The influence of implant length on the outcomes of total hip arthroplasty

ISRCTN ISRCTN13154542
DOI https://doi.org/10.1186/ISRCTN13154542
Secondary identifying numbers 2 (01-04-16)
Submission date
30/06/2017
Registration date
14/07/2017
Last edited
05/09/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Osteoarthritis is a condition that causes joints to become painful and stiff. Hip osteoarthritis can be treated with hip replacement surgery, where the damaged hip joint is replaced with an artificial implant. The surgeon has various choices as to which implant they use. The implant that surgeons routinely use comes in two different lengths: the original (150mm) length or the ‘short’ (125mm) length. It is not known whether patient outcomes differ based on the length of the implant used. The aim of this study is to find out whether the length of the hip replacement stem has any influence on pain and physical function after total hip replacement.

Who can participate?
Patients aged 45-80 undergoing total hip replacement for osteoarthritis

What does the study involve?
Participants are randomly allocated to receive either an ‘original’ (150mm) or ‘short’ (125mm) stem as part of routine total hip replacement at the study centre. Hip function, quality of life, pain, joint awareness, satisfaction and implant position are measured at the start of the study and after 1 and 2 years.

What are the possible benefits and risks of participating?
It is thought that the length of stem does not affect patient recovery or outcomes after surgery in any way. Participants do not directly benefit from taking part in this study, but the knowledge gained may benefit other people by helping to find the best way to treat people who need total hip replacement in the future. Both stem lengths are available for routine use in the study centres, and as such there are no additional risks in taking part in this study beyond those of having routine total hip replacement surgery.

Where is the study run from?
1. Royal Infirmary of Edinburgh (UK)
2. Golden Jubilee National Hospital (UK)

When is the study starting and how long is it expected to run for?
January 2016 to December 2019

Who is funding the study?
Stryker (USA)

Who is the main contact?
Dr David Hamilton
d.f.hamilton@ed.ac.uk

Contact information

Dr David Hamilton
Scientific

Chancellor's Building
49 Little France Crescent
Edinburgh
EH16 4SB
United Kingdom

ORCiD logoORCID ID 0000-0001-9060-9255
Phone +44 (0)131 242 6301
Email d.f.hamilton@ed.ac.uk

Study information

Study designMulti-centre prospective randomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not currently available in web format, please use contact details to request a participant information sheet
Scientific titleCan Arthroplasty Stem INfluence Outcome? (CASINO): a randomised controlled equivalence trial of 125mm vs 150mm Exeter stems in total hip arthroplasty
Study acronymCASINO
Study objectivesThat the use of the 125mm ExeterTM stem in routine total hip arthroplasty achieves equivalent short-term (up to 2 years post-op) patient-reported and radiographic outcomes as the 150mm Exeter stem.
Ethics approval(s)South East Scotland Research Ethics Committee 02, 12/05/2017, ref:16/SS/0176
Health condition(s) or problem(s) studiedHip osteoarthritis
InterventionPatients will be randomised on a 1:1 ratio to receive either an ‘original’ (150mm) or ‘short’ (125mm) ExeterTM stem as part of routine total hip arthroplasty at the study centre. Randomisation will be by computer-generated number, stratified by centre using random block sizes.

A standard operative technique will be employed by all trial surgeons; using the posterior approach, ExeterTM femoral component and ContemporaryTM acetabular component (Stryker). All implants will be cemented. The routine post-operative patient care protocol of the study centre will be employed.
Intervention typeDevice
Pharmaceutical study type(s)Not Applicable
PhaseNot Applicable
Drug / device / biological / vaccine name(s)150mm ExeterTM hip stem, 125mm ExeterTM hip stem
Primary outcome measurePatient reported function, measured using the Oxford Hip Score at baseline, 1 year and 2 years
Secondary outcome measures1. Quality of life, measured using the EQ5D-5L questionnaire at baseline, 1 year and 2 years
2. Pain, measured using the visual analogue scale at baseline, 1 year and 2 years
3. Joint awareness, measured using the Forgotten Joint Score-12 at baseline, 1 year and 2 years
4. Satisfaction, measured using a satisfaction Likert response scale at 1 and 2 years
5. Radiographic implant position, measured using AP pelvis radiographs at 1 year
Overall study start date01/01/2016
Completion date31/12/2020

Eligibility

Participant type(s)Patient
Age groupMixed
Lower age limit40 Years
Upper age limit80 Years
SexBoth
Target number of participants220
Key inclusion criteria1. Planned total hip replacement for osteoarthritis
2. Planned primary hip arthroplasty with standard implants
3. Patients aged 45-80
4. Patient willing and able to comply to the study protocol
Key exclusion criteria1. Dysplasia of the hip/acetabulum
2. Requirement for acetabular bone grafting
3. Planned bilateral procedures within the trial period
4. Activity-limiting pain in either knee or contralateral hip
5. Procedures done for pain relief (such as for patients with no walking capacity)
6. Already recruited to the trial
Date of first enrolment01/06/2017
Date of final enrolment01/06/2018

Locations

Countries of recruitment

  • Scotland
  • United Kingdom

Study participating centres

Royal Infirmary of Edinburgh
Edinburgh
EH16 4SA
United Kingdom
Golden Jubilee National Hospital
Glasgow
G81 4DY
United Kingdom

Sponsor information

ACCORD; The University of Edinburgh & NHS Lothian
Industry

The Queen’s Medical Research Institute
47 Little France Crescent
Edinburgh
EH16 4TJ
United Kingdom

Website http://www.accord.scot/
ROR logo "ROR" https://ror.org/01x6s1m65

Funders

Funder type

Industry

Stryker
Private sector organisation / For-profit companies (industry)
Alternative name(s)
Stryker Corporation
Location
United States of America

Results and Publications

Intention to publish date31/12/2021
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
Publication and dissemination planPublication of trial results will be sought through high-ranked peer reviewed speciality journals with an expectation of publication 1 year following the end of the last patient follow-up.
IPD sharing planThe current data sharing plans for the current study are unknown and will be made available at a later date.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
HRA research summary 28/06/2023 No No
Protocol article 16/04/2023 05/09/2023 Yes No

Editorial Notes

05/09/2023: Publication reference added.
07/08/2018: The following changes have been made to the trial record:
1. The overall trial end date has been changed from 31/12/2019 to 31/12/2020
2. The intention to publish date has been changed from 31/12/2020 to 31/12/2021