial knee or patellofemoral arthroplasty
- Previous ORIF of the distal femur or proximal tibia or patella
- Current or previous extensor mechanism (patellar tendon, quadriceps tendon, or patella fracture) disruption or repair
- Poly-trauma status (Injury Severity Score>15) or any associated major injuries of the lower extremities that may hinder post-operative ambulation
- Medical contraindication to surgery
AI-Screening
AI-Powered Screening
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Trial Site Locations
Total: 1 location
1
St. Michael's Hospital
Toronto, Ontario, Canada, M5B 1W8
Actively Recruiting
Research Team
C
Cassandra Tardif-Theriault
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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