Simple Bone Cysts in Kids

NCT ID: NCT02193841

Last Updated: 2023-07-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-03-31

Study Completion Date

2027-03-31

Brief Summary

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Simple bone cysts (SBCs) are cysts filled with fluid that occur most frequently in the long bones (arms or legs) of children. There are many ways to treat SBCs but it is unclear if one is better than another. The purpose of this research trial is to compare the effectiveness of two common treatments that are used by surgeons today.

Detailed Description

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In general, few randomized clinical trials have been undertaken in paediatric orthopaedics, and only one to date has addressed the problem of simple bone cysts (SBCs). Also known as unicameral bone cysts, they are the commonest bone lesion in children. Despite general opinion, these cysts do not resolve at skeletal maturity.

Many forms of treatment have been recommended but none, including the popular methods of corticosteroid or bone marrow injections, have reliably eradicated SBC. Although the lesions are considered benign (non-cancerous), they cause pain, frequently interfere with function, dramatically restrict play activity, may re-fracture leading to growth arrest and/or deformity, and cause enormous anxiety for children and their families.

With a well-developed network of surgeons and researchers, we will provide evidence comparing the effectiveness of two treatment interventions for SBC. More specifically, our goals for this study are:

1. to compare the rate of radiographic healing between two standard treatments including curettage with puncture alone, and curettage with puncture followed by injection with Vitoss morsels;
2. to identify prognostic radiographic factors associated with simple bone cyst healing and fracture;
3. to determine the impact of simple bone cyst on children/family functioning.

Conditions

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Bone Cyst

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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C & P

Curettage with puncture (C \& P) will be performed alone

Group Type ACTIVE_COMPARATOR

Curettage with puncture (C & P)

Intervention Type PROCEDURE

A curette will be inserted to scrape the contents of the cyst (curettage) and a hole in the cyst wall will be made (puncture) near the bone marrow cavity

Curette

Intervention Type DEVICE

A small surgical instrument with a rounded edge designed for scraping

C & P with Vitoss

A predetermined amount of Vitoss morsels will be injected following the curettage and puncture (C \& P)

Group Type ACTIVE_COMPARATOR

Curettage with puncture (C & P)

Intervention Type PROCEDURE

A curette will be inserted to scrape the contents of the cyst (curettage) and a hole in the cyst wall will be made (puncture) near the bone marrow cavity

Curette

Intervention Type DEVICE

A small surgical instrument with a rounded edge designed for scraping

Vitoss morsels

Intervention Type DEVICE

A bone substitute intended for use as a filler for voids or gaps in bones

Interventions

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Curettage with puncture (C & P)

A curette will be inserted to scrape the contents of the cyst (curettage) and a hole in the cyst wall will be made (puncture) near the bone marrow cavity

Intervention Type PROCEDURE

Curette

A small surgical instrument with a rounded edge designed for scraping

Intervention Type DEVICE

Vitoss morsels

A bone substitute intended for use as a filler for voids or gaps in bones

Intervention Type DEVICE

Other Intervention Names

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Tri-calcium phosphate bone graft substitute

Eligibility Criteria

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Inclusion Criteria

* Patients with a confirmed simple bone cyst in a long bone (ie. arm or leg) within last 3 months
* At least 3 weeks must have elapsed since last fracture
* At least 3 months must have elapsed since last cyst treatment
* Patients and/or their legal representatives willing to provide written informed consent (and assent, when appropriate)
* Patients with stabilizing implants in the bone where the cyst is located

Exclusion Criteria

* Patients with bone disease (ie. osteogenesis imperfecta, cancer, osteoporosis, Paget's disease)
* Pregnant or breastfeeding female
* Patients with cysts crossing the growth plate (area where bone grows)
Minimum Eligible Age

2 Years

Maximum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Canadian Institutes of Health Research (CIHR)

OTHER_GOV

Sponsor Role collaborator

The Hospital for Sick Children

OTHER

Sponsor Role lead

Responsible Party

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James Wright

Orthopaedic Surgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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James G. Wright

Role: PRINCIPAL_INVESTIGATOR

The Hospital for Sick Children

Sevan Hopyan

Role: PRINCIPAL_INVESTIGATOR

The Hospital for Sick Children

Locations

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Children's Hospital of Alabama

