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N-Force Screws Augmented With N-Force Blue in Hip Fractures

N-Force Screws Augmented With N-Force Blue in Intracapsular Proximal Femur Fracture Treatment

Status
Terminated
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03807349
Acronym
N-Force
Enrollment
12
Registered
2019-01-16
Start date
2019-02-21
Completion date
2021-03-11
Last updated
2022-06-08

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Garden Grade II Subcapital Fracture of Femoral Neck, Garden Grade I Subcapital Fracture of Femoral Neck, Intracapsular Proximal Femur Fracture

Keywords

Cannulated Screws, Augmentation

Brief summary

The objective of this prospective study is to confirm safety and performance of N-Force Screws augmented with N-Force Blue applied in intracapsular proximal femur fracture treatment.

Detailed description

Primary Endpoint: • Re-operation within 12 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Secondary Endpoints: * Radiographic and clinical fracture healing of the proximal femur using standard scoring methods and patient satisfaction. * Cost effectiveness

Interventions

DEVICEN-Force Screws Augmented with N-Force Blue

N-Force Fixation System 7.3 mm (Non-fenestrated/fenestrated) applied with washers; N-Force Blue (Bone Substitute Material)

Sponsors

Zimmer Biomet
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Patient has primary Garden I or II intracapsular proximal femur fracture requiring surgical intervention and is eligible for fixation by three cannulated screws augmented with N-Force Blue. * Patient receives operative treatment within 7 days of injury. * Patient was ambulatory before injury. * Patient is 50 years of age or older.

Exclusion criteria

* Patient has Garden III or IV intracapsular proximal femur fracture. * Patient has major cognitive impairment (including dementia). * Patient is on dialysis. * Patient is not expected to survive follow-up schedule. * Patient is expected to have problems maintaining follow-up compliance, i.e. patients with no fixed address, patients not mentally competent to give informed consent, etc. (Investigator's discretion). * Patient is a prisoner. * Patient is known to be pregnant and/or breastfeeding. * Patient is a known alcohol or drug abuser. * Patient had previous/has active acute or chronic infections, especially at the site of operation. * Patient has non-viable bone, or has areas where surrounding bone is not viable or capable of supporting and anchoring the implant. * Patient has traumatic injuries with open wounds or close to the proximal femur fracture, which are likely to become infected. * Patient is expected to be non-compliant with recommended post-operative weight-bearing instructions. * Physical conditions, in the opinion of the investigator, that would prohibit adequate implant support or impede healing.

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants With a Reoperation12 monthsReoperation after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function.

