Long Term Follow-up of Integra® Cadence™ Total Ankle System in Primary Ankle Joint Replacement

June 17, 2026 updated by: Smith & Nephew, Inc.
This study will evaluate the long term performance and safety data for the Cadence™ Total Ankle System (CTAS) when used for primary arthroplasty in patients with primary arthritis (e.g. degenerative disease), secondary arthritis (e.g. post-traumatic, avascular necrosis, if minimally 2/3 of the talus is preserved), and systemic arthritis of the ankle (e.g. rheumatoid arthritis, hemochromatosis)

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Terminated

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
65

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Belgium
      • Ghent, Belgium, 9000
        • Universitair Ziekenhuis Gent
      • Woluwe-St-Lambert, Belgium, B-1200
        • Foot and Ankle Institute
  • Canada
      • Toronto, Canada, M5C 1R6
        • St. Michael's Hospital
  • France
      • Tours, France, 37044
        • CHRU Tours
  • Spain
      • Barcelona, Spain, 08024
        • Clinica Nostra Senhora del Remei
  • United Kingdom
      • Carlisle, United Kingdom, CA2 7HY
        • North Cumbria University Hospitals

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Patient with ankle arthritis requiring total ankle replacement

Description

Inclusion Criteria:

Subjects will be included if he/she:

  1. Is > 18 years of age.
  2. Is skeletally mature.
  3. Qualifies for primary TAR per the surgeon and has a diagnosis of one of the following: primary arthritis (e.g. degenerative disease), secondary arthritis (e.g. post-traumatic, avascular necrosis, if minimally 2/3 of the talus is preserved), or systemic arthritis of the ankle (e.g. rheumatoid arthritis, hemochromatosis).
  4. Is suitable for TAR with CTAS per the study surgeon based on the product indication and having considered deformity, stability, bone quality, soft- tissue envelope, and neurovascular status.
  5. Is willing and able to cooperate in the required post-operative therapy.
  6. Is willing and able to complete scheduled follow-up visits, evaluations, and questionnaires as described in the Informed Consent or Information Letter and Data Transfer Authorization Form, as applicable.
  7. Reads, understands and signs the Ethical Committee approved Informed Consent or Information Letter and Data Transfer Authorization Form, as applicable

Exclusion Criteria:

Subjects will be excluded from the study if he/she:

  1. Is Morbidly Obese (defined by BMI > 40 or BMI of 35 - 40 with significant medical problems caused by or made worse by their weight).
  2. Is an active nicotine user (smoking, chewing, smokeless tobacco, patch) and unwilling to cease nicotine use within 1 month prior to surgery, and 2 months post-surgery.
  3. Has one of the following conditions, which could compromise the affected limb: ankle arthrodesis with malleolar exeresis, severe neurological (Charcot's Arthropathy) or vascular disease, loss of musculature or neuromuscular compromise.
  4. Has an active local/systemic infection that may affect the prosthetic joint or has a recent history of infection.
  5. Continues on long-term medication, which may compromise bone stock (e.g. undergoing immunosuppressive therapy, long-term steroids) and is unable to cease medication usage from 3 weeks prior to surgery to 3 weeks post-surgery.
  6. Has a condition that may impair proper wound healing (e.g., poor soft tissue envelope).
  7. Had previous ankle surgery and/or injury that has adversely affected the anklebone stock.
  8. Has had or is scheduled to have contralateral TAR surgery.
  9. Is pregnant or plans to become pregnant during the follow up period.
  10. Has a metabolic disorder or disease that may compromise bone quality (e.g. arthrogryposis etc.), physiological or anatomical anomalies, and/or malignancy/local bone tumors.
  11. Has severe avascular necrosis of the talus/tibia.
  12. Has inadequate neuromuscular status (e.g., prior paralysis, severe neuropathy).
  13. Has a known sensitivity or allergic reaction to one or more of the implanted materials.
  14. Is a poor candidate for general anesthesia.
  15. Is a prisoner, mentally incompetent or unable to understand what participation in this study entails, a known alcohol or drug abuser, or anticipated to be non- compliant.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort

