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A randomised controlled trial of single antibiotic cement versus dual antibiotic cement in patients receiving a partial hip joint replacement after fracture

WHiTE 8 COPAL: a randomised controlled trial of low dose single antibiotic loaded cement versus high dose dual antibiotic loaded cement in patients receiving a hip hemiarthroplasty after fracture

Status
Active, not recruiting
Phases
Unknown
Study type
Interventional
Source
ISRCTN
Registry ID
ISRCTN15606075
Enrollment
4920
Registered
2018-07-17
Start date
2018-08-01
Completion date
Unknown
Last updated
2023-07-10

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

Conditions

Hip fracture Surgery Fracture of hip NOS

Interventions

Participants will undergo surgery at the next available opportunity on a planned trauma list. Participants will be blinded to the treatment allocation. The operating surgeon will not be blinded to the

Sponsors

Northumbria Healthcare NHS Foundation Trust
Lead Sponsor

Eligibility

Sex/Gender
All

Inclusion criteria

Inclusion criteria: 1. Aged 60 years or older 2. Intracapsular hip fracture, which in the opinion of the treating surgeon requires acute surgical treatment with a cemented hip hemiarthroplasty

Exclusion criteria

Exclusion criteria: Patients will be excluded if they are allergic to gentamicin or clindamycin

Design outcomes

Primary

MeasureTime frame
Deep Infection of surgical wound; the trialists will use the Centre for Disease Control and Prevention definition of a “deep surgical site infection”, that is a wound infection involving the tissues deep to the skin that occurs within 90 days of injury. Medical records for all patients will be reviewed by appropriately trained staff for indicators of infection at the time of the patient’s discharge from the research site. In addition, at 120 days post-surgery, the patients will self-report (via telephone interview, electronic media or postal questionnaire) on signs of infections. When potential signs of infection have been found, either at discharge or 120 days, the site will be asked to provide, if available, copies of: any re-operation records for surgery related to the index hip fracture, details of antibiotics prescribed, microbiology reports if samples of the suspected infected tissues around the hip were sent for analysis and imaging reports for any deep imaging that occurred in relation to suspected infection. These data will be collated by the central trial team in Oxford.

Secondary

MeasureTime frame
1. Mortality recorded at discharge from the research site as well as in the 120-day follow-up. Sites or consultees may also report mortality at any point in the time between discharge and 120 days. 2. Health-related quality of life measured by EuroQol EQ-5D-5L at baseline and at 120 days post-surgery 3. All complications and surgical interventions related to the index wound will be recorded. These are reported by sites as they become aware of events, as well as by patients, carers or consultees at 4 months (120 days) 4. Antibiotic prescription information will be obtained from the patient, consultee or carer at the 4 months (120 days) follow-up. Should the patient be entered into the trial under nominated consultee agreement and this information not be available from a carer, the trial team may contact the patient’s GP for this information 5. Resistance patterns of infections; all infections identified in the primary endpoint will be assessed for antibiotic resistance profiles by the local microbiology team 6. Resource use; cost data will be obtained from national databases or will be estimated in consultation with the hospital finance department. The cost consequences following discharge, including NHS costs and patients' out-of-pocket expenses will be recorded via a short questionnaire, which will be administered at 4 months (120 days) post-surgery. This will be either by patient or consultee 7. Mobility; the ability to walk indoors and outdoors is rated very highly by patients. It has been included in a recommended ‘core outcome set’ for trials assessing interventions in hip fractures, hence it will be recorded using the CRF. It will be captured at baseline and at 4 months (120 days). 8. Residential status; also captured on CRF. The residential status is also part of the core outcome set for hip fractures and NHFD dataset. It will be captured at baseline and at 4 months (120 days)

Countries

England, United Kingdom, United States of America, Wales

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Feb 11, 2026