Cam Type FAI is a Cause of Hip Pain in the Young Adult and a Precursor to OA

NCT ID: NCT04080466

Last Updated: 2024-01-05

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

PHASE2

Total Enrollment

58 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-02-20

Study Completion Date

2025-01-31

Brief Summary

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An abnormally formed hip joint (cam deformity) is a major cause of osteoarthritis (OA). Individuals may not experience any symptoms until OA is severe due to extensive cartilage loss and changes in underlying bone. A series of studies showed that the cam deformity can lead to the development of OA if left untreated, thus strongly suggesting a causal relationship. Currently, the cam deformity that causes pain is surgically removed to relieve the pain and treat the associated cartilage damage. Recent studies have demonstrated that surgical treatment leads to bone and cartilage changes that were related to improved function and reduced pain.

Detailed Description

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This study will allow the investigators to gain a better understanding of the relationship between cartilage and bone changes. The investigators will examine adult participants in the disease state that require surgical correction and compare to age-matched controls. The investigators will look at the impact of surgical intervention through joint-specific biomarkers of OA, specifically the PET-MRI and blood/urine biomarkers, which will allow them to simultaneously query cartilage and bone activity. The investigators propose that the use of PET-MRI will give more sensitive and hip-specific information about the joint health compared to the blood/urine biomarkers in patients with symptomatic cam morphology. Participants will undergo motion analysis and 3D modeling to help the investigators better understand the disease process during the performance of specific activities and define joint contact mechanics as they relate to the PET-MRI imaging, validating a biomarker for early joint degeneration. This diagnostic tool will be extremely useful for younger individuals with a cam deformity who have not yet developed symptoms. In the future the investigators could use this to detect early degeneration in adolescents to prevent and mitigate development of OA later on. This will also help the investigators develop activity guidelines for people with smaller cam deformities in order to avoid surgery and prevent degeneration.

Conditions

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Hip Dysplasia Femoroacetabular Impingement Osteoarthritis

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Non-randomized, single centre trial with 2 parallel groups
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Cam Group

This group will consist of patients that are scheduled for surgery to undergo cam resection by hip arthroscopy.

Group Type EXPERIMENTAL

Low-dose CT Scan

Intervention Type RADIATION

Low dose computed tomography, also known as qCT, is sensitive to the mineral content within bone tissue, and can assess bone mineral density, a strong predictor of bone strength and stiffness, which can influence the health of the cartilage. Participants will undergo a low dose CT scan of both hips.

Participants in the Cam Group will undergo this scan once as part of their standard of care. Participants in the Control Group will undergo this scan once as part of the study.

Blood/Urine Collection

Intervention Type OTHER

Collection of blood and urine allows the researchers to look for a biomarker in the blood and urine that might help to predict the evolution of disease/hip osteoarthritis. Identifying a marker in the blood and urine that could be used for early detection of individuals with cam deformity that are at-risk of hip degeneration could greatly improve patient care.

Participants in the Cam Group will undergo the blood and urine collection twice; once before surgery and once 2-years post-operative. Participants in the Control Group will undergo a blood and urine collection once as part of the study.

Patient Reported Questionnaires

Intervention Type OTHER

The purpose of the questionnaires is to assess how much trouble the participant is having with their hip and how it affects their quality of life.

Participants in the Cam Group will complete the questionnaires twice; once before surgery and once 2-years post-operative. Participants in the Control Group will complete the questionnaires once as part of the study.

EOS Scan

Intervention Type RADIATION

The EOS® uses a new imaging technique that allows precise measurement of the hip and pelvis geometry and structure. This innovative x-ray technique exposes participants to 2-10 times less radiation than a routine x-ray and can capture multiple images at once.

Participants in the Cam Group will undergo the EOS scan twice; once before surgery and once 2-years post-operative. Participants in the Control Group will undergo the scan once as part of the study.

PET-MRI

Intervention Type RADIATION

Positron emission tomography combined with magnetic resonance imaging (PET-MRI) is a technology that allows physicians to examine bone and cartilage at the molecular level.

Participants in the Cam Group will undergo the scan twice; once before surgery and once 2-years post-operative. Participants in the Control Group will undergo the scan once as part of the study.