Group / Cohort

A group or subgroup of participants in an observational study that is assessed for biomedical or health outcomes.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Integra Cadence Total Ankle System
Device: Implantation of Integra Cadence Total Ankle System
Primary Ankle Arthroplasty

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Implant Survivorship at 2 Years
Time Frame: 2 years
Implant survivorship determined by the percentage of participants with survival of the device. Successful device survival was defined as absence of device removal or revision.
2 years

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Implant Survivorship at 5 Years and 10 Years
Time Frame: 5 years and 10 years
Implant survivorship at 5 years and 10 years was determined by the percentage of participants with device survival. Survivorship was measured using a Kaplan-Meier survival estimate with survival defined as absence of device removal or revision.
5 years and 10 years
Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) - Mobility
Time Frame: Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
The PROMIS - Physical Function and Mobility score consisted of 15 components on a 5-point Likert scale. Responses were combined to produce a score that ranged from 0 to 100 where higher values represented higher mobility (i.e., a higher score was a better outcome).
Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) Subscale
Time Frame: Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
The Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) Subscale scored 21 components on a 5-point Likert scale. Score totals ranged from 0 to 84 and were transformed to percentage scores with 100 representing no dysfunction (i.e., a higher score was a better outcome).
Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
Visual Analogue Scale (VAS) Pain Score: Resting
Time Frame: Baseline, 6 weeks, 3 months, 6 months, 1 year, 2 years, 5 years
A Visual Analogue Scale (VAS) assessment was used to rate ankle pain while resting. The participant would indicate the level of pain by placing a vertical mark on a 100mm scale. Scores ranged from 0 to 100 with higher scores indicating a higher level of pain (i.e., a higher score was a worse outcome).
Baseline, 6 weeks, 3 months, 6 months, 1 year, 2 years, 5 years
Visual Analogue Scale (VAS) Pain Score: Activity
Time Frame: Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
A Visual Analogue Scale (VAS) assessment was used to rate ankle pain while during activity. The participant would indicate the level of pain by placing a vertical mark on a 100mm scale. Scores ranged from 0 to 100 with higher scores indicating a higher level of pain (i.e., a higher score was a worse outcome).
Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
Short Form-36 Version 2 Health Survey (SF-36v2): Physical Functioning
Time Frame: Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
The SF-36v2 Health Survey is composed of 36 questions across 8 domains. The Physical Functioning domain focused on limitations in daily activities like running, climbing stairs, bending, or walking. Scores ranged from 0 to 100 with lower scores indicating greater physical disability (i.e., a higher score was a better outcome).
Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
Short Form-36 Version 2 Health Survey (SF-36v2): Role Limitations Due to Physical Health
Time Frame: Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
The SF-36v2 Health Survey is composed of 36 questions across 8 domains. The Role Limitations Due to Physical Health domain focused on limitations in work or other regular daily activities as a result of their physical health. Scores ranged from 0 to 100 with lower scores indicating greater limitation (i.e., a higher score was a better outcome).
Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
Short Form-36 Version 2 Health Survey (SF-36v2): Role Limitations Due to Emotional Problems
Time Frame: Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
The SF-36v2 Health Survey is composed of 36 questions across 8 domains. The Role Limitations Due to Emotional Problems domain focused on limitations in work or other regular daily activities as a result of any emotional problems such as feeling depressed or anxious. Scores ranged from 0 to 100 with lower scores indicating greater limitation (i.e., a higher score was a better outcome).
Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
Short Form-36 Version 2 Health Survey (SF-36v2): Energy/Fatigue
Time Frame: Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
The SF-36v2 Health Survey is composed of 36 questions across 8 domains. The Energy/Fatigue domain focused on feelings of energy, tiredness, and being worn out over the past four weeks. Scores ranged from 0 to 100 with lower scores indicating less energy and more fatigue (i.e., a higher score was a better outcome).
Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
Short Form-36 Version 2 Health Survey (SF-36v2): Emotional Well-being
Time Frame: Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
The SF-36v2 Health Survey is composed of 36 questions across 8 domains. The Emotional Well-being domain focused on feelings of their mental health over the past four weeks. Scores ranged from 0 to 100 with lower scores indicating poor emotional well-being (i.e., a higher score was a better outcome).
Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
Short Form-36 Version 2 Health Survey (SF-36v2): Social Functioning
Time Frame: Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
The SF-36v2 Health Survey is composed of 36 questions across 8 domains. The Social Functioning domain focused on how physical health or emotional problems interfered with their social activities (like visiting with friends, relatives, etc.). Scores ranged from 0 to 100 with lower scores indicating greater disfunction (i.e., a higher score was a better outcome).
Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
Short Form-36 Version 2 Health Survey (SF-36v2): Pain
Time Frame: Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
The SF-36v2 Health Survey is composed of 36 questions across 8 domains. The Pain domain focused on how much pain affected daily activities over the last four weeks. Scores ranged from 0 to 100 with lower scores indicating more pain (i.e., a higher score was a better outcome).
Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
Short Form-36 Version 2 Health Survey (SF-36v2): General Health
Time Frame: Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
The SF-36v2 Health Survey is composed of 36 questions across 8 domains. The General Health domain focused on perception of overall health and health change over time. Scores ranged from 0 to 100 with lower scores indicating worse health (i.e., a higher score was a better outcome).
Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
Short Form-36 Version 2 Health Survey (SF-36v2): Physical Component Score
Time Frame: Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
The SF-36v2 Health Survey is composed of 36 questions across 8 domains. The Physical Component score combined scores from the Physical Functioning, Role Limitations Due to Physical Health, Pain, and General Health domains. Scores ranged from 0 to 100 with lower scores indicating worse physical health (i.e., a higher score was a better outcome).
Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
Short Form-36 Version 2 Health Survey (SF-36v2): Mental Component Score
Time Frame: Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
The SF-36v2 Health Survey is composed of 36 questions across 8 domains. The Physical Component score combined scores from the Role Limitations Due to Emotional Problems, Energy/Fatigue, Emotional Well-being, and Social Functioning domains. Scores ranged from 0 to 100 with lower scores indicating worse mental health (i.e., a higher score was a better outcome).
Baseline, 3 months, 6 months, 1 year, 2 years, 5 years
Radiographic Success
Time Frame: 6 weeks, 3 months, 6 months, 1 year, 2 years, 5 years

