Fixing the hip socket with plates and screws versus adding a hip replacement for older adults with a broken acetabulum
GATOR: Geriatric Acetabular fracTures: Open Reduction Internal Fixation Versus Replacement - A Large Cohort of Acute Open Reduction Internal Fixation (ORIF) Versus Total Hip Arthroplasty for Geriatric Acetabular Fractures
This study will try two surgical approaches—ORIF alone versus ORIF plus a primary total hip replacement—in people 60 and older with an acute displaced acetabular (hip socket) fracture to see which gives better pain, function, and quality of life.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 104 (estimated) |
| Ages | 60 Years and up |
| Sex | All |
| Sponsor | Unity Health Toronto Academic / other |
| Locations | 1 site (Toronto, Ontario) |
| Trial ID | NCT03713853 on ClinicalTrials.gov |
What this trial studies
This is a multicentre observational cohort of patients aged 60 and older with acute displaced acetabular fractures treated either with open reduction internal fixation (ORIF) alone or with ORIF plus a primary total hip arthroplasty (THA) at surgeon discretion. Enrolled participants are followed to 24 months with standard-of-care clinic visits at 6 weeks, 3, 6, 12, and 24 months. Outcomes include patient-reported measures (Oxford Hip Score, EQ-5D) and objective mobility testing (Timed Up & Go). The study aims to compare functional recovery, quality of life, and need for subsequent hip procedures between the two surgical strategies.
Who should consider this trial
Good fit: Ideal candidates are ambulatory adults aged 60 or older with an isolated, displaced acetabular fracture within three weeks of injury who require surgical treatment, can provide informed consent, and can read English.
Not a fit: Patients with open fractures, active local infection, bilateral or pathological (non-osteoporotic) or periprosthetic fractures, dementia, or contraindications to surgery are unlikely to benefit from participation or be eligible.
Why it matters
Potential benefit: If successful, the results could help surgeons choose the operation that leads to better pain relief, mobility, and fewer reoperations for older adults with acetabular fractures.
How similar studies have performed: Previous observational series and registry data have reported high rates of later hip replacement after ORIF alone, but direct comparative randomized evidence between ORIF and ORIF+THA in this population is limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * 60 years of age or older * Isolated and Displaced (more or equal to 2mm on any radiographic view) fracture of the acetabulum * Patient requires surgical treatment, either THA+ORIF or ORIF surgeries * Fracture is acute (within 3 weeks of injury) * Patient was ambulatory (with or without walking aids) prior to their acetabular fracture injury * Patient is able to provide informed consent to participation in the study * Patient is able to read and understand English Exclusion Criteria: * Presence of an active or chronic infection around the fracture (soft tissue or bone) * Open/compound fracture * Bilateral acetabular fractures * Pathological fracture excluding osteoporosis * Periprosthetic fracture (previous arthroplasty or hardware or ORIF in-situ). Hardware (screws or plates or nails or hemi-arthroplasty) on the femoral side are not excluded. * Medical or surgical contraindication to surgery * Dementia
Where this trial is running
Toronto, Ontario
- Unity Health Toronto - St Michael's Hospital — Toronto, Ontario, Canada (Recruiting)
Study contacts
- Principal investigator: Amir Khoshbin, MD — Unity Health Toronto
- Study coordinator: Cassandra Tardif-Theriault, BKin
- Email: cassandra.tardif-theriault@unityhealth.to
- Phone: 4168646060
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.