CompletedInterventional

AceFIT – a study comparing three methods of treatment of acetabular fractures (a type of hip fracture) in older patients; surgical fixation versus surgical fixation and hip replacement versus non-surgical treatment

Around 1,500 older adults in the UK break the pelvic socket of their hip joint each year. Because bones can be fragile in later life, these injuries are difficult to treat. Doctors usually recommend one of three standard options: resting the leg without surgery, an operation to fix the broken bone with screws and plates, or an operation that fixes the bone and replaces the hip joint. Resting or standard bone fixation means you cannot put weight on your leg for several weeks. Adding a hip replacement may allow you to walk much sooner. However, doctors do not yet know which approach gives patients the best long-term recovery and quality of life. The AceFIT study compares these three treatments in adults aged 60 and over. Patients are randomly assigned to one option and followed for nine months to see which method leads to the best healing and mobility.

At a glance

Status

Completed

Sponsor

Cambridge University Hospitals NHS Foundation Trust

Enrolment target

Start

20 Nov 2017

Estimated completion

31 Dec 2019

Musculoskeletal trauma

What is this study about?

The hip is a ball-and-socket joint. When older adults suffer a serious fall, they can break the socket part of the pelvis, known as the acetabulum. These breaks can be complex because older bones are often weaker and can shatter into several pieces.

At present, NHS hospitals treat this injury in three different ways. The first is non-surgical care, which allows the bone to heal on its own while the patient avoids putting weight on the injured leg. The second is an operation where a surgeon uses metal plates and screws to hold the broken pieces in place. The third option fixes the broken bone and replaces the worn or damaged hip joint with an artificial one during the same operation. This third method often allows patients to walk on the leg immediately.

Doctors do not yet agree on which treatment works best. Avoiding surgery prevents operation risks, but long periods of bed rest can cause weakness. Bone fixation repairs the natural joint, but recovery can be slow. A hip replacement allows quicker walking, but artificial joints carry their own surgical risks.

The AceFIT study is designed to see whether running a large-scale national trial comparing these three treatments is practical. By gathering information on healing, pain, and everyday activity, researchers hope to discover which approach offers older patients the safest and quickest path back to independence.

Key takeaways

AceFIT compares three standard treatments for broken hip sockets in adults aged 60 and over.
Treatments include non-surgical rest, fixing the bone with plates and screws, or bone fixation combined with a hip replacement.
Participants are randomly assigned to one of the three treatment paths.
Follow-up lasts for nine months and includes two hospital clinic visits.
The goal is to find out which option provides the best mobility, safety, and quality of life.

Who may be eligible?

This study is designed for adults aged 60 and older who have broken the socket of their hip joint, where the bone has moved out of place enough that an orthopaedic surgeon would consider surgery. People who have memory problems or confusion (such as dementia) can still take part if a family member or legal representative agrees on their behalf.

You cannot take part if the broken bone has pierced through your skin (an open fracture) or if you are not well enough to have a general anaesthetic. The study is also not suitable for people who already had an artificial hip replacement on the injured side before the break happened.

Finally, patients cannot join if they were already unable to walk before the injury (for example, completely confined to a bed or wheelchair) or if they have other severe broken bones that would stop them from completing normal rehabilitation.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

I am aged 60 or older.
I have recently broken the socket part of my hip (acetabulum).
My broken bone has moved out of place and surgery is being considered.
I did not have an artificial hip joint on this side before the break.
I was able to walk (not completely confined to a bed or chair) before the injury.
I do not have other major broken bones that prevent standard recovery.

Answer every question to see your result.

What does participation involve?

If you take part, an automated computer system will randomly place you into one of three treatment groups: resting without surgery, surgery to fix the bone, or surgery to fix the bone and replace the hip joint. All three are standard NHS treatments. You will receive standard hospital care during your stay. After going home, you will attend two outpatient clinic visits over a nine-month period. During these check-ups, the research team will examine your hip, ask questions about your daily activities, pain levels, and quality of life, and review your standard healing X-rays. You will be in the study for a total of nine months.

Potential risks and benefits

Participants benefit from closer monitoring and regular access to a dedicated research nurse who can answer questions about recovery. Because all three options are standard NHS treatments, being in the trial does not involve untested procedures. However, all treatments carry potential risks. Operations carry risks of bleeding, blood clots, wound infection, nerve damage, or complications from anaesthesia. Non-surgical care requires keeping weight off the leg for weeks, which can cause muscle weakness, stiffness, and lasting pain. You are free to leave the study at any point without giving a reason, and your medical care will not be affected.

Locations (12)

Addenbrooke’s Hospital (Lead Centre)
City only
Cambridge, England
The Royal London Hospital
Approximate
London, England
Southmead Hospital
Approximate
Bristol, England
Walsgrave General Hospital
City only
Coventry, England
Queens Medical Centre
Approximate
Nottingham, England
St James’s University Hospital
Unverified
Leeds, England
University Hospitals of North Midlands NHS Trust
Unverified
Stoke on Trent, England
John Radcliffe Hospital
Unverified
Oxford, England
The James Cook University Hospital
Unverified
Middlesbrough, England
Cardiff and Vale University Health Board
Unverified
Cardiff, Wales
St George's University Hospitals NHS Foundation Trust
Unverified
London, England
Morriston Hospital
Unverified
Swansea, Wales

Common questions

Can I choose which of the three treatments I get?

No. A computer randomly selects your treatment so that researchers can make a fair and unbiased comparison between the three options.

Will I need extra X-rays because of the study?

No. The X-rays you receive are the same routine scans you would have during normal NHS care to check that your bone is healing.

Can someone join if they cannot make decisions for themselves?

Yes. If an older adult lacks the capacity to consent due to illness or memory loss, a close family member or nominated representative can agree on their behalf.

Does this trial involve experimental drugs or devices?

No. All plates, screws, hip implants, and non-surgical methods used in this study are already approved and routinely used in the NHS.

What happens if I change my mind later on?

Taking part is entirely voluntary. You can withdraw from the study at any time, and you will continue to receive standard NHS care.

How to find out more

Andrew Carrothers

andrew.carrothers@addenbrookes.nhs.uk +44 (0)1223 257093 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.