Personalised Against Standard High Tibial Osteotomy

NCT ID: NCT04666571

Last Updated: 2024-12-16

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

56 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-01

Study Completion Date

2025-06-29

Brief Summary

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A study to compare the accuracy of achieving the planned correction between personalised (TOKA) high tibial osteotomy (HTO) procedure and standard generic HTO procedure.

Detailed Description

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The trial design is a multi-centre, blinded, superiority two arm, parallel group design randomised controlled trial (RCT) of personalised (TOKA) versus standard high tibial osteotomy (HTO).

The aim of the PASHiOn trial is to establish whether digitally planned personalised HTO surgery (TOKA) increases the accuracy of bone correction in comparison to conventional HTO surgery. Embedded within the trial is a non-randomised pre-RCT technology check and safety assessment of 5 patients (Phase 1), followed by a randomised controlled trial of 88 (revised to 50) patients (Phase 2) .

During Phase 1 of the clinical investigation, 5 patients fulfilling the inclusion criteria will be recruited and assessed in an identical way to the 88 (revised to 50) patients recruited in the main trial, but without randomisation. Recruitment of the remaining patients (Phase 2) will take place after the six-week assessment on the fifth patient is complete and the oversight committee supports progression to Phase 2.

Patients will be randomised to Phase 2 in a 1:1 ratio and patients will be blinded as to which treatment arm they receive.

Conditions

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Medial Knee Osteoarthritis

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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Personalised (TOKA)

During HTO surgery, the personalised plate will be inserted below the knee.

The investigational device and comparator are two types of metal plate used to fix the bone in place during a high tibial osteotomy (HTO).

Group Type EXPERIMENTAL

TOKA

Intervention Type DEVICE

The device is a digitally planned (using individual CT scan measured anatomic data) personalised opening wedge high tibial osteotomy (HTO) procedure using a custom 3D printed surgical guide and plate.

Standard (Tomofix or ActivMotion)

During HTO surgery, the standard plate will be inserted below the knee.

Group Type ACTIVE_COMPARATOR

Tomofix or ActivMotion

Intervention Type DEVICE

The comparators, Tomofix and ActivMotion, are the most widely used devices for HTO procedures in the UK. Surgical procedures using the Tomofix and ActiveMotion are similar to TOKA, however, they are not patient specific and do not use custom-made plates.

Interventions

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TOKA

The device is a digitally planned (using individual CT scan measured anatomic data) personalised opening wedge high tibial osteotomy (HTO) procedure using a custom 3D printed surgical guide and plate.

Intervention Type DEVICE

Tomofix or ActivMotion

The comparators, Tomofix and ActivMotion, are the most widely used devices for HTO procedures in the UK. Surgical procedures using the Tomofix and ActiveMotion are similar to TOKA, however, they are not patient specific and do not use custom-made plates.

Intervention Type DEVICE

Other Intervention Names

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Tailored Osteotomy Knee Alignment Personalised HTO Standard HTO Generic HTO

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing High Tibial Osteotomy
* Male or Female, aged 18 to 65 years
* Primary diagnosis of Non-Inflammatory Degenerative Joint Disease (NIDJD)
* Predominately diagnosed with unicompartmental medial osteoarthritis of the knee with the normal clinically acceptable level of other compartmental involvement
* Varus deformity \<20 °
* BMI ≤ 35. An exemption to this may be made if the participant (in the investigators opinion) is suitable for surgery.
* Participant is willing and able to give informed consent for participation in the study.
* Able (in the Investigators opinion) and willing to comply with all study requirements.
* Willing to allow his or her General Practitioner and consultant, if appropriate, to be notified of participation in the study.

Exclusion Criteria

* Female participants who are pregnant, lactating or planning pregnancy during the course of the study.
* Prisoners
* Participants with a known deep tissue sensitivity to device materials
* Participants with an active or suspected latent infection in or about the affected knee joint
* Participants who have received any orthopaedic surgical intervention to the lower extremities (excluding investigative surgery) within the past 12 months, or is expected to require any orthopaedic surgical intervention to the lower extremities, other than the HTO to be enrolled in this study, within the next 12 months (including intra-articular procedures).
* Participants who require bilateral HTO with surgery planned on their second knee within 6 months of their first operation (bilateral HTO patients are otherwise included).
* Participants who require bilateral HTO who have had a previous unsuccessful contralateral partial replacement or HTO
* Chronic heart failure (NYHA Stage ≥ 2)
* Neuromuscular or neurosensory deficiency, which limits the ability to evaluate the safety and efficacy of the device
* Systemic disease diagnosis (e.g. Lupus Erythematosus) or a metabolic disorder (e.g. Paget's disease) leading to progressive bone deterioration.
* Participant is immunologically suppressed or receiving steroids in excess of normal physiological requirements (e.g. \> 30 days).
* Participant is a smoker.
* Any other significant disease or disorder which, in the opinion of the Investigator, may either put the participants at risk because of participation in the study, or may influence the result of the study, or the participant's ability to participate in the study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Oxford

OTHER

Sponsor Role collaborator

3D Metal Printing Ltd

INDUSTRY

Sponsor Role collaborator

Versus Arthritis

OTHER

Sponsor Role collaborator

University of Bath

OTHER

Sponsor Role lead

Responsible Party

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Richie Gill

Professor of Healthcare Engineering

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Richie Gill, Prof

Role: PRINCIPAL_INVESTIGATOR

University of Bath

Locations

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Royal United Hospitals NHS Trust

Bath, Avon, United Kingdom

Site Status

Oxford University Hospitals NHS Trust

Oxford, Oxfordshire, United Kingdom

Site Status

Cardiff and Vale University Health Board

Cardiff, Wales, United Kingdom

Site Status

Royal Orthopaedic Hospital

Birmingham, West Midlands, United Kingdom

Site Status

Walsall Manor Hospital

Walsall, West Midlands, United Kingdom

Site Status

Great Western Hospital

Swindon, Wiltshire, United Kingdom

Site Status

Royal Devon and Exeter NHS Foundation Trust

Exeter, , United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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OCTRU263

Identifier Type: -

Identifier Source: org_study_id