Allograft vs. Autograft Nonunion

NCT ID: NCT07310082

Last Updated: 2025-12-30

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

156 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-03-31

Study Completion Date

2030-12-31

Brief Summary

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The purpose of this research study is to find out if patients treated for nonunion fracture with autograft or allograft return to activity faster.

Detailed Description

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The goal of this multi-center prospective randomized controlled trial is to compare short and long-term outcomes of adult patients with long-bone nonunion treated with autograft versus allograft. The main question it aims to answer is: will patients who receive an allograft return to work faster than patients who receive an autograft to treat nonunion fracture.

Participants will be randomized to one of two treatment groups and will complete follow-up surveys during their recovery.

Conditions

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Nonunion Fracture

Keywords

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Allograft Autograft Nonunion

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Autograft

Patients randomized to autograft

Group Type ACTIVE_COMPARATOR

Autograft

Intervention Type PROCEDURE

Surgeons will decide on the location and method of donor site based on the clinical situation. Most commonly, bone graft will be harvested from the anterior or posterior iliac crest or utilizing the Reamer Irrigator Aspirator in an appropriate long bone. Surgeons may choose to harvest autograft from proximal tibia or distal femur. Donor site location is at the discretion of treating surgeon for patients who randomize to autograft. This treatment arm will not include local autograft only. For large bone defects requiring expansion of autograft with allograft, this will be allowed and recorded. We will use intent-to-treat for statistical analysis of those with allograft expansion of autograft. This autograft will be applied to the nonunion site using the surgeon's typical technique. Internal fixation, revision of fixation, and/or augmentation of fixation will be performed at the discretion of the surgeon.

Allograft

Patients randomized to allograft.

Group Type ACTIVE_COMPARATOR

Allograft

Intervention Type PROCEDURE

Allograft bone will consist of cancellous or corticocancellous sterile packaged human cadaveric bone. No bone morphogenetic protein, bone marrow aspirate, or other biologic augment will be added. Demineralized bone matrix may be added at the surgeon's discretion. This allograft will be applied to the nonunion site using the surgeon's typical technique. Internal fixation, revision of fixation, and/or augmentation of fixation will be performed at the discretion of the surgeon.

Interventions

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Autograft

Surgeons will decide on the location and method of donor site based on the clinical situation. Most commonly, bone graft will be harvested from the anterior or posterior iliac crest or utilizing the Reamer Irrigator Aspirator in an appropriate long bone. Surgeons may choose to harvest autograft from proximal tibia or distal femur. Donor site location is at the discretion of treating surgeon for patients who randomize to autograft. This treatment arm will not include local autograft only. For large bone defects requiring expansion of autograft with allograft, this will be allowed and recorded. We will use intent-to-treat for statistical analysis of those with allograft expansion of autograft. This autograft will be applied to the nonunion site using the surgeon's typical technique. Internal fixation, revision of fixation, and/or augmentation of fixation will be performed at the discretion of the surgeon.

Intervention Type PROCEDURE

Allograft

Allograft bone will consist of cancellous or corticocancellous sterile packaged human cadaveric bone. No bone morphogenetic protein, bone marrow aspirate, or other biologic augment will be added. Demineralized bone matrix may be added at the surgeon's discretion. This allograft will be applied to the nonunion site using the surgeon's typical technique. Internal fixation, revision of fixation, and/or augmentation of fixation will be performed at the discretion of the surgeon.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients 18 years or older
* Long bone (tibia, femur, and humerus) nonunion appropriate for either study treatment: to be treated with bone graft harvested from a remote site or using reamer harvester (RIA)
* Nonunion surgery to be performed at least five months after initial fracture fixation
* Prior operative fixation of fracture
* Radiographic apparent bone gap (RABG) of \>5cm

Exclusion Criteria

* Patient that speaks neither English nor Spanish
* Patients whose treatment plan includes local autograft only (available callus from the nonunion site or no planned bone graft)
* Known active infection (defined as any clinical signs or symptoms of active infection, such as fevers, wound redness, warmth, swelling, induration or drainage, and abnormal while blood cell count, erythrocyte sedimentation rate, or C-reactive protein) being treated with antibiotics
* Body mass index greater than 50
* Patients unlikely to follow-up due to homelessness, or planning follow-up at another institution
* Prisoner
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wake Forest University Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Joseph R Hsu, MD

Role: PRINCIPAL_INVESTIGATOR

Wake Forest University Health Sciences

Locations

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Atrium Health Carolinas Medical Center

Charlotte, North Carolina, United States

Site Status

Countries

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United States

Central Contacts

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Christine Churchill

Role: CONTACT

Phone: 704-355-6947

Email: [email protected]

Facility Contacts

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Rachel B Seymour, PhD

Role: primary

Christine Churchill, MA

Role: backup

Other Identifiers

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HT9425-25-1-0424

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

IRB00140521

Identifier Type: -

Identifier Source: org_study_id