Fractured Neck of Femur

Hip fracture is one of the most serious health care problems affecting older people. Most of the hip fractures are caused by osteoporosis and occur after a fall.1-2

Proximal femur fractures generally require hospitalisation and surgical treatment. They often lead to disability and are associated with high morbidity and mortality.3

Early surgery and coordinated care are important to help patients with fractured neck of femur (FNOF) recover faster and regain mobility.4

Hemiarthroplasty (HA) after FNOF is considered an option for less fit and less mobile patients with limited life expectancy. Advantages of HA include a short operation time and quick mobilisation of the patient associated with acceptable clinical, functional, and radiological results.5

Deep SSI reduction from 3.5% to 1.1% in hip hemiarthroplasty after FNOF using COPAL® G+C bone cement6

Study by Sprowson et al. (2016): The use of high-dose dual impregnated antibiotic-laden cement with hemiarthroplasty for the treatment of a fracture of the hip. Study design: Double blinded, 2 arm, quasi randomised trial performed in the UK. Study Results: Significant reduction of SSI rate with high-dose dual antibiotics in deep SSI (from 3.5% to 1.1%)

The study by Sprowson et al. (2016) concluded that the use of high dose dual antibiotic-loaded bone cement (COPAL® G+C) leads to a significant reduction in the rate of deep surgical site infection in the treatment of patients with an intracapsular FNOF, with no associated increase in other complications.

This double blinded, two arm, quasi-randomised controlled trial (RCT) was performed between 05/2008 and 11/2011 in Wansbeck General Hospital and North Tyneside General Hospital, Northumbria, UK.

Find out more about the product features of COPAL® G+C bone cement

WHiTE 8 COPAL study

The WHiTE 8 COPAL study will be a multicentre, multi-surgeon, parallel, two arm, randomised controlled trial. This will be embedded in the World Hip Trauma Evaluation (WHiTE) comprehensive cohort.

All adult patients 60 years of age and over presenting at the trial centres, who in the opinion of the treating surgeon require acute surgical treatment with a cemented hip hemiarthroplasty are eligible for inclusion.

The aim of this pragmatic randomised controlled trial is to determine the rate of deep infection in patients treated with either low dose single antibiotic loaded cement (PALACOS® R+G) or high dose dual antibiotic loaded cement (COPAL® G+C) for the treatment of hip fracture with a hemi-arthroplasty.

This study is sponsored by the Northumbria Healthcare NHS Foundation Trust and is funded by Heraeus Medical. The trial is managed by Oxford Trauma, at the University of Oxford.

Interested to find out more about the WHiTE 8 study and the recruitment process?

Please find the Study Protocol  here .

1 Metcalfe D. The pathophysiology of osteoporotic hip fracture. Mcgill J Med. 2008 Jan; 11(1): 51–57

2 Liener, Becker, Rapp. Weißbuch Alterstraumatologie. W. Kohlhammer GmbH 2018

3 Johnell O, Kanis JA. An estimate of the worldwide prevalence, mortality and disability associated with hip fracture. Osteoporos Int 2004; 15: 897–902

4  NHS. Overview hip fracture. Visited on 29/06/21

5 Ossendorf C, Scheyerer MJ, Wanner GA, Simmen HP, Werner CM. Treatment of femoral neck fractures in elderly patients over 60 years of age - which is the ideal modality of primary joint replacement? Patient Saf Surg 2010; 4: 16

6 Sprowson AP, Jensen C, Chambers S, Reed M et al. The use of high-dose dual impregnated antibiotic-laden cement with hemiarthroplasty for the treatment of a fracture of the hip: The Fractured Hip Infection trial. Bone Joint J 2016; 98-B: 1534–1541