The number of participants with radiographic success were categorized as either 'Fail' or 'Success'. Success was defined as absence of implant radiolucency, subsidence, tilting, and/or migration with failure specifically defined as occurring if:

  1. ≥3 of the 20 radiolucency zones had >4mm in width, OR
  2. device tilting = present, OR
  3. device subsidence (tibial OR talar) = >4mm, OR
  4. device migration (tibial OR talar) = >4mm
6 weeks, 3 months, 6 months, 1 year, 2 years, 5 years
Radiographic Assessment: Ankle Dorsiflexion and Plantarflexion Range of Motion
Time Frame: Baseline, 1 year, 2 years
Range of motion measurements for ankle dorsiflexion and ankle plantarflexion in degrees were derived from radiographs in positions of maximum plantarflexion and dorsiflexion.
Baseline, 1 year, 2 years
Radiographic Assessment: Tibiotalar Range of Motion
Time Frame: Baseline, 1 year, 2 years
Range of motion measurements were derived from radiographs in positions of maximum plantarflexion and dorsiflexion. Tibiotalar range of motion in degrees was calculated as the difference between the ankle dorsiflexion and ankle plantarflexion angles.
Baseline, 1 year, 2 years

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Smith & Nephew, Inc.

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
Smith & Nephew Orthopaedics AG

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 18, 2017

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
September 6, 2023

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
September 6, 2023

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
August 8, 2017

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
August 8, 2017

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
August 11, 2017

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 22, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 17, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
December 1, 2024

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • T-CTAS-002

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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Sponsors and Collaborators

Medical Conditions

Drug Interventions

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

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