Evaluation of the Clinical Effectiveness of Bioactive Glass (S53P4) in the Treatment of Tibia and Femur Non-unions

NCT ID: NCT05049915

Last Updated: 2021-09-20

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-06-01

Study Completion Date

2022-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Abstract Background: Treatment of non-union remains challenging and often necessitates augmentation of the resulting defect with an autologous bone graft (ABG). ABG is limited in quantity and its harvesting incurs an additional surgical intervention leaving the risk for associated complications and morbidities. Therefore, artificial bone graft substitutes that might replace autologous bone are needed. S53P4-type bioactive glass (BaG) is a promising material which might be used as bone graft substitute due to its osteostimulative, conductive and antimicrobial properties. In this study, the investigators plan to examine the clinical effectiveness of BaG as a bone graft substitute in Masquelet therapy in comparison with present standard Masquelet therapy using an ABG with tricalciumphosphate to fill the bone defect.

Methods/design: This randomized controlled, clinical non-inferiority trial will be carried out at the Department of Orthopedics and Traumatology at Heidelberg University. Patients who suffer from tibial or femoral non-unions with a segmental bone defect of 2-5 cm and who are receiving Masquelet treatment will be included in the study. The resulting bone defect will either be filled with autologous bone and tricalciumphosphate (control group, N = 25) or BaG (S53P4) (study group, N = 25). Subsequent to operative therapy, all patients will receive the same standardized follow-up procedures. The primary endpoint of the study is union achieved 1year after surgery.

Discussion: The results from the current study will help evaluate the clinical effectiveness of this promising biomaterial in non-union therapy. In addition, this randomized trial will help to identify potential benefits and limitations regarding the use of BaG in Masquelet therapy. Data from the study will increase the knowledge about BaG as a bone graft substitute as well as identify patients possibly benefiting from Masquelet therapy using BaG and those who are more likely to fail, thereby improving the quality of non-union treatment.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Pseudoarthrosis of Bone

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Masquelet technique: bioactive glass

Group Type EXPERIMENTAL

bioglass (S53P4)

Intervention Type DEVICE

surgical procedure: Masquelet defect augmentation with bioglass

Masquelet technique: RIA + TCP

Group Type ACTIVE_COMPARATOR

RIA and TCP

Intervention Type DEVICE

surgical procedure: Masquelet defect augmentation with RIA and TCP

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

bioglass (S53P4)

surgical procedure: Masquelet defect augmentation with bioglass

Intervention Type DEVICE

RIA and TCP

surgical procedure: Masquelet defect augmentation with RIA and TCP

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* pseudarthrosis of the tibia or femur
* bone defect \< 5 cc
* surgical treatment with Masquelet technique

Exclusion Criteria

* age under 18
* disagreement
* patients who require amputation of the affected limb
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Bonalive Biomaterials Ltd

INDUSTRY

Sponsor Role collaborator

Sebastian Findeisen

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Sebastian Findeisen

Intern

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Gerhard Schmidmaier, Prof. Dr.

Role: STUDY_DIRECTOR

HTRG

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

University Hospital Heidelberg

Heidelberg, Baden-Wurttemberg, Germany

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Germany

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Sebastian Findeisen, Dr. med.

Role: CONTACT

+4962215634330

Patrick Haubruck, Dr. med.

Role: CONTACT

References

Explore related publications, articles, or registry entries linked to this study.

Einhorn TA. The cell and molecular biology of fracture healing. Clin Orthop Relat Res. 1998 Oct;(355 Suppl):S7-21. doi: 10.1097/00003086-199810001-00003.

Reference Type BACKGROUND
PMID: 9917622 (View on PubMed)

Schmidmaier G, Moghaddam A. [Long Bone Nonunion]. Z Orthop Unfall. 2015 Dec;153(6):659-74; quiz 675-6. doi: 10.1055/s-0035-1558259. Epub 2015 Dec 15. German.

Reference Type BACKGROUND
PMID: 26670151 (View on PubMed)

Hak DJ, Fitzpatrick D, Bishop JA, Marsh JL, Tilp S, Schnettler R, Simpson H, Alt V. Delayed union and nonunions: epidemiology, clinical issues, and financial aspects. Injury. 2014 Jun;45 Suppl 2:S3-7. doi: 10.1016/j.injury.2014.04.002.

Reference Type BACKGROUND
PMID: 24857025 (View on PubMed)

Giannoudis PV, Einhorn TA, Marsh D. Fracture healing: the diamond concept. Injury. 2007 Sep;38 Suppl 4:S3-6. doi: 10.1016/s0020-1383(08)70003-2.

Reference Type BACKGROUND
PMID: 18224731 (View on PubMed)

Romano CL, Logoluso N, Meani E, Romano D, De Vecchi E, Vassena C, Drago L. A comparative study of the use of bioactive glass S53P4 and antibiotic-loaded calcium-based bone substitutes in the treatment of chronic osteomyelitis: a retrospective comparative study. Bone Joint J. 2014 Jun;96-B(6):845-50. doi: 10.1302/0301-620X.96B6.33014.

Reference Type BACKGROUND
PMID: 24891588 (View on PubMed)

Valimaki VV, Aro HT. Molecular basis for action of bioactive glasses as bone graft substitute. Scand J Surg. 2006;95(2):95-102. doi: 10.1177/145749690609500204.

