- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03129971
Platelet-rich Plasma Combined With Conventional Surgery in the Treatment of Atrophic Nonunion of Femoral Shaft Fractures
Platelet-rich Plasma Combined With Conventional Surgery in the Treatment of Atrophic Nonunion of Femoral Shaft Fractures: a Prospective, Randomized, Controlled Clinical Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
History and current related studies:
Fracture healing is a continuous process, and if any phase is disturbed by unfavorable factors, the healing process will be blocked. Clinical studies have found that non-healing rate of long bone fracture was approximately 5%. A certain site and type of fracture, if not healed within a mean time (usually 3-6 months), is called delayed union by US Food and Drug Administration. Simultaneously, the fracture that has not healed after 9 months and has no tendency for further healing in the next 3 months is called nonunion. According to fracture end activity, nonunion is classified into hypertrophic nonunion and atrophic nonunion.7, 8 Hypertrophic nonunion is mostly caused by unstable fixation of fracture ends, and can be cured by strengthening the stability of fracture site using conventional surgery. Atrophic nonunion is difficult to be cured, because of the lack of adequate blood supply and bone formation at the fracture ends, so it is unable to form the periosteal callus. At present, atrophic nonunion is commonly treated by internal and external fixation combined with autologous bone graft, but this method has a long treatment cycle, and there is a situation that cannot be cured.
Platelet-rich plasma (PRP) is blood plasma that has been enriched with platelets by centrifuging autologous blood. Platelet after activation can secrete platelet derived growth factor, transforming growth factor beta, vascular endothelial growth factor and epidermal growth factor. These growth factors can promote cell proliferation and differentiation, matrix synthesis and vascular regeneration, and accelerate tissue healing and bone repair. PRP contains a large number of leukocytes, which can locally phagocytize bacteria, scavenge necrotic tissue, inhibit inflammatory reaction, and resist infection. PRP fibrin can locally build the three-dimensional structure required for tissue repair. Since Assoian et al. first isolated PRP and used PRP in the clinic in 1984, PRP has received increasing attention in areas such as oral and maxillofacial surgery, orthopedics, plastic surgery, and neurosurgery.
Data management:
Clinical researchers filled in the clinical trial observation form to ensure the data were accurate, complete and timely collected. After the trial, all data were input into the computer. After data collection, the main clinical investigators and inspectors monitored and checked the integrity and accuracy of the data. The data were locked by the main investigators. Data processing statisticians further verified and checked the completeness and accuracy of the data after data entry. Anonymized trial data will be published at www.figshare.com.
Statistical analysis:
- Measurement data were expressed as the mean ± SD and analyzed using SPSS 17.0 software (SPSS, Chicago, IL, USA). Count data were expressed as a percentage.
- A normality test and variance homogeneity test were conducted. Normally distributed data with homogeneity were compared using one-way analysis of variance. Non-normally distributed data were compared using Wilcoxon's two-sample rank sum test.
- The incidence of adverse reactions between groups was compared using chi-square test. A P value of < 0.05 was considered statistically significant. Results followed the intention-to-treat principle.
Confidentiality:
Clinical trial observation forms and informed consents were password-protected. No person, other than an authorized researcher, might be in contact with it.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Femoral shaft fractures
- Fracture time is more than 9 months
- X-ray reveals gap and sclerosis at the fracture ends, medullary closure, osteoporosis, with the absence of trabecular bone formation among callus, and for more than 3 months
- Magnetic resonance imaging reveals widened gap and atrophic fracture ends, a small amount or even no callus formation
- Histological examination reveals that the gap at the fracture ends is filled with fibrous tissue without osteogenic activity
- Age of 18-70 years
Exclusion Criteria:
- The underlying disease that affects wound healing, such as diabetes, hematological system diseases, immune diseases, connective tissue diseases
- Pregnancy or lactation
- Heart, lung, liver, and kidney dysfunction
- Participate in other clinical trials
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: control group
Patients with atrophic nonunion of femoral shaft fractures are equally and randomly assigned to control group, which received conventional surgery.
|
Patients with atrophic nonunion of femoral shaft fractures are equally and randomly assigned to control group, which received conventional surgery.