Motion Analysis

Intervention Type OTHER

Motion analysis is the study of how joints move and which muscles fire during specific movements. In the lab, participants will be asked to perform movements that they might do during a typical day or when exercising.

Participants in the Cam Group will undergo the Motion Analysis session twice; once before surgery and once 2-years post-operative. Participants in the Control Group will undergo the Motion Analysis session once as part of the study.

3T MRI

Intervention Type RADIATION

Participants will undergo a 3-Tesla (3T) Magnetic Resonance Imaging (MRI) of both hips.

Participants in the Cam Group will undergo this scan once as part of their standard of care. Participants in the Control Group will undergo this scan once as part of the study.

Control Group

This group will consist of a matched cohort of control participants.

Group Type ACTIVE_COMPARATOR

Low-dose CT Scan

Intervention Type RADIATION

Low dose computed tomography, also known as qCT, is sensitive to the mineral content within bone tissue, and can assess bone mineral density, a strong predictor of bone strength and stiffness, which can influence the health of the cartilage. Participants will undergo a low dose CT scan of both hips.

Participants in the Cam Group will undergo this scan once as part of their standard of care. Participants in the Control Group will undergo this scan once as part of the study.

Blood/Urine Collection

Intervention Type OTHER

Collection of blood and urine allows the researchers to look for a biomarker in the blood and urine that might help to predict the evolution of disease/hip osteoarthritis. Identifying a marker in the blood and urine that could be used for early detection of individuals with cam deformity that are at-risk of hip degeneration could greatly improve patient care.

Participants in the Cam Group will undergo the blood and urine collection twice; once before surgery and once 2-years post-operative. Participants in the Control Group will undergo a blood and urine collection once as part of the study.

Patient Reported Questionnaires

Intervention Type OTHER

The purpose of the questionnaires is to assess how much trouble the participant is having with their hip and how it affects their quality of life.

Participants in the Cam Group will complete the questionnaires twice; once before surgery and once 2-years post-operative. Participants in the Control Group will complete the questionnaires once as part of the study.

EOS Scan

Intervention Type RADIATION

The EOS® uses a new imaging technique that allows precise measurement of the hip and pelvis geometry and structure. This innovative x-ray technique exposes participants to 2-10 times less radiation than a routine x-ray and can capture multiple images at once.

Participants in the Cam Group will undergo the EOS scan twice; once before surgery and once 2-years post-operative. Participants in the Control Group will undergo the scan once as part of the study.

PET-MRI

Intervention Type RADIATION

Positron emission tomography combined with magnetic resonance imaging (PET-MRI) is a technology that allows physicians to examine bone and cartilage at the molecular level.

Participants in the Cam Group will undergo the scan twice; once before surgery and once 2-years post-operative. Participants in the Control Group will undergo the scan once as part of the study.

Motion Analysis

Intervention Type OTHER

Motion analysis is the study of how joints move and which muscles fire during specific movements. In the lab, participants will be asked to perform movements that they might do during a typical day or when exercising.

Participants in the Cam Group will undergo the Motion Analysis session twice; once before surgery and once 2-years post-operative. Participants in the Control Group will undergo the Motion Analysis session once as part of the study.

3T MRI

Intervention Type RADIATION

Participants will undergo a 3-Tesla (3T) Magnetic Resonance Imaging (MRI) of both hips.

Participants in the Cam Group will undergo this scan once as part of their standard of care. Participants in the Control Group will undergo this scan once as part of the study.

Interventions

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Low-dose CT Scan

Low dose computed tomography, also known as qCT, is sensitive to the mineral content within bone tissue, and can assess bone mineral density, a strong predictor of bone strength and stiffness, which can influence the health of the cartilage. Participants will undergo a low dose CT scan of both hips.

Participants in the Cam Group will undergo this scan once as part of their standard of care. Participants in the Control Group will undergo this scan once as part of the study.

Intervention Type RADIATION

Blood/Urine Collection

Collection of blood and urine allows the researchers to look for a biomarker in the blood and urine that might help to predict the evolution of disease/hip osteoarthritis. Identifying a marker in the blood and urine that could be used for early detection of individuals with cam deformity that are at-risk of hip degeneration could greatly improve patient care.