Secondary

MeasureTime frameDescription
Participant Steinberg Classification at 12 Months12 monthsSteinberg Classification is based on the radiographic appearance and location of lesion. It is concise and delineates the progression and extent of Avascular Necrosis (AVN) involvement more accurately. \[stage 0:\] normal or non-diagnostic radiographs, MRI and bone scan of at risk hip (often contralateral hip involved, or patient has risk factors and hip pain) \[stage I:\] normal radiograph, abnormal bone scan and/or MRI \[stage II:\] cystic and sclerotic radiographic changes \[stage III:\] subchondral lucency or crescent sign \[stage IV:\] flattening of femoral head, with depression graded into mild: \<2 mm moderate: 2-4 mm severe: \>4 mm \[stage V:\] joint space narrowing with or without acetabular involvement \[stage VI\]: advanced degenerative changes
Average FIX-IT Score (Clinical Fracture Healing of the Intracapsular Femur)6 weeks, 3 months, 6 months, and 12 monthsThe Function IndeX for Trauma (FIX-IT) score is an assessment tool for patients with lower extremity fractures, incorporating pain and the ability to weight-bear. The score utilizes two questions to assess the ability to bear weight and two questions to assess pain at the fracture site. The maximum subtotal for each set of questions is 6 points, yielding a maximum overall score of 12 points and a minimum score (lowest weight bearing and highest pain) of 0 points.
Average EQ-5D-5L Score (Clinical Fracture Healing of the Intracapsular Femur)6 weeks, 3 months, 6 months, and 12 monthsThe EuroQol five dimensions questionnaire (EQ-5D-5L) is a five dimensional self-assessment that is comprised of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. These five dimensions can be used to index a subject's health utility on a scale of 0 to 1, where 0 is death and 1 is perfect health. The scoring rule for EQ-5D permits scores less than 0, implying that some health states may be worse than death. The Health Status is scored on a VAS scale of 0 to 100, where 100 ('the best imaginable health state' or 'the best health state you can imagine') to 0 ('the worst imaginable health state' or 'the worst health you can imagine').
Number of Participants With Radiographic Fracture Healing of the Intracapsular Femur (RUSH)6 weeks, 3 months, 6 months, and 12 monthsRadiographic fracture healing as seen on x-ray and defined using Radiographic Union Score for Hips (RUSH) scoring system. The RUSH quantifies four measures of healing: cortical bridging, cortical fracture disappearance, trabecular consolidation, and trabecular fracture disappearance. Cortical healing is assessed in four anatomic femoral neck regions (anterior, posterior, medial, lateral) and trabecular healing is measured with two assessments (fracture line disappearance and consolidation of matrix). Each of the 10 assessed dimensions of radiographic femoral neck healing are scored 1 to 3, leading to a minimum score of 10 (no signs of healing) and a maximum score of 30 (perfect healing).
Number of Participants That Performed Timed Up-and-Go Test (Clinical Fracture Healing of the Intracapsular Femur)6 weeks, 3 months, 6 months, and 12 monthsThis will be measured using the Timed 'Up-and-Go' Test. It uses the time that a person takes to rise from a chair, walk three meters, turn around, walk back to the chair, and sit down.This test is used to assess a person's mobility and requires both static and dynamic balance. Scores of ten seconds or less indicate normal mobility, 11-20 seconds are within normal limits for frail elderly and disabled patients, and greater than 20 seconds means the person needs assistance outside and indicates further examination and intervention. A score of 30 seconds or more suggests that the person may be prone to falls.
Average Participant Time to Complete Timed Up-and-Go Test (Clinical Fracture Healing of the Intracapsular Femur)6 weeks, 3 months, 6 months, and 12 monthsThis will be measured using the Timed 'Up-and-Go' Test. It uses the time that a person takes to rise from a chair, walk three meters, turn around, walk back to the chair, and sit down.This test is used to assess a person's mobility and requires both static and dynamic balance. Scores of ten seconds or less indicate normal mobility, 11-20 seconds are within normal limits for frail elderly and disabled patients, and greater than 20 seconds means the person needs assistance outside and indicates further examination and intervention. A score of 30 seconds or more suggests that the person may be prone to falls.
Cost-Effective Analysis12 monthsAnalysis will be performed comparing N-Force to standard non-augmented cannulated screws.
Average Harris Hips Score (Clinical Fracture Healing of the Intracapsular Femur)6 weeks, 3 months, 6 months, and 12 monthsThis will be measured using Harris Hip Score. This is quantified on a scale of 0-100 and the domains covered are pain, function, absence of deformity, and range of motion. The score is quantified on a scale of 0-100, with 100 points being the best possible outcome. The domains cover pain (1 item, 0-44 points), function (7 items, 0-47 points), absence of deformity (1 item, 4 points), and range of motion (2 items, 5 points).

Countries

United States

Participant flow

Participants by arm

ArmCount
N-Force Screws
N-Force Screws augmented with N-Force Blue in Intracapsular Femur Fractures. N-Force Screws Augmented with N-Force Blue: N-Force Fixation System 7.3 mm (Non-fenestrated/fenestrated) applied with washers; N-Force Blue (Bone Substitute Material)
12
Total12

Withdrawals & dropouts

PeriodReasonFG000
Overall StudyEarly Study Termination9

Baseline characteristics

CharacteristicN-Force Screws
Age, Continuous77 years
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
11 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
Race (NIH/OMB)
Asian
0 Participants
Race (NIH/OMB)
Black or African American
1 Participants
Race (NIH/OMB)
More than one race
0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
Race (NIH/OMB)
White
10 Participants
Region of Enrollment
United States
12 participants
Sex: Female, Male
Female
9 Participants
Sex: Female, Male
Male
3 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 12
other
Total, other adverse events
8 / 12
serious
Total, serious adverse events
1 / 12

Outcome results

Primary

Number of Participants With a Reoperation

Reoperation after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function.

