New Tools for Assessing Fracture Risk

NCT ID: NCT02436356

Last Updated: 2020-11-02

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-06-30

Study Completion Date

2018-11-08

Brief Summary

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The goal of this study is to determine whether two new, non-X-ray techniques can discriminate between high-energy fractures of normal bone (trauma) and low-energy fractures (fragility) of osteoporotic bone. The current gold-standard for assessing fracture risk areal bone mineral density (aBMD) by dual energy X-ray absorptiometry (DXA) is not particularly effective at identifying individuals who are at risk of suffering a fracture. Yet, there is a growing population of diabetics and elderly individuals prone to fractures. In effect, the age-related and diabetes-related increase in fracture risk is independent of a person's aBMD. These findings stress the urgency in developing diagnostic tools that can improve fracture risk prediction so that patients can be treated with the appropriate anti-fracture therapies.

Detailed Description

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Conditions

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Osteoporosis Fracture Risk Assessment

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Distal Radius Fracture Operative Group

Fracture group patients will undergo DXA and MRI scans, along with Osteoprobe indentation.

Group Type ACTIVE_COMPARATOR

Osteoprobe-Reference Point Indentation (RPI)

Intervention Type DEVICE

Diagnostic tool used for bone indentation to measure the ability of the tissue to resist microindentation (bone mineral strength).

Dual-energy X-ray absorptiometry (DXA) Scans

Intervention Type RADIATION

Assessment of Fracture Risk

MRI

Intervention Type RADIATION

Determines bound water and pore water of bone.

Healthy Volunteers (Non Fracture Group)

Healthy volunteers will undergo DXA and MRI scans.

Group Type ACTIVE_COMPARATOR

Dual-energy X-ray absorptiometry (DXA) Scans

Intervention Type RADIATION

Assessment of Fracture Risk

MRI

Intervention Type RADIATION

Determines bound water and pore water of bone.

Distal Radius Fracture Non-operative Group

Fracture group patients will undergo DXA and MRI scans, but will not undergo Osteoprobe indentation.

Group Type ACTIVE_COMPARATOR

Dual-energy X-ray absorptiometry (DXA) Scans

Intervention Type RADIATION

Assessment of Fracture Risk

MRI

Intervention Type RADIATION

Determines bound water and pore water of bone.

Interventions

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Osteoprobe-Reference Point Indentation (RPI)

Diagnostic tool used for bone indentation to measure the ability of the tissue to resist microindentation (bone mineral strength).

Intervention Type DEVICE

Dual-energy X-ray absorptiometry (DXA) Scans

Assessment of Fracture Risk

Intervention Type RADIATION

MRI

Determines bound water and pore water of bone.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

1. Patients who are 18 years of age or older. This age range accounts for 60% of all distal radius fractures seen at Vanderbilt University Medical Center.
2. Patients who have sustained a low or high energy distal radius fracture that involves the metaphysis and requires open reduction internal fixation using volar plating.
3. English speaking due to feasibility of employing study personnel to deliver and assess study intervention.


1. Patients who are 18 years of age or older.
2. Patients who have no history of fracture or family history of pathologic fracture
3. English speaking due to feasibility of employing study personnel to deliver and assess study intervention.


1. Patients who are 18 years of age or older. This age range accounts for 60% of all distal radius fractures seen at Vanderbilt University Medical Center.
2. Patients who have sustained a low or high energy distal radius fracture that requires nonoperative treatment
3. English speaking due to feasibility of employing study personnel to deliver and assess study intervention.

Exclusion Criteria

Number of patients in Arm#1= 60 patients


1. Patients who have known risk factors of pathologic fractures (e.g. bone metastasis)
2. Patients who have or are receiving treatment for osteoporosis (e.g. bisphosphonate) lasted longer than 5 years
3. Patients who have Type 1 diabetes
4. Patients who have other bone disease (e.g., osteogenesis imperfecta, Paget's disease, thyroid disease, Vitamin D deficiency, hyperparathyroidism)
5. Patients that have a history of cancer, abnormal serum calcium, or chronic steroid use
6. Patients that would not be able to have a DXA scan (weight \>350lbs, hardware in hips, patients that have lap band device)
7. Patients who are pregnant or who think they may be pregnant
8. Patients that have a medical contraindication to MRI (if patients are undergoing a study MRI)
9. Patients who have concurrent, bilateral upper extremity fractures where hardware or casting may affect study scan measurements
10. Patients who have distal radial shaft fractures



Number of patients in Arm#2= 40 patients


1. Patients who are taking medication to treat osteoporosis (e.g. bisphosphonate)
2. Patients who have or are receiving treatment for osteoporosis (e.g. bisphosphonate) lasted longer than 5 years
3. Patients who have Type 1 diabetes
4. Patients who have other bone disease (e.g., osteogenesis imperfecta, Paget's disease, thyroid disease, Vitamin D deficiency, hyperparathyroidism).
5. Patients that have a history of cancer, abnormal serum calcium, or chronic steroid use.
6. Patients that would not be able to have a DXA scan (weight \>350lbs, hardware in hips, patients that have lap band device)
7. Patients who are pregnant or who think they may be pregnant.
8. Patients that have a medical contraindication to MRI.



Number of patients in Arm#3= up to 10 patients


1. Patients who have known risk factors of pathologic fractures (e.g. bone metastasis)
2. Patients who have or are receiving treatment for osteoporosis (e.g. bisphosphonate) lasted longer than 5 years
3. Patients who have Type 1 diabetes
4. Patients who have other bone disease (e.g., osteogenesis imperfecta, Paget's disease, thyroid disease, Vitamin D deficiency, hyperparathyroidism)
5. Patients that have a history of cancer, abnormal serum calcium, or chronic steroid use
6. Patients that would not be able to have a DXA scan (weight \>350lbs, hardware in hips, patients that have lap band device)
7. Patients who are pregnant or who think they may be pregnant
8. Patients that have a medical contraindication to MRI (if patients are undergoing a study MRI)
9. Patients who have concurrent, bilateral upper extremity fractures where hardware or casting may affect study scan measurements
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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ActiveLife Scientific

INDUSTRY

Sponsor Role collaborator

National Center for Advancing Translational Sciences (NCATS)

NIH

Sponsor Role collaborator

Vanderbilt University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Jeffry Nyman

Assistant Professor of Orthopaedics and Rehabilitation

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jeffry S Nyman, PhD

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt University Medical Center

Locations

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Vanderbilt Univeristy Medical Center

Nashville, Tennessee, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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UL1TR000445

Identifier Type: NIH

Identifier Source: secondary_id

View Link

141125

Identifier Type: -

Identifier Source: org_study_id