Bio-Integrative Versus Metallic Screws for Calcaneus Osteotomies

NCT ID: NCT05018130

Last Updated: 2023-09-06

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

44 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-11-01

Study Completion Date

2024-12-01

Brief Summary

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The use of bio-integrative implants in orthopedic surgery is growing exponentially. As many biomechanical and histological studies were able to sustain its structural and biological properties, few clinical studies are available to support its advantages, such as good osteosynthesis, lower rates of removal, and diminished implant-related artifact in imaging studies. This information is vital to providers when choosing the proper material and planning postoperative treatment. This trial intends to test the capacity of the bioabsorbable screws in reaching the same clinical and radiographical outcomes of the current metallic screws.

Detailed Description

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A minimum of 44 patients undergoing Medial or Lateral Displacement Calcaneal Osteotomy (MDCO) will be randomized in two parallel groups for surgery, considering applied the implant. One group will be operated using two 4.0mm cannulated bio-integrative (absorbable) screws, and the other group using two 4.0mm cannulated metallic screws. Patients will be blinded evaluated for a mean follow-up of twelve weeks in terms of bone healing, complications, and implant-related artifact using weight-bearing computed tomography (WBCT).

Conditions

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Flatfoot Bone Resorption Cavus Deformity Osteolysis Complication

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized, investigator-blinded, in parallel groups, two-arms, single-center, non-inferiority, clinical trial.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
The evaluator doctor will not have access to the protocol test applied to each patient and the surgeries will be conducted by different physicians.

Study Groups

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Bio-integrative

Traditional oblique calcaneus osteotomy through a lateral approach. After a 10mm displacement, the osteotomy will be fixed with two 4.0mm bio-integrative cannulated screws.

Group Type EXPERIMENTAL

Calcaneus Osteotomy (Bio-integrative)

Intervention Type PROCEDURE

Calcaneus Displacement Osteotomy using two bio-integrative screws

Metallic

Traditional oblique calcaneus osteotomy through a lateral approach. After a 10mm displacement, the osteotomy will be fixed with two 4.0mm metallic cannulated screws.

Group Type ACTIVE_COMPARATOR

Calcaneus Osteotomy (Metallic)

Intervention Type PROCEDURE

Calcaneus Displacement Osteotomy using two metallic screws

Interventions

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Calcaneus Osteotomy (Metallic)

Calcaneus Displacement Osteotomy using two metallic screws

Intervention Type PROCEDURE

Calcaneus Osteotomy (Bio-integrative)

Calcaneus Displacement Osteotomy using two bio-integrative screws

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Individuals must be older than 18 and younger than 75 years of age, both genders;
* Participants must be experiencing symptoms related to their baseline condition for at least six months before the surgery;
* Clinical diagnosis of hindfoot malignment, defined as the presence of a clinical hindfoot angle above 10 degrees of valgus or any degree of varus;
* Surgical planning, including a calcaneus displacement osteotomy through a traditional oblique cut.

Exclusion Criteria

* Previous surgery involving the affected calcaneus;
* History or documented evidence of autoimmune or peripheral vascular diseases;
* History or documented evidence of peripheral neuropathy (nervous compression syndrome, tarsal tunnel syndrome) or systemic inflammatory disease a (rheumatoid arthritis, spondylitis, Reiter Syndrome, etc.);
* Any condition that represents a contraindication of the proposed therapies;
* Impossibility or incapacity to sign the informed Consent Form;
* Presence of infectious process (superficial on the skin and cellular tissue, or deep in the bone) in the region to be treated.
* Osteotomies requiring resection of wedges (Dweyer, triple Dweyer, etc.);
* Osteotomies planned to occur in a non-traditional cut (Malerba, Scarf, etc.).
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Iowa

OTHER

Sponsor Role lead

Responsible Party

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John Femino

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Nacime Salomao Barbachan Mansur

Role: STUDY_DIRECTOR

Visiting Associate

Locations

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Departament of Orthopaedics and Rehabilitation, University of Iowa, Carver College of Medicine

Iowa City, Iowa, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Nacime Salomao Barbachan Mansur, MD, PhD

Role: CONTACT

3194007911

Facility Contacts

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Nacime Mansur, MD, PhD

Role: primary

References

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Acar B, Kose O, Unal M, Turan A, Kati YA, Guler F. Comparison of magnesium versus titanium screw fixation for biplane chevron medial malleolar osteotomy in the treatment of osteochondral lesions of the talus. Eur J Orthop Surg Traumatol. 2020 Jan;30(1):163-173. doi: 10.1007/s00590-019-02524-1. Epub 2019 Aug 2.

