RecruitingNot ApplicableNCT07244211

MAPT Protocol: Fixation Versus Arthroplasty Surgical Treatments for Early Recovery After HIP Fracture (FASTER-HIP)

Musculoskeletal Adaptive Platform Trial (MAPT): Fixation Versus Arthroplasty Surgical Treatments for Early Recovery After HIP Fracture (FASTER-HIP)

Sponsor

University of Southern California

Enrollment

600 participants

Start Date

Jan 23, 2026

Study Type

INTERVENTIONAL

Conditions

Femoral Neck Fractures

Summary

This study is an intervention domain of the Musculoskeletal Adaptive Platform Trial. The primary goal of this pragmatic, randomized, open-label, comparative effectiveness trial is to evaluate if arthroplasty is superior to internal fixation when used to treat minimally displaced femoral neck fractures in older adults ≥60 years old. We hypothesize that arthroplasty will reduce death, preserve ambulation, increase days alive and out of hospital, and improve health status compared to internal fixation within 4 months and 12 months from randomization.

Eligibility

Min Age: 60 Years

Inclusion Criteria6

years of age or older undergoing surgery due to a minimally displaced femoral neck fracture
The patient has a health condition affecting physical mobility.
Complete fracture of the femoral neck (AO/OTA 31B) confirmed with anteroposterior and lateral hip radiographs, computed tomography, or magnetic resonance imaging.
Minimally displaced fracture that could be, in the judgment of the attending surgeon, managed with either arthroplasty or in situ internal fixation without reduction.
Low energy injury mechanism.
Surgeons with expertise in internal fixation and total hip arthroplasty or hemiarthroplasty are available to perform surgery.

Exclusion Criteria19

The patient is not clinically suitable for either compared treatment.
Expected injury survival of less than 12 months.
Terminal illness with expected survival of less than 12 months.
Incarceration.
Unable to obtain informed consent due to language barriers.
Unable to obtain informed consent because the legally authorized representative was unavailable.
Problems, in the judgment of the study personnel, with maintaining follow-up with the patient.
Currently enrolled in a study or intervention domain that does not permit co-enrollment.
Prior enrollment in the specific platform trial intervention domain.
Patient or legally authorized representative did not provide informed consent (declined participation).
Eligible patient or legally authorized representative was not approached within the screening window (missed participant).
Other reasons to exclude the patient, as approved by the data coordinating center.
Associated lower extremity injury that prevents post-operative weight-bearing.
Retained hardware around the hip that precludes either study treatment.
Infection around the hip (soft tissue or bone).
Pathologic fracture with a lytic lesion in the femoral neck that precludes internal fixation.
Injury did not occur within 21 days of screening.
Patient is too ill, in the judgment of the attending surgeon, for internal fixation.
Patient is too ill, in the judgment of the attending surgeon, for arthroplasty.

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Interventions

PROCEDUREHip arthroplasty

Participants will undergo surgical treatment using standard hip arthroplasty techniques for femoral minimally displaced femoral neck fracture. A modern porous-coated press-fit or cemented hip arthroplasty prosthesis will be used at the treating surgeon's discretion. Press-fit implants that have no ingrowth or ongrowth surface will not be permitted. The type of hip prosthesis (hemiarthroplasty or total hip arthroplasty), bearing (single or dual mobility), or the method of arthroplasty fixation (cemented or uncemented) will be at the discretion of the treating surgeon.

PROCEDUREInternal fixation

Participants will undergo surgical treatment using standard fixation techniques for minimally displaced femoral neck fractures. The treating surgeon may perform fracture reduction maneuvers if desired. Fixed-angle devices and multiple screws will be permitted. The internal fixation device(s) will be inserted through a small lateral incision. Internal fixation constructs combining cancellous screws and fixed-angle devices will be permitted.