Hip fracture is a serious injury which mostly occurs in older patients. In the UK there are more than 70,000 hip fractures every year. A hip fracture is a potentially catastrophic event; approximately 30% of patients will die during the first year following this injury and those that survive will have a significant reduction in their quality of life.
The most common type of hip fracture is treated with a partial hip replacement or ‘hemiarthroplasty’. The hemiarthroplasty can be fixed to the patient’s thigh bone with or without the use of ‘bone cement’. Cement is the current standard technique, but there are some risks with bone cement which could be avoided by using ‘uncemented’ implants. These risks prompted a recent alert from the National Patient Safety Agency.
However, traditionally the outcomes with the early types (first generation) of uncemented implants were inferior to the cemented implants currently used. Since these studies were done, there have been significant improvements in uncemented implant technology and the current, limited evidence suggests that these modern (contemporary) implants may be as good as the cemented implants but without the risks of using cement.
The research needed is a trial to compare cemented with uncemented hemiarthroplasty implants. In order to find out which type of implant is better for patients with hip fracture, we first need to undertake a smaller feasibility study (this work). This will establish the feasibility of running such a trial and gain vital data to determine how many participants we will need to, and be able to, recruit in the full trial to answer this important research question.
***Update*** The study has now been analysed and published N Engl J Med 2022; 386:521-530
09/02/2022 The results paper can be accessed here
05/05/2021 The study has been declared ended and the results will be published soon
04/12/2019 Recruitment finished - a big "thank you" to all participating sites!!!
01/04/2019 Southport Hospital, Linclon County Hospital and Pilgrim Hospital are all open to recruitment- good luck!
31/08/2018 Royal Lancaster Infirmary is now open to recruitment- good luck!
14/06/2018 7 sites open to recruitment!
16/04/2018 The main study is now open to recruitment at Coventry&Warwickshire Hospital, Queen Alexandra Hospital (Portsmouth), Wexham Park Hospital, Slough and John Radcliffe, Oxford. Good luck everyone!!!
22/11/2017 Main Study has been approved by the REC. We are now setting up sites and aiming to resume recruiting very soon!
28/08/2017 End of recruitment for the feasibility study- many thanks to all participating sites and all team's effort, as we have not only reached our target of 100 patients but also recruited 41 on top of that! Well done everyone!
11/May/2017: WHiTE5 is 1/3 of the way through recruitment – a quarter of those patients have come from University Hospital Coventry.
28th April 2017:
Queen Alexandra Hospital (Portsmouth) are now open to recruitment!
18th April 2017:
Royal Berkshire Hospital (Reading) are now open to recruitment!
- Study received ethical approval 2nd December and HRA approval 14th December
- Open to recruitment in Coventry 10th March 2017
- REC approval of amendment to add collection of intra-operative blood pressure information
Inclusion criteria
- All Patients, both those with and without capacity, presenting with an AO type 31-B3 (subcapital, displaced, nonimpacted) fracture of the hip.
Exclusion criteria
- Patients younger than 60 years of age
- Patients who are managed non-operatively
- Patients who do not receive hemiarthroplasty (e.g. total hip replacement or internal fixation)
