A randomised feasibility study comparing total hip arthroplasty with and without dual mobility acetabular component in the treatment of displaced intracapsular fractures of the proximal femur : The Warwick Hip Trauma Evaluation Two : WHiTE Two.
OBJECTIVE
The optimal treatment for independent patients with a displaced intracapsular fracture of the hip remains controversial. The recognised alternatives are hemiarthroplasty and total hip arthroplasty. At present there is no established standard of care, with both types of arthroplasty being used in many centres.


METHODS
We conducted a feasibility study comparing the clinical effectiveness of a dual mobility acetabular component compared with standard polyethylene component in total hip arthroplasty for independent patients with a displaced intracapsular fracture of the hip, for a 12-month period beginning in June 2013. The primary outcome was the risk of dislocation one year post-operatively. Secondary outcome measures were EuroQol 5 Dimensions, ICEpop CAPability measure for Older people, Oxford hip score, mortality and re-operation.


RESULTS
Only 20 patients were recruited during this time. The baseline demographics were similar in the two groups and no patient suffered a dislocation. Differences in secondary outcomes were not analysed due to the small sample.


CONCLUSIONS
This feasibility study suggests that any trial investigating the effectiveness of total hip arthroplasty for fracture of the hip might not be deliverable within the constraints of current systems of care in the United Kingdom. Cite this article: Bone Joint J 2016;98-B:1431-5.
University of Oxford, Kadoorie Centre, Oxford OX3 9DU, UK.
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XL
Griffin
University of Warwick, Gibbet Hill, Coventry, CV4 7AL, UK.
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Parsons
University of Oxford, Kadoorie Centre, Oxford OX3 9DU, UK.
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J
Achten
University of Oxford, Kadoorie Centre, Oxford OX3 9DU, UK.
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Costa
D000077:Acetabulum / Q000601:surgery*; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000209:etiology; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016896:Treatment Outcome
Dual mobility; Hip fracture; Randomised controlled trial; Total hip arthroplasty