Time frame: 12 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
N-Force ScrewsNumber of Participants With a Reoperation0 Participants
Secondary

Average EQ-5D-5L Score (Clinical Fracture Healing of the Intracapsular Femur)

The EuroQol five dimensions questionnaire (EQ-5D-5L) is a five dimensional self-assessment that is comprised of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. These five dimensions can be used to index a subject's health utility on a scale of 0 to 1, where 0 is death and 1 is perfect health. The scoring rule for EQ-5D permits scores less than 0, implying that some health states may be worse than death. The Health Status is scored on a VAS scale of 0 to 100, where 100 ('the best imaginable health state' or 'the best health state you can imagine') to 0 ('the worst imaginable health state' or 'the worst health you can imagine').

Time frame: 6 weeks, 3 months, 6 months, and 12 months

Population: At the time of early study termination, 12 subjects enrolled into the study. At 6 weeks, data was available for all 12 subjects; at 3 months, data was available for 9 subjects; at 6 months, data was available for 5 subjects; and, at 12 months, data was available for 3 of the 12 subjects.

ArmMeasureGroupValue (MEAN)Dispersion
N-Force ScrewsAverage EQ-5D-5L Score (Clinical Fracture Healing of the Intracapsular Femur)6 week - EQ-5D Score.605 score on a scaleStandard Deviation 0.257
N-Force ScrewsAverage EQ-5D-5L Score (Clinical Fracture Healing of the Intracapsular Femur)3 month - EQ-5D Score.674 score on a scaleStandard Deviation 0.136
N-Force ScrewsAverage EQ-5D-5L Score (Clinical Fracture Healing of the Intracapsular Femur)6 month - EQ-5D Score.719 score on a scaleStandard Deviation 0.131
N-Force ScrewsAverage EQ-5D-5L Score (Clinical Fracture Healing of the Intracapsular Femur)12 month - EQ-5D Score.542 score on a scaleStandard Deviation 0.42
N-Force ScrewsAverage EQ-5D-5L Score (Clinical Fracture Healing of the Intracapsular Femur)6 week - Health Status68.7 score on a scaleStandard Deviation 17.1
N-Force ScrewsAverage EQ-5D-5L Score (Clinical Fracture Healing of the Intracapsular Femur)3 month - Health Status74.4 score on a scaleStandard Deviation 25.2
N-Force ScrewsAverage EQ-5D-5L Score (Clinical Fracture Healing of the Intracapsular Femur)6 month - Health Status68 score on a scaleStandard Deviation 23.1
N-Force ScrewsAverage EQ-5D-5L Score (Clinical Fracture Healing of the Intracapsular Femur)12 month - Health Status78.3 score on a scaleStandard Deviation 2.9
Secondary

Average FIX-IT Score (Clinical Fracture Healing of the Intracapsular Femur)

The Function IndeX for Trauma (FIX-IT) score is an assessment tool for patients with lower extremity fractures, incorporating pain and the ability to weight-bear. The score utilizes two questions to assess the ability to bear weight and two questions to assess pain at the fracture site. The maximum subtotal for each set of questions is 6 points, yielding a maximum overall score of 12 points and a minimum score (lowest weight bearing and highest pain) of 0 points.

Time frame: 6 weeks, 3 months, 6 months, and 12 months

Population: At the time of early study termination, 12 subjects enrolled into the study. At 6 weeks, data was available for all 12 subjects; at 3 months, data was available for 9 subjects; at 6 months, data was available for 5 subjects; and, at 12 months, data was available for 3 of the 12 subjects.

ArmMeasureGroupValue (MEAN)Dispersion
N-Force ScrewsAverage FIX-IT Score (Clinical Fracture Healing of the Intracapsular Femur)6 week - Fix-IT Score6.4 score on a scaleStandard Deviation 2.4
N-Force ScrewsAverage FIX-IT Score (Clinical Fracture Healing of the Intracapsular Femur)3 month - Fix-IT Score8.2 score on a scaleStandard Deviation 2.1
N-Force ScrewsAverage FIX-IT Score (Clinical Fracture Healing of the Intracapsular Femur)6 month - Fix-IT Score8.6 score on a scaleStandard Deviation 3.5
N-Force ScrewsAverage FIX-IT Score (Clinical Fracture Healing of the Intracapsular Femur)12 month - Fix-IT Score7 score on a scaleStandard Deviation 5.3
Secondary

Average Harris Hips Score (Clinical Fracture Healing of the Intracapsular Femur)

This will be measured using Harris Hip Score. This is quantified on a scale of 0-100 and the domains covered are pain, function, absence of deformity, and range of motion. The score is quantified on a scale of 0-100, with 100 points being the best possible outcome. The domains cover pain (1 item, 0-44 points), function (7 items, 0-47 points), absence of deformity (1 item, 4 points), and range of motion (2 items, 5 points).

