Zimmer® Natural Nail® (ZNN) Bactiguard Tibia Post-Market Clinical Follow-up Study

NCT ID: NCT05022485

Last Updated: 2025-11-25

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

Total Enrollment

500 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-04-11

Study Completion Date

2027-07-31

Brief Summary

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Primary objective of this study is to compare fracture related infection (FRI) rates of ZNN Bactiguard Tibia to conventional uncoated titanium-alloy nails 12 months after tibia fracture fixation.

The secondary objectives are confirmation of safety, performance and clinical benefits of ZNN Bactiguard implant and related instrumentation12 months after fracture fixation.

Detailed Description

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This is a multicenter, prospective, Post-market Clinical Follow-up (PMCF) Study with retrospective controls.

The study will enroll patients that will be implanted with the Zimmer Natural Nail Bactiguard Tibia device and retrospective controls implanted with standard titanium-alloy tibia nails.

500 tibias will be recruited at maximum 15 sites and allocated on a 1:1 ratio into an:

* investigational group (prospective/consecutive series of 250 tibias treated with ZNN Bactiguard tibia)
* a control group (retrospective series of 250 tibias treated with uncoated titanium-alloy tibia nail - data collection will be retrospective, these subjects will not have to undergo any study-related procedure).

The primary endpoint is the Fracture Related Infection (FRI) rate in the study population 12 months after fracture fixation.

The secondary endpoint is the confirmation of safety, performance and clinical benefits of ZNN Bactiguard implant and related instrumentation through the following measure systems:

* Radiologic (RUST) \& clinical (FIX-IT) fracture healing 12 months after fracture fixation (performance).
* Patients' outcomes assessed by the Oxford Knee Score 12 months after fracture fixation (clinical benefits).
* EQ5D-5L (patients' quality of life).
* Incidence and frequency of adverse events (safety).

Data will be collected at 2 weeks, 3 months, 6 months and 1 year after fracture fixation.

Conditions

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Tibial Fractures Fracture Infection

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Investigational group

Subjects that will be implanted with the ZNN Bactiguard tibia device.

ZNN Bactiguard tibia

Intervention Type DEVICE

Tibia fracture fixation

Control group

Subjects that have received an uncoated titanium-alloy tibia nail in the past (data collection is retrospective; patients will not have to undergo any study-related procedure).

No interventions assigned to this group

Interventions

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ZNN Bactiguard tibia

Tibia fracture fixation

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patient must be 18 or older.
* Patient has signed IRB/EC-approved informed consent (if applicable for retrospective controls, based on local requirements).
* Patient suffered primary tibia fracture (monolateral or bilateral) at high risk of infection, eligible for fixation by intramedullary (IM) nailing (standard or suprapatellar approach) and meets at least one of the following conditions:

* Open fractures (incl. gunshot fractures): Gustilo Type I, II, III A and III B.
* Delayed treatment (initial treatment by external fixation due to swelling/ high energy trauma followed by definitive treatment by intramedullary nail).
* Fracture associated with ipsilateral leg compartment syndrome treated with fasciotomy wound(s).
* Closed fractures with severe tissue damage: Tscherne grade C2 and C3.
* Patient:

* will be treated with ZNN Bactiguard tibia for inclusion in investigational group (retrospective enrollment is allowed up to 1st follow-up visit);
* was treated with uncoated (conventional) titanium-alloy intramedullary tibia nail for inclusion in control group;

Exclusion Criteria

* Patient is unwilling or unable to give consent.
* Patient is not expected to survive follow-up schedule.
* Patient is anticipated to be non-compliant to the study protocol.
* Patient has a mental or neurological condition or alcohol/drug addiction that will not allow for proper informed consent and/or participation in follow-up program.
* Patient is a prisoner.
* Patient is known to be pregnant and/or breastfeeding.
* Patient suffered tibia fracture that meets any of the following conditions:

