Fractured Hip Infection Trial: FHIT- low vs. high dose antibiotic impregnated cement in the treatment of patients with fractured neck of femur

ISRCTN ISRCTN25633145
DOI https://doi.org/10.1186/ISRCTN25633145
Protocol serial number N/A
Sponsor Northumbria Healthcare NHS Foundation Trust (UK)
Funder Heraeus Medical GmbH (UK)
Submission date
06/12/2012
Registration date
21/03/2013
Last edited
18/10/2018
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Injury, Occupational Diseases, Poisoning
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
We are carrying out a study on patients who have sustained a fractured hip in order to compare
different doses of antibiotics within the cement at the time of hip surgery. Our goal is to establish if adding a higher dose of antibiotics into the cement will reduce the rate of surgical site infection. We will look at a number of patient characteristic such as age, gender, rates of infection, timing of surgery, and other characteristics. The study's findings should help to improve the well being of patients with a fractured hip in the UK and to enhance the country's research base in orthopaedic infection.

Who can participate?
The study aims to recruit about 850 patients, aged above 18 years old, from the Northumbria NHS Trust (UK) who have sustained a fractured hip.

What does the study involve?
Patients will be randomly allocated to one of two groups. Randomisation, which is like a coin toss, will allocate the antibiotic cement given to the patient. Group 1 will receive low antibiotic dose cement (that is used in normal practice) and group 2 will receive high antibiotic dose cement (that is used in other forms of hip surgery in normal practice). Both groups will then have the same postoperative care and follow up. At the end of the study, we will compare the rates of surgical site infection between the groups. Patients will be given the same clinical care whether they are in group 1 or 2.

What are the possible benefits and risks of participating?
Risks include those normally associated with an operation and will be discussed at the time of the operation. The study may lead to a positive change in treatment for this operation in the NHS. There may be no differences between the two groups.

Where is the study run from?
The study has been set up by the Northumbria NHS Trust (UK).

When is the study starting and how long is it expected to run for?
Recruitment started in July 2008. Participants will be enrolled until the target number of 850 is reached.

Who is funding the study?
A small amount of educational funding has been supplied by Heraeus Medical (UK).

Who is the main contact?
Mr Mike Reed, mike.reed@nhs.net
Mr Andrew Sprowson, apsprowson@gmail.com

Contact information

Mr Mike Reed
Scientific

Northumbria Healthcare NHS Foundation Trust
Research and Development
North Tyneside General Hospital
Rake Lane
North Shields
NE29 8NH
United Kingdom

Email mike.reed@nhs.net

Study information

Primary study designInterventional
Study designTwin site two arm assessor blinded randomised controlled trial
Secondary study designRandomised controlled trial
Study type Participant information sheet
Scientific titleLow vs. high dose antibiotic impregnated cement in the treatment of patients with fractured neck of femur: a two arm assessor blinded randomised controlled trial
Study acronymFHIT
Study objectivesIt is hypothesised that high dose antibiotic impregnated cement will reduce the rates of surgical site infection in patients undergoing a hip hemiarthroplasty for fractured neck of femur vs. standard of care low dose antibiotic impregnated cement.

The null hypothesis is that there will be reduction in surgical site infection between treatment groups.
Ethics approval(s)NRES Committee Newcastle & North Tyneside 2 Research Ethics Committee, 16 July 2008, ref: 07/H0901/63
Health condition(s) or problem(s) studiedFracture of neck of femur / Surgical site infection / orthopaedic
InterventionIn this pragmatic trial, patients will undergo emergency hip hemiarthroplasty (cemented) using the standard technique of the anaesthetist and the operating surgeon. In addition, the patient will undergo one of the two peri-operative cements:

Usual best standard: Standard cement used to cement the hip hemiarthroplasty into the femur, which contains 0.5g of gentamicin. No technique modification is needed.

Intervention: Revision cement used to cement the hip hemiarthroplasty into the femur, which contains 1g gentamicin and 1g of clindamycin. No technique modification is needed.
Intervention typeOther
Primary outcome measure(s)

Deep surgical site infection as defined by the Health Protection Agency

Key secondary outcome measure(s)

1. Superficial surgical site infection as defined by the Health Protection Agency
2. Length of stay
3. Surgeon grade will be documented as consultant orthopaedic surgeon, specialist trainee or core training doctor.
4. Admission to high dependency unit
5. All complications will be recorded

All baseline data will be summarised descriptively by treatment group.

Completion date01/04/2013

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexAll
Target sample size at registration848
Key inclusion criteriaAll trauma orthopaedic patients (age 18 and over) who require a hip hemiarthroplasty for a fractured neck of femur will be included in the study
Key exclusion criteriaPatients under 18
Date of first enrolment01/07/2008
Date of final enrolment01/04/2013

Locations

Countries of recruitment

  • United Kingdom
  • England

Study participating centre

Northumbria Healthcare NHS Foundation Trust
North Shields
NE29 8NH
United Kingdom

Results and Publications

Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/11/2016 Yes No
Protocol article protocol 17/12/2013 Yes No
Participant information sheet Participant information sheet 11/11/2025 11/11/2025 No Yes

Editorial Notes

18/10/2018: Publication reference added.