Time frame: 6 weeks, 3 months, 6 months, and 12 months

Population: At the time of early study termination, 12 subjects enrolled into the study. At 6 weeks, data was available for all 12 subjects; at 3 months, data was available for 9 subjects; at 6 months, data was available for 5 subjects; and, at 12 months, data was available for 3 of the 12 subjects.

ArmMeasureGroupValue (MEAN)Dispersion
N-Force ScrewsAverage Harris Hips Score (Clinical Fracture Healing of the Intracapsular Femur)6 weeks - Harris Hip Score55.7 score on a scaleStandard Deviation 16
N-Force ScrewsAverage Harris Hips Score (Clinical Fracture Healing of the Intracapsular Femur)3 months - Harris Hip Score59.3 score on a scaleStandard Deviation 17.6
N-Force ScrewsAverage Harris Hips Score (Clinical Fracture Healing of the Intracapsular Femur)6 months - Harris Hip Score65.4 score on a scaleStandard Deviation 15.7
N-Force ScrewsAverage Harris Hips Score (Clinical Fracture Healing of the Intracapsular Femur)12 months - Harris Hip Score68.7 score on a scaleStandard Deviation 28.7
Secondary

Average Participant Time to Complete Timed Up-and-Go Test (Clinical Fracture Healing of the Intracapsular Femur)

This will be measured using the Timed 'Up-and-Go' Test. It uses the time that a person takes to rise from a chair, walk three meters, turn around, walk back to the chair, and sit down.This test is used to assess a person's mobility and requires both static and dynamic balance. Scores of ten seconds or less indicate normal mobility, 11-20 seconds are within normal limits for frail elderly and disabled patients, and greater than 20 seconds means the person needs assistance outside and indicates further examination and intervention. A score of 30 seconds or more suggests that the person may be prone to falls.

Time frame: 6 weeks, 3 months, 6 months, and 12 months

Population: At the time of early study termination, 12 subjects enrolled into the study. At 6 weeks, data was available for all 12 subjects (only 5 could complete the test); at 3 months, data was available for 9 subjects (only 6 could complete the test); at 6 months, data was available for 5 subjects (only 4 could complete the test); and, at 12 months, data was available for 3 (only 1 could complete the test) of the 12 subjects.

ArmMeasureGroupValue (MEAN)Dispersion
N-Force ScrewsAverage Participant Time to Complete Timed Up-and-Go Test (Clinical Fracture Healing of the Intracapsular Femur)6 Week - Average Time to Complete Test (seconds)21.8 secondsStandard Deviation 9.5
N-Force ScrewsAverage Participant Time to Complete Timed Up-and-Go Test (Clinical Fracture Healing of the Intracapsular Femur)3 Month - Average Time to Complete Test (seconds)35.3 secondsStandard Deviation 39.9
N-Force ScrewsAverage Participant Time to Complete Timed Up-and-Go Test (Clinical Fracture Healing of the Intracapsular Femur)6 Month - Average Time to Complete Test (seconds)15.5 secondsStandard Deviation 7
N-Force ScrewsAverage Participant Time to Complete Timed Up-and-Go Test (Clinical Fracture Healing of the Intracapsular Femur)1 Year - Average Time to Complete Test (seconds)11 secondsStandard Deviation 0
Secondary

Cost-Effective Analysis

Analysis will be performed comparing N-Force to standard non-augmented cannulated screws.

Time frame: 12 months

Population: Cost effective analysis was not performed due to lack of overall study data.

Secondary

Number of Participants That Performed Timed Up-and-Go Test (Clinical Fracture Healing of the Intracapsular Femur)

This will be measured using the Timed 'Up-and-Go' Test. It uses the time that a person takes to rise from a chair, walk three meters, turn around, walk back to the chair, and sit down.This test is used to assess a person's mobility and requires both static and dynamic balance. Scores of ten seconds or less indicate normal mobility, 11-20 seconds are within normal limits for frail elderly and disabled patients, and greater than 20 seconds means the person needs assistance outside and indicates further examination and intervention. A score of 30 seconds or more suggests that the person may be prone to falls.