* Pathologic fracture.
* Gustilo Type IIIC open fracture.
* Patient has multisegmented fracture NOT eligible for fixation by intramedullary nailing.
* Patients with wound closure more than 10 days after injury.
* Besides IM nail, patient requires additional tibia fixation by plate (additional tibia fixation by screw(s) and/or fibula plate fixation are allowed).
* Concomitant with fracture, patient suffered head injury with Abbreviated Injury Score (AIS) ≥ 3.
* For control group:

* patient doesn't have all the minimum required data available:

1. demographic information
2. injury classification
3. FRI information
4. operative report and device information
5. radiographic analyses (until fracture healing or confirmation of non-union leading to reoperation)
* Tibia medullary canal is obliterated by a previous fracture or tumor\*
* Tibia bone shaft having excessive bow or a deformity\*
* Lack of bone substance or bone quality, which makes stable seating of the nail implant impossible\*
* All concomitant diseases that can impair the operation, functioning or the success of the nail implant\*
* Insufficient blood circulation\*
* Skeletally immature patients\*
* Infection\*

* ZNN Bactiguard tibia contraindication
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Zimmer Biomet

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Emilie Rohmer

Role: STUDY_DIRECTOR

Clin Ops Director

Locations

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Tirolkliniken Innsbruck

Innsbruck, , Austria

Site Status RECRUITING

Hôpital Ambroise-Paré

Boulogne-Billancourt, , France

Site Status RECRUITING

Hôpitaux Universitaires de Marseille Nord

Marseille, , France

Site Status RECRUITING

Universitätsklinikum Marburg

Marburg, Hesse, Germany

Site Status RECRUITING

Universitätsklinikum Leipzig

Leipzig, , Germany

Site Status RECRUITING

Universitätsklinikum Regensburg

Regensburg, , Germany

Site Status RECRUITING

AOU Policlinico di Bari

Bari, , Italy

Site Status RECRUITING

Azienda Ospedaliero-Universitaria Careggi

Florence, , Italy

Site Status RECRUITING

Tygerberg Hospital

Cape Town, , South Africa

Site Status RECRUITING

Groote Schuur Hospital

Cape Town, , South Africa

Site Status RECRUITING

Hospital Universitario Valle de Hebrón

Barcelona, Catalonia, Spain

Site Status RECRUITING

Kantonsspital Winterthur

Winterthur, Canton of Zurich, Switzerland

Site Status RECRUITING

Royal Infirmary of Edinburgh

Edinburgh, , United Kingdom

Site Status RECRUITING

Leeds General Infirmary

Leeds, , United Kingdom

Site Status RECRUITING

The Royal London Hospital

London, , United Kingdom

Site Status RECRUITING

King's College Hospital NHS Trust

London, , United Kingdom

Site Status RECRUITING

Countries

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Austria France Germany Italy South Africa Spain Switzerland United Kingdom

Central Contacts

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Gemma de Ramon Francas

Role: CONTACT

+41 79 377 11 96

Lisa To

Role: CONTACT

+32 2 456 12 70

Facility Contacts

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Rohit Arora, MD

Role: primary

Thomas Bauer, MD

Role: primary

0033149095575

Xavier Flecher, MD

Role: primary

0033 4 91 96 86 94

Antonius Korschinsky, MD

Role: primary

+49 6421 58-64904

Georg Osterhoff, MD

Role: primary

Volker Alt, MD

Role: primary

Giovanni Vicenti, MD

Role: primary

Massimo Sangiovanni, MD

Role: primary

Nando Ferreira, MD

Role: primary

+27 83 324 5585

Maritz Laubscher, MD

Role: primary

+27(0)83 3841191

Yaiza Garcia

Role: primary

Christoph Meier, MD

Role: primary

Sam Molyneux, MD

Role: primary

Nik Kanakaris, MD

Role: primary

Alexandros Vris, MD

Role: primary

Aaron Saini, MD

Role: primary

+44 (0)20 3299 1919

Other Identifiers

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CMG2020-32T

Identifier Type: -

Identifier Source: org_study_id

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