Evidence map›Paper›PMID 33630700›Full record

ArticleBone & joint open2021

A randomized clinical trial of low dose single antibiotic-loaded cement versus high dose dual antibiotic-loaded cement in patients receiving a hip hemiarthroplasty after fracture: A protocol for the WHiTE 8 COPAL study.

Nickil Ramesh Agni, Matthew L Costa, Juul Achten, Heather O'Connor, May Ee Png, Nicholas Peckham, Susan J Dutton, Stephanie Wallis, Svetlana Milca, Mike Reed

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in Bone & joint open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05164081 (DAICY Trial - Dual vs. Single-Antibiotic Impregnated Cement in Hemiarthroplasty for Femoral Neck Fracture), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05164081 phase3active not recruitingnot on this mapstarted 2022, after this paper: background citation

DAICY Trial - Dual vs. Single-Antibiotic Impregnated Cement in Hemiarthroplasty for Femoral Neck Fracture: A Register-based Cluster-randomized Cross-over Controlled Trial

TypeinterventionalSponsorUmeå UniversityRan2022 to 2027Enrolled7,000ConditionsFemoral Neck Fractures, Prosthetic InfectionArmsantibiotic loaded bone cement (gentamicin+clindamycin) COPAL G+C (Heraeus)., antibiotic loaded bone cement (gentamicin) Paladins R+G (Heraeus) or Refobacin (Biomet).
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Nickil Ramesh AgniTrauma and Orthopaedics, Northumbria Healthcare NHS Foundation Trust, Ashington, UK.
Matthew L CostaOxford Trauma and Emergency Care, NDORMS, University of Oxford, Kadoorie Centre, John Radcliffe Hospital, Oxford, UK.
Juul AchtenOxford Trauma and Emergency Care, NDORMS, University of Oxford, Kadoorie Centre, John Radcliffe Hospital, Oxford, UK.
Heather O'ConnorOxford Clinical Trial Research Unit, NDORMS, University of Oxford, Oxford, UK.
May Ee PngNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Nicholas PeckhamOxford Clinical Trial Research Unit, NDORMS, University of Oxford, Oxford, UK.
Susan J DuttonOxford Clinical Trial Research Unit, NDORMS, University of Oxford, Oxford, UK.
Stephanie WallisOxford Trauma and Emergency Care, NDORMS, University of Oxford, Kadoorie Centre, John Radcliffe Hospital, Oxford, UK.
Svetlana MilcaOxford Trauma and Emergency Care, NDORMS, University of Oxford, Kadoorie Centre, John Radcliffe Hospital, Oxford, UK.
Mike ReedTrauma and Orthopaedics, Northumbria Healthcare NHS Foundation Trust, Ashington, UK.
University of Oxford · GBJohn Radcliffe Hospital · GBNorthumbria Healthcare NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsPatients receiving cemented hemiarthroplasties after hip fracture have a significant risk of deep surgical site infection (SSI). Standard UK practice to minimize the risk of SSI includes the use of antibiotic-loaded bone cement with no consensus regarding type, dose, or antibiotic content of the cement. This is the protocol for a randomized clinical trial to investigate the clinical and cost-effectiveness of high dose dual antibiotic-loaded cement in comparison to low dose single antibiotic-loaded cement in patients 60 years and over receiving a cemented hemiarthroplasty for an intracapsular hip fracture.

methodsThe WHiTE 8 Copal Or Palacos Antibiotic Loaded bone cement trial (WHiTE 8 COPAL) is a multicentre, multi-surgeon, parallel, two-arm, randomized clinical trial. The pragmatic study will be embedded in the World Hip Trauma Evaluation (WHiTE) (ISRCTN 63982700). Participants, including those that lack capacity, will be allocated on a 1:1 basis stratified by recruitment centre to either a low dose single antibiotic-loaded bone cement or a high dose dual antibiotic-loaded bone cement. The primary analysis will compare the differences in deep SSI rate as defined by the Centers for Disease Control and Prevention within 90 days of surgery via medical record review and patient self-reported questionnaires. Secondary outcomes include UK Core Outcome Set for hip fractures, complications, rate of antibiotic prescription, resistance patterns of deep SSI, and resource use (more specifically, cost-effectiveness) up to four months post-randomization. A minimum of 4,920 patients will be recruited to obtain 90% power to detect an absolute difference of 1.5% in the rate of deep SSI at 90 days for the expected 3% deep SSI rate in the control group.

conclusionThe results of this trial will provide evidence regarding clinical and cost-effectiveness between low dose single and high dose dual antibiotic-loaded bone cement, which will inform policy and practice guidelines such as the National Institute for Health and Care Excellence guidance on management of hip fractures. Cite this article:

Indexed as

Deep infectionHemiarthroplastyHigh dose antibiotic loaded cementHip fractureRandomized clinical trial

Identifiers

PMID33630700
PMCPMC7925209
OpenAlexW3126906165

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.