Participants in the Cam Group will undergo the blood and urine collection twice; once before surgery and once 2-years post-operative. Participants in the Control Group will undergo a blood and urine collection once as part of the study.

Intervention Type OTHER

Patient Reported Questionnaires

The purpose of the questionnaires is to assess how much trouble the participant is having with their hip and how it affects their quality of life.

Participants in the Cam Group will complete the questionnaires twice; once before surgery and once 2-years post-operative. Participants in the Control Group will complete the questionnaires once as part of the study.

Intervention Type OTHER

EOS Scan

The EOS® uses a new imaging technique that allows precise measurement of the hip and pelvis geometry and structure. This innovative x-ray technique exposes participants to 2-10 times less radiation than a routine x-ray and can capture multiple images at once.

Participants in the Cam Group will undergo the EOS scan twice; once before surgery and once 2-years post-operative. Participants in the Control Group will undergo the scan once as part of the study.

Intervention Type RADIATION

PET-MRI

Positron emission tomography combined with magnetic resonance imaging (PET-MRI) is a technology that allows physicians to examine bone and cartilage at the molecular level.

Participants in the Cam Group will undergo the scan twice; once before surgery and once 2-years post-operative. Participants in the Control Group will undergo the scan once as part of the study.

Intervention Type RADIATION

Motion Analysis

Motion analysis is the study of how joints move and which muscles fire during specific movements. In the lab, participants will be asked to perform movements that they might do during a typical day or when exercising.

Participants in the Cam Group will undergo the Motion Analysis session twice; once before surgery and once 2-years post-operative. Participants in the Control Group will undergo the Motion Analysis session once as part of the study.

Intervention Type OTHER

3T MRI

Participants will undergo a 3-Tesla (3T) Magnetic Resonance Imaging (MRI) of both hips.

Participants in the Cam Group will undergo this scan once as part of their standard of care. Participants in the Control Group will undergo this scan once as part of the study.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Skeletally mature patient undergoing cam resection by hip arthroscopy with hip pain longer than 6 months
* Absence of arthritis (Tonnis Grade 0 or 1)
* Absence of dysplasia (LCEA \> 25°) or overcoverage (LCEA \> 39°)
* Alpha angle greater than 55° on multiplanar imaging
* Subject is over the age of 18 years old at time of enrollment
* Subject is willing and able to complete required study visits and assessments
* Subject is willing to sign the approved Informed Consent Form


* Normal femoral head neck contour and no evidence of dysplasia
* Subject is over the age of 18 years old at time of enrollment
* Subject is willing and able to complete required study visits and assessments
* Subject is willing to sign the approved Informed Consent Form

Exclusion Criteria

* Prior joint replacement surgery in any lower-limb joint due to OA
* History of lower-limb joint or back injury in the last year that impairs mobility
* Metallic prosthesis
* Worked with metal, metal fragments in the eye
* Blood transmittable disease(s)
* In vivo devices (Aneurysm clip(s), Pacemaker, ICD, Implanted hearing device)
* Extreme claustrophobia
* Overweight or obese (BMI \> 30) and/or waist circumference \>102cm in men and \>88cm in women
* Diagnosis of Parkinson's or uncontrollable tremors
* Known history of early OA in the immediate family
* Pregnant, Breastfeeding, or planning to get pregnant
* Cognitive impairment that prevents accurate completion of patient-reported outcome questionnaires
* Patient unable/unwilling to complete all required follow-up visits
* Participants who have been exposed to other sources of radiation within the last year (Bringing radiation exposure above annual maximum)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Canadian Institutes of Health Research (CIHR)

OTHER_GOV

Sponsor Role collaborator

Ottawa Hospital Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Paul Beaule, MD, FRCSC

Role: PRINCIPAL_INVESTIGATOR

The Ottawa Hospital Research Institute

Locations

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The Ottawa Hospital

Ottawa, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Paul Beaule, MD, FRCSC

Role: CONTACT

613-737-8920

Cheryl Kreviazuk, BA

Role: CONTACT

613-737-8920

Facility Contacts

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Cheryl Kreviazuk, BA

Role: primary

613-737-8920

Other Identifiers

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20190456

Identifier Type: -

Identifier Source: org_study_id

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