Other Names:
|
Experimental: experimental group
Patients with atrophic nonunion of femoral shaft fractures are equally and randomly assigned to experimental group, which are injected with autologous platelet-rich plasma on the basis of conventional surgery.
|
Patients with atrophic nonunion of femoral shaft fractures are equally and randomly assigned to experimental group, which are injected with autologous platelet-rich plasma on the basis of conventional surgery.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Fracture healing rate
Time Frame: month 9 after surgery
|
To assess the condition of fracture healing.
The disunion was identified if the fracture was not healed at postoperative 9 months.
Fracture healing includes clinical healing and bone healing.
|
month 9 after surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Visual analogue scale scores
Time Frame: changes of baseline and month 3, month 6, month 9, month 12 after surgery
|
Visual analogue scale is a method to assess pain intensity.
Using a ruler with 10 scales, the ends are 0 and 10, respectively.
0 represents no pain; 10 represents the most unbearable severe pain.
|
changes of baseline and month 3, month 6, month 9, month 12 after surgery
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Zichun Zhao, bachelor, Affiliated Hospital of Qinghai University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- QinghaiUH_008
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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.
Clinical Trials on Nonunion of Fracture
-
Zimmer BiometTerminatedNonunion of Fracture of Fifth MetatarsalUnited States
-
Cedars-Sinai Medical CenterStryker NordicCompletedTibial Fractures | Nonunion of Fracture | Femur Fracture | Tibia Fracture | Nonunion of Fracture of Tibia | Nonunion of Fracture of Femur (Diagnosis)United States
-
Saglik Bilimleri UniversitesiCompletedNonunion of Fracture of Tibia | Tibia Distal FractureTurkey
-
Banc de Sang i TeixitsHospital ASEPEYO Sant CugatCompletedAtrophic Nonunion of FractureSpain
-
Second Affiliated Hospital, School of Medicine,...CompletedNonunion of Fracture of Tibia (Diagnosis)China
-
Istituto Ortopedico RizzoliCompletedNonunion of Fracture [Pseudarthrosis], Site UnspecifiedItaly
-
Aesculap AGTerminatedSternum Wound Infection | Nonunion of Fracture of SternumGermany, Switzerland
-
University of CalgaryBioventus LLC; Workers' Compensation Board, Alberta; Calgary Orthopaedic Research...Active, not recruitingFractures, Ununited | Nonunion of Fracture of Scaphoid BoneCanada
-
University of LouisvilleRecruitingTibial Fractures | Nonunion of Fracture | Delayed Union of FractureUnited States
Clinical Trials on conventional surgery
-
Shanghai Changzheng HospitalNaval Specialty Medical Center, China; The NO.72 Army Hospital of Huzhou, China and other collaboratorsNot yet recruitingDegenerative Cervical Kyphosis With StenosisChina
-
University of BelgradeCompleted
-
National Medical Research Council (NMRC), SingaporeUnknownColorectal CancerChina, Singapore
-
Instituto do Cancer do Estado de São PauloUnknownHead and Neck Cancer | Gastric Cancer | Pancreatic Cancer | Esophageal Cancer | Lung Cancer | Rectal Cancer | Prostate Cancer | Bladder Cancer | Renal Cancer | Uterus CancerBrazil
-
Alliance for Clinical Trials in OncologyNational Cancer Institute (NCI)Completed
-
Gynecologic Oncology GroupNational Cancer Institute (NCI)CompletedCervical Adenocarcinoma | Cervical Adenosquamous Carcinoma | Cervical Squamous Cell Carcinoma | Recurrent Cervical Carcinoma | Cervical Small Cell CarcinomaUnited States, Spain
-
European Organisation for Research and Treatment...Eastern Cooperative Oncology Group; NCIC Clinical Trials Group; Southwest Oncology... and other collaboratorsCompleted
-
Jonsson Comprehensive Cancer CenterNational Cancer Institute (NCI)Completed
-
European Organisation for Research and Treatment...CompletedProstate CancerBelgium, Italy, Slovakia
-
Southwest Oncology GroupNational Cancer Institute (NCI); American College of SurgeonsCompletedSarcomaUnited States