Reference Type BACKGROUND
PMID: 16821652 (View on PubMed)

Lindfors N, Geurts J, Drago L, Arts JJ, Juutilainen V, Hyvonen P, Suda AJ, Domenico A, Artiaco S, Alizadeh C, Brychcy A, Bialecki J, Romano CL. Antibacterial Bioactive Glass, S53P4, for Chronic Bone Infections - A Multinational Study. Adv Exp Med Biol. 2017;971:81-92. doi: 10.1007/5584_2016_156.

Reference Type BACKGROUND
PMID: 28050878 (View on PubMed)

Lindfors NC, Hyvonen P, Nyyssonen M, Kirjavainen M, Kankare J, Gullichsen E, Salo J. Bioactive glass S53P4 as bone graft substitute in treatment of osteomyelitis. Bone. 2010 Aug;47(2):212-8. doi: 10.1016/j.bone.2010.05.030.

Reference Type BACKGROUND
PMID: 20624692 (View on PubMed)

van Gestel NA, Geurts J, Hulsen DJ, van Rietbergen B, Hofmann S, Arts JJ. Clinical Applications of S53P4 Bioactive Glass in Bone Healing and Osteomyelitic Treatment: A Literature Review. Biomed Res Int. 2015;2015:684826. doi: 10.1155/2015/684826. Epub 2015 Oct 4.

Reference Type BACKGROUND
PMID: 26504821 (View on PubMed)

Kokubo T, Takadama H. How useful is SBF in predicting in vivo bone bioactivity? Biomaterials. 2006 May;27(15):2907-15. doi: 10.1016/j.biomaterials.2006.01.017. Epub 2006 Jan 31.

Reference Type BACKGROUND
PMID: 16448693 (View on PubMed)

Stoor P, Apajalahti S, Kontio R. Regeneration of Cystic Bone Cavities and Bone Defects With Bioactive Glass S53P4 in the Upper and Lower Jaws. J Craniofac Surg. 2017 Jul;28(5):1197-1205. doi: 10.1097/SCS.0000000000003649.

Reference Type BACKGROUND
PMID: 28538076 (View on PubMed)

Stoor P, Pulkkinen J, Grenman R. Bioactive glass S53P4 in the filling of cavities in the mastoid cell area in surgery for chronic otitis media. Ann Otol Rhinol Laryngol. 2010 Jun;119(6):377-82. doi: 10.1177/000348941011900603.

Reference Type BACKGROUND
PMID: 20583735 (View on PubMed)

Kankare J, Lindfors NC. Reconstruction of Vertebral Bone Defects using an Expandable Replacement Device and Bioactive Glass S53P4 in the Treatment of Vertebral Osteomyelitis: Three Patients and Three Pathogens. Scand J Surg. 2016 Dec;105(4):248-253. doi: 10.1177/1457496915626834. Epub 2016 Jun 23.

Reference Type BACKGROUND
PMID: 26929284 (View on PubMed)

Fischer C, Frank M, Kunz P, Tanner M, Weber MA, Moghaddam A, Schmidmaier G, Hug A. Dynamic contrast-enhanced ultrasound (CEUS) after open and minimally invasive locked plating of proximal humerus fractures. Injury. 2016 Aug;47(8):1725-31. doi: 10.1016/j.injury.2016.05.005. Epub 2016 May 14.

Reference Type BACKGROUND
PMID: 27242329 (View on PubMed)

Fischer C, Preuss EM, Tanner M, Bruckner T, Krix M, Amarteifio E, Miska M, Moghaddam-Alvandi A, Schmidmaier G, Weber MA. Dynamic Contrast-Enhanced Sonography and Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Preoperative Diagnosis of Infected Nonunions. J Ultrasound Med. 2016 May;35(5):933-42. doi: 10.7863/ultra.15.06107. Epub 2016 Apr 1.

Reference Type BACKGROUND
PMID: 27036169 (View on PubMed)

Fischer C, Nissen M, Schmidmaier G, Bruckner T, Kauczor HU, Weber MA. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the prediction of non-union consolidation. Injury. 2017 Feb;48(2):357-363. doi: 10.1016/j.injury.2017.01.021. Epub 2017 Jan 9.

Reference Type BACKGROUND
PMID: 28088373 (View on PubMed)

Haubruck P, Kammerer A, Korff S, Apitz P, Xiao K, Buchler A, Biglari B, Zimmermann G, Daniel V, Schmidmaier G, Moghaddam A. The treatment of nonunions with application of BMP-7 increases the expression pattern for angiogenic and inflammable cytokines: a matched pair analysis. J Inflamm Res. 2016 Sep 22;9:155-165. doi: 10.2147/JIR.S110621. eCollection 2016.

Reference Type BACKGROUND
PMID: 27703392 (View on PubMed)

Moghaddam A, Breier L, Haubruck P, Bender D, Biglari B, Wentzensen A, Zimmermann G. Non-unions treated with bone morphogenic protein 7: introducing the quantitative measurement of human serum cytokine levels as promising tool in evaluation of adjunct non-union therapy. J Inflamm (Lond). 2016 Jan 22;13:3. doi: 10.1186/s12950-016-0111-x. eCollection 2016.

Reference Type BACKGROUND
PMID: 26807043 (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)

Provided Documents

Download supplemental materials such as informed consent forms, study protocols, or participant manuals.

Document Type: Study Protocol

View Document

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

S-472/2017

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Persona Ti-Nidium Post-Market Clinical Follow-up
NCT04817969 ACTIVE_NOT_RECRUITING NA