Reference Type BACKGROUND
PMID: 31375999 (View on PubMed)

Cicchinelli LD, Stalc J, Richter M, Miller S. Prospective, Multicenter, Clinical and Radiographic Evaluation of a Biointegrative, Fiber-Reinforced Implant for Proximal Interphalangeal Joint Arthrodesis. Foot Ankle Orthop. 2020 Nov 27;5(4):2473011420966311. doi: 10.1177/2473011420966311. eCollection 2020 Oct.

Reference Type BACKGROUND
PMID: 35097414 (View on PubMed)

Daghino W, Bistolfi A, Aprato A, Masse A. Bioabsorbable implants in foot trauma surgery. Injury. 2019 Aug;50 Suppl 4:S47-S55. doi: 10.1016/j.injury.2019.01.016. Epub 2019 Jan 23.

Reference Type BACKGROUND
PMID: 30711319 (View on PubMed)

Hovis WD, Bucholz RW. Polyglycolide bioabsorbable screws in the treatment of ankle fractures. Foot Ankle Int. 1997 Mar;18(3):128-31. doi: 10.1177/107110079701800303.

Reference Type BACKGROUND
PMID: 9116891 (View on PubMed)

Park S, Kim JH, Kim IH, Lee M, Heo S, Kim H, Kim EH, Choy YB, Heo CY. Evaluation of poly(lactic-co-glycolic acid) plate and screw system for bone fixation. J Craniofac Surg. 2013 May;24(3):1021-5. doi: 10.1097/SCS.0b013e31827fee09.

Reference Type BACKGROUND
PMID: 23714938 (View on PubMed)

Partio N, Mattila VM, Maenpaa H. Bioabsorbable vs. titanium screws for first tarsometatarsal joint arthrodesis: An in-vitro study. J Clin Orthop Trauma. 2020 May-Jun;11(3):448-452. doi: 10.1016/j.jcot.2019.08.017. Epub 2019 Aug 28.

Reference Type BACKGROUND
PMID: 32405207 (View on PubMed)

Qi L, Chang C, Xin T, Xing PF, Tianfu Y, Gang Z, Jian L. Double fixation of displaced patella fractures using bioabsorbable cannulated lag screws and braided polyester suture tension bands. Injury. 2011 Oct;42(10):1116-20. doi: 10.1016/j.injury.2011.01.025. Epub 2011 Feb 22.

Reference Type BACKGROUND
PMID: 21345433 (View on PubMed)

Tanner MC, Heller R, Westhauser F, Miska M, Ferbert T, Fischer C, Gantz S, Schmidmaier G, Haubruck P. Evaluation of the clinical effectiveness of bioactive glass (S53P4) in the treatment of non-unions of the tibia and femur: study protocol of a randomized controlled non-inferiority trial. Trials. 2018 May 30;19(1):299. doi: 10.1186/s13063-018-2681-9.

Reference Type BACKGROUND
PMID: 29843766 (View on PubMed)

Zhang J, Xiao B, Wu Z. Surgical treatment of calcaneal fractures with bioabsorbable screws. Int Orthop. 2011 Apr;35(4):529-33. doi: 10.1007/s00264-010-1183-5. Epub 2011 Jan 5.

Reference Type BACKGROUND
PMID: 21207026 (View on PubMed)

Jones CP, Coughlin MJ, Shurnas PS. Prospective CT scan evaluation of hindfoot nonunions treated with revision surgery and low-intensity ultrasound stimulation. Foot Ankle Int. 2006 Apr;27(4):229-35. doi: 10.1177/107110070602700401.

Reference Type BACKGROUND
PMID: 16624210 (View on PubMed)

Other Identifiers

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202106228

Identifier Type: -

Identifier Source: org_study_id

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