Time frame: 6 weeks, 3 months, 6 months, and 12 months

Population: At the time of early study termination, 12 subjects enrolled into the study. At 6 weeks, data was available for all 12 subjects; at 3 months, data was available for 9 subjects; at 6 months, data was available for 5 subjects; and, at 12 months, data was available for 3 of the 12 subjects.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
N-Force ScrewsNumber of Participants That Performed Timed Up-and-Go Test (Clinical Fracture Healing of the Intracapsular Femur)6 Week - Did Patient perform test?5 Participants
N-Force ScrewsNumber of Participants That Performed Timed Up-and-Go Test (Clinical Fracture Healing of the Intracapsular Femur)3 Month - Did Patient perform test?6 Participants
N-Force ScrewsNumber of Participants That Performed Timed Up-and-Go Test (Clinical Fracture Healing of the Intracapsular Femur)6 Month - Did Patient perform test?4 Participants
N-Force ScrewsNumber of Participants That Performed Timed Up-and-Go Test (Clinical Fracture Healing of the Intracapsular Femur)1 Year - Did Patient perform test?1 Participants
Secondary

Number of Participants With Radiographic Fracture Healing of the Intracapsular Femur (RUSH)

Radiographic fracture healing as seen on x-ray and defined using Radiographic Union Score for Hips (RUSH) scoring system. The RUSH quantifies four measures of healing: cortical bridging, cortical fracture disappearance, trabecular consolidation, and trabecular fracture disappearance. Cortical healing is assessed in four anatomic femoral neck regions (anterior, posterior, medial, lateral) and trabecular healing is measured with two assessments (fracture line disappearance and consolidation of matrix). Each of the 10 assessed dimensions of radiographic femoral neck healing are scored 1 to 3, leading to a minimum score of 10 (no signs of healing) and a maximum score of 30 (perfect healing).

Time frame: 6 weeks, 3 months, 6 months, and 12 months

Population: At the time of early study termination, 12 subjects enrolled into the study. At 6 weeks, data was available for all 12 subjects; at 3 months, data was available for 9 subjects; at 6 months, data was available for 5 subjects; and, at 12 months, data was available for 3 of the 12 subjects.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
N-Force ScrewsNumber of Participants With Radiographic Fracture Healing of the Intracapsular Femur (RUSH)6 weeks - RUSH Healing5 Participants
N-Force ScrewsNumber of Participants With Radiographic Fracture Healing of the Intracapsular Femur (RUSH)3 months - RUSH Healing6 Participants
N-Force ScrewsNumber of Participants With Radiographic Fracture Healing of the Intracapsular Femur (RUSH)6 months - RUSH Healing5 Participants
N-Force ScrewsNumber of Participants With Radiographic Fracture Healing of the Intracapsular Femur (RUSH)12 months - RUSH Healing3 Participants
Secondary

Participant Steinberg Classification at 12 Months

Steinberg Classification is based on the radiographic appearance and location of lesion. It is concise and delineates the progression and extent of Avascular Necrosis (AVN) involvement more accurately. \[stage 0:\] normal or non-diagnostic radiographs, MRI and bone scan of at risk hip (often contralateral hip involved, or patient has risk factors and hip pain) \[stage I:\] normal radiograph, abnormal bone scan and/or MRI \[stage II:\] cystic and sclerotic radiographic changes \[stage III:\] subchondral lucency or crescent sign \[stage IV:\] flattening of femoral head, with depression graded into mild: \<2 mm moderate: 2-4 mm severe: \>4 mm \[stage V:\] joint space narrowing with or without acetabular involvement \[stage VI\]: advanced degenerative changes

Time frame: 12 months

Population: At the time of early study termination, 12 subjects enrolled into the study. Steinberg classification is only measured for subjects that have completed their 12 month follow-up visit. Although 3 subjects completed the 12 month follow-up, Steinberg Classification is only available on 2 subjects.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
N-Force ScrewsParticipant Steinberg Classification at 12 MonthsStage 0: Normal radiographs1 Participants
N-Force ScrewsParticipant Steinberg Classification at 12 MonthsStage VI: Advanced degenerative changes1 Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026