RecruitingInterventional

Effectiveness and cost-effectiveness of hip implant types in patients younger than 70 years undergoing primary elective total hip replacement

A hip replacement replaces a worn-out hip joint with an artificial ball-and-socket implant. Surgeons can secure these implants in three standard ways: using special bone cement, using an uncemented implant that grips the bone directly, or using a hybrid mix of both. For older patients, cemented hips have an excellent safety record and cost less. However, in people under 70, surgeons often choose more expensive uncemented or hybrid implants, even though there is no clear proof they work any better. The HIPPY study aims to find out which implant type gives the best pain relief, movement, and value for money in adults under 70 having planned hip surgery for osteoarthritis on the NHS. Participants are randomly placed into one of the three treatment groups and followed up for 10 years using yearly questionnaires and routine health records.

At a glance

Status

Recruiting

Sponsor

North Bristol NHS Trust

Enrolment target

7,866

Start

21 Aug 2024

Estimated completion

30 Jun 2027

Osteoarthritis

What is this study about?

Hip replacement surgery is one of the most successful operations in the NHS. For most people, it relieves severe joint pain and restores everyday mobility. During the operation, the damaged ball and socket are replaced with artificial parts. Surgeons can fit these parts using bone cement, without cement (allowing bone to grow onto the surface), or with a hybrid method where one part is cemented and the other is not.

Cemented implants are well-tested, safe, and reasonably priced. For older patients, national guidelines recommend them as the best choice. In younger, more active adults under 70, however, surgeons often choose uncemented or hybrid implants that can cost up to four times as much. At present, doctors do not know for sure if these newer, more expensive options truly last longer or improve recovery compared with traditional cemented hips.

If a replacement hip wears out or comes loose, a patient may need revision surgery. This is a bigger, more complicated operation that can be tough to recover from. By tracking patients over a 10-year period, this study wants to give doctors clear evidence on which implant design gives people under 70 the best long-term quality of life while making the best use of NHS resources.

Key takeaways

Compares three standard hip implant types (cemented, uncemented, and hybrid) for people under 70.
Open to NHS patients aged 18 to 69 having their first planned hip replacement for osteoarthritis.
Implant type is assigned at random by a computer.
Follow-up lasts for 10 years and involves filling out one questionnaire per year.
Does not require extra hospital visits beyond your normal NHS surgical care.

Who may be eligible?

You may be able to join this study if you are between 18 and 69 years of age and are scheduled for a planned (elective) first-time total hip replacement on the NHS because of osteoarthritis.

You will not be able to participate if you need hip surgery primarily for reasons other than osteoarthritis (such as rheumatoid arthritis), or if you require an emergency operation or a custom-made implant.

People paying privately for their surgery, those undergoing a two-stage hip operation, prisoners, and anyone unable to give their own informed consent are also unable to take part.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you aged between 18 and 69?
Are you having a first-time total hip replacement on the NHS?
Is your hip replacement planned because of osteoarthritis?
Are you receiving NHS treatment rather than paying privately?
Are you happy to complete a health questionnaire once a year for 10 years?

Answer every question to see your result.

What does participation involve?

If you agree to take part, a computer programme will randomly choose which of the three standard hip implants you receive: cemented, uncemented, or hybrid. Your operation and hospital stay will follow normal NHS care, and you will not have to attend extra hospital visits just for the trial.

Before your operation, you will fill out a questionnaire about your hip pain, daily activities, and general quality of life. After surgery, the study team will ask you to complete a similar questionnaire once a year for up to 10 years, which you can do from home. You will also be asked to let researchers check your routine NHS records over those 10 years to see how your new hip is doing and whether you need any further treatment.

Potential risks and benefits

All three implant types are already widely used across the NHS, and you will receive standard, high-quality surgical care no matter which group you are in. Taking part may not help your hip directly, but you will have extra contact with the research team if you have questions, and your results will help future patients get the best possible care. The main risks or inconveniences are that you cannot choose your implant type, and you will need to spend a little time each year filling out questionnaires. Taking part is entirely voluntary, and you can withdraw at any time without your NHS care or legal rights being affected.

Locations (1)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

North Bristol NHS Trust
City only
Bristol, England

Common questions

Will I have to pay anything to take part?

No. The trial is funded by the National Institute for Health and Care Research (NIHR), and all treatment is carried out as part of normal NHS care.

Will my surgery be delayed if I join the trial?

No. Joining the study will not alter your planned date for surgery or change the way your surgical team prepares you for your operation.

Can I choose which implant I get?

No. To make the trial fair and accurate, a computer system randomly decides whether you receive a cemented, uncemented, or hybrid implant.

Do I have to attend extra hospital appointments?

No extra hospital visits are required for the study. Follow-up is handled through questionnaires you can complete at home and routine NHS records.

What happens if I change my mind later?

You are free to leave the study at any point. Deciding to withdraw will not change your medical care or your relationship with your healthcare team.

How to find out more

Samantha Abbs

hippy-trial@bristol.ac.uk +44 (0)1174554799 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.