Birmingham, Alabama, United States

Site Status WITHDRAWN

Loma Linda University

Loma Linda, California, United States

Site Status RECRUITING

Nemours/Alfred I. duPont Hospital for Children

Wilmington, Delaware, United States

Site Status COMPLETED

Ann & Robert H. Lurie Children's Hospital of Chicago

Chicago, Illinois, United States

Site Status RECRUITING

The John Hopkins Hospital

Baltimore, Maryland, United States

Site Status WITHDRAWN

Hospital for Joint Diseases

New York, New York, United States

Site Status WITHDRAWN

Hospital for Special Surgery

New York, New York, United States

Site Status WITHDRAWN

The Children's Hospital at Montefiore

The Bronx, New York, United States

Site Status COMPLETED

University of North Carolina - Chapel Hill

Chapel Hill, North Carolina, United States

Site Status RECRUITING

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, United States

Site Status COMPLETED

Texas Children's Hospital

Houston, Texas, United States

Site Status RECRUITING

The Royal Children's Hospital

Melbourne, , Australia

Site Status RECRUITING

Alberta Children's Hospital

Calgary, Alberta, Canada

Site Status RECRUITING

BC Children's Hospital

Vancouver, British Columbia, Canada

Site Status RECRUITING

Winnipeg Health Sciences Centre

Winnipeg, Manitoba, Canada

Site Status WITHDRAWN

IWK Health Centre

Halifax, Nova Scotia, Canada

Site Status RECRUITING

Children's Hospital at London Health Sciences Centre

London, Ontario, Canada

Site Status RECRUITING

Children's Hospital of Eastern Ontario

Ottawa, Ontario, Canada

Site Status RECRUITING

The Hospital for Sick Children

Toronto, Ontario, Canada

Site Status RECRUITING

Shriners Hospital for Children - Canadian Unit

Montreal, Quebec, Canada

Site Status COMPLETED

Alder Hey Children's Hospital

Liverpool, , United Kingdom

Site Status RECRUITING

Great Ormond Street Hospital for Children

London, , United Kingdom

Site Status RECRUITING

Royal Manchester Children's Hospital

Manchester, , United Kingdom

Site Status RECRUITING

Nuffield Orthopaedic Centre

Oxford, , United Kingdom

Site Status RECRUITING

Sheffield Children's Hospital

Sheffield, , United Kingdom

Site Status RECRUITING

Countries

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United States Australia Canada United Kingdom

Central Contacts

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Project Manager

Role: CONTACT

Facility Contacts

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Elisabeth Clarke

Role: primary

Carly Strohbach

Role: primary

Jamie Burgess

Role: backup

Julie Titter

Role: primary

Grace Anand

Role: primary

Melissa Formosa

Role: primary

Yoga Dhanapala

Role: primary

Harpreet Chhina

Role: primary

Role: backup

Jennifer Hurry

Role: primary

Jacob Davidson

Role: primary

Holly Livock

Role: primary

Julie Shiu

Role: primary

Emma Spink

Role: primary

Kim Gardiner

Role: primary

Imelda Mayor

Role: primary

Rebecca Harmer

Role: primary

Aimee Corcoran

Role: primary

References

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Wright JG, Yandow S, Donaldson S, Marley L; Simple Bone Cyst Trial Group. A randomized clinical trial comparing intralesional bone marrow and steroid injections for simple bone cysts. J Bone Joint Surg Am. 2008 Apr;90(4):722-30. doi: 10.2106/JBJS.G.00620.

Reference Type BACKGROUND
PMID: 18381307 (View on PubMed)

Donaldson S, Wright JG. Recent developments in treatment for simple bone cysts. Curr Opin Pediatr. 2011 Feb;23(1):73-7. doi: 10.1097/MOP.0b013e3283421111.

Reference Type BACKGROUND
PMID: 21191299 (View on PubMed)

Canavese F, Wright JG, Cole WG, Hopyan S. Unicameral bone cysts: comparison of percutaneous curettage, steroid, and autologous bone marrow injections. J Pediatr Orthop. 2011 Jan-Feb;31(1):50-5. doi: 10.1097/BPO.0b013e3181ff7510.

Reference Type BACKGROUND
PMID: 21150732 (View on PubMed)

Donaldson S, Chundamala J, Yandow S, Wright JG. Treatment for unicameral bone cysts in long bones: an evidence based review. Orthop Rev (Pavia). 2010 Mar 20;2(1):e13. doi: 10.4081/or.2010.e13.

Reference Type BACKGROUND
PMID: 21808696 (View on PubMed)

Related Links

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Other Identifiers

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1000042364

Identifier Type: -

Identifier Source: org_study_id

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