Hip Fractures Clinical Trial
Official title:
Prospective, Double Blind Randomised Controlled Trial Comparing the Uncemented (CORAIL, DePuy) Versus Cemented (Exeter) Total Knee Arthroplasty for Displaced Subcapital Hip Fractures
Displaced subcapital hip fractures are very common and account for almost 50% of all hip fractures. The aim of the present study is to determine whether an uncemented total hip replacement is better than conventional cemented hip replacement to treat these fractures.
Hip fractures account for 20% of all fractures and displaced subcapital fractures represent
45% of the hip fracture workload. All of these patients are treated with some form of hip
replacement. Recent randomised trials have confirmed that total hip replacement is probably
the best choice of treatment in a fit older patient and is better than partial hip
replacement or repair of the fracture with screws which are the other most commonly used
treatments. Hip replacements may be cemented or uncemented. The uncemented type of hip
replacement has not been commonly used in this group of patients but may have some
advantages. The uncemented hip replacement is a shorter operation and this may be
advantageous in the hip fracture population group since these are older patients, many of
whom have other medical problems. The use of cement is occasionally associated with
development of heart problems during anaesthesia.
Participants: The original aim was to recruit 200 patients who have been admitted with a
displaced subcapital hip fracture to the New Royal Infirmary and will undergo total hip
replacement surgery within 48 hours of admission. Patients fitting the inclusion criteria
will be given a patient information sheet and will be given between 24−48 hours to decide
whether they give consent to participate in the trial. Patients who have given their consent
will be randomly allocated to one of two groups i.e.. allocation to one of the two groups
will entirely by chance. Each group will have 100 patients.
Intervention Both groups will received a total hip replacement. The only difference between
the two groups is the type of hip replacement and the way it is fixed in the thigh bone. One
type of hip replacement requires cement ('Exeter'), the other ('CORAIL' from DePuy) doesn't.
Other surgical protocols and care after the surgery will be exactly the same for both groups.
Purpose The purpose of this research is to compare the clinical outcome (i.e. complications,
revisions etc.) and the function of the patients between the two groups at several different
time points: around 8 weeks, 4 months, 12 months and 24 months post surgery.
Outcome measures Clinical: Surgery complications, duration of surgery, readmissions, revision
surgery, duration of hospital stay.
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