- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04494672
A Study to Verify if the Surgery for the Proximal Femur Fracture Can be Improved With the Help of a Navigation System
Improving Intramedullary Nailing of Proximal Femoral Fractures Through a Navigation Assisted Technique: a Double Blinded Randomized Control Trial
Study Overview
Status
Conditions
Detailed Description
This study is a 2-arm randomized controlled trial comparing intramedullary nailing of proximal fracture of the femur (AO classified as 31 A1.3 , 31 A2.1, 31 A2.2 31 A2.3, 31 A3.1, 31 A3.2, 31 A3.3) performed with the ADAPT system (arm-A) and those performed without (arm-B).
The ADAPT system has been developed with the aim to reduce the rate of complications in intramedullary nailing and its usefulness has been previously explored only in two underpowered randomized controlled trials. Thanks to the possibility to track screw placement in real-time, allowing improved screw placement, the ADAPT system could be a valid tool, in order to minimize radiation exposure, surgical time, and rate of complications.
All the patients undergoing intramedullary nailing at the Ospedale Regionale di Lugano satisfying the eligibility criteria reported at section 7.1 will be enrolled in the study and randomly allocated (allocation ratio 1:1) to receive preoperatively:
- Intramedullary nailing with ADAPT system (arm-A)
- Intramedullary nailing without ADAPT system (arm-B) Patients and physicians evaluating the results will be blinded to the assigned group.
The total number of patients enrolled will be 96 (48 arm-A, 48 arm-B). After surgery, data about duration of the procedure, intraoperative blood loss, satisfaction of the surgeon and radiation exposure time will be collected.
Fracture healing, and rate of complications (cut-through and cut out) will be evaluated during all the follow-up visits, alongside VAS and a functional evaluation of the injured hip through the Oxford Hip score.
All treatment related adverse events will be reported up to follow-up visit 4, i.e. up to 12 ± 1 months.
Every patient will be involved in the trial for 1 year. The expected time to complete the trial is 4 years: 3 years for patient enrolment and 1 year to complete the last follow-up
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Christian Candrian, MD
- Phone Number: 0041918117029
- Email: RicercaOrtopedia.ORL@eoc.ch
Study Locations
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-
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Lugano, Switzerland, 6900
- Recruiting
- Christian Candrian
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Contact:
- Christian Candrian, Prof.Dr.med
- Phone Number: +41 (0) 91 811 61 23
- Email: christian.candrian@eoc.ch
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Contact:
- Gianluigi Capone, Dr.
- Email: gianluigi.capone@eoc.ch
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients undergoing unilateral primary intramedullary nailing at the Ospedale Regionale di Lugano.
- Patients aged 50-85 years old.
- Patients with a BMI >18 and <35.
- Patients able to provide informed consent and follow all the study procedures as indicated by the protocol.
- Radiological evidence of proximal fracture of the femur, AO classified as 31 A1.3, 31 A2.1, 31 A2.2, 31 A2.3, 31 A3.1, 31 A3.2, 31 A3.3.
Exclusion Criteria:
- Other clinically significant concomitant disease states (e.g. renal failure, major hepatic dysfunction, life-threatening cardiovascular disease, etc..).
- Known or suspected non-compliance, drug or alcohol abuse.
- Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant.
- Previous enrolment into the current study.
- Enrolment of the investigator, his/her family members, employees and other dependent persons.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intramedullary nailing with ADAPT system (arm-A)
A commercial product, namely ADAPT will be used as investigation product in arm-A
|
Stryker ADAPT®system (ADAPT, Stryker Leibinger GmbH & Co. KG, Freiburg, Germany) is a computer navigation system which can reconstruct a 3D model of the femoral head from the positional information oriented by bidirectional fluoroscopic views.
ADAPT shows the distance from the tip of the screw to the surface of the femoral head, tip-to-head-surface distance (TSD), and tip-apex distance (TAD) intraoperatively
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Active Comparator: Intramedullary nailing without ADAPT system (arm-B)
No aid in performing intramedullary nailing for proximal femoral fractures will be implemented in arm-B
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Intramedullary nailing without ADAPT system
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
TAD (tip to apex) index at the post-operative X-Ray control prior discharge
Time Frame: immediately after the surgery
|
The primary outcome of the study is the TAD (tip to apex) index at the post-operative X-Ray control prior discharge. The TAD is the tip-apex distance, which is the sum of the distance from the tip of the lag screw to the apex of the femoral head on an anteroposterior radiograph and this distance on a lateral radiograph, after controlling for magnification. The percentage of cut-outs has been correlated directly to both the severity of proximal femoral fractures and the TAD. |
immediately after the surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
time of the procedure
Time Frame: immediately after the surgery
|
time
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immediately after the surgery
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intraoperative blood loss
Time Frame: during the surgery
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intraoperative blood loss
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during the surgery
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intraoperative radiation time
Time Frame: during the surgery
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intraoperative radiation time
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during the surgery
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surgeon satisfaction on the satisfaction Numerical Rating Scale (NRS scale)
Time Frame: immediately after the surgery
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The satisfaction NRS is a self-assessment scale in which surgeons rate their satisfaction on an 11-point numerical scale from 0 (completely dissatisfied) to 10 (completely satisfied).
The satisfaction NRS will be administered after surgery
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immediately after the surgery
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non-union
Time Frame: at 6 weeks, 3 months, 6 months and 1-year
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fracture not alligned
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at 6 weeks, 3 months, 6 months and 1-year
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cut-through rate
Time Frame: at 6 weeks, 3 months, 6 months and 1-year
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cut-through rate
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at 6 weeks, 3 months, 6 months and 1-year
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cut-out rate
Time Frame: at 6 weeks, 3 months, 6 months and 1-year
|
cut-out rate
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at 6 weeks, 3 months, 6 months and 1-year
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VAS
Time Frame: at 6 weeks, 3 months, 6 months and 1-year
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Visual pain analogue scale, [from 0 (no pain) to 10 (worst pain)]
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at 6 weeks, 3 months, 6 months and 1-year
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Oxford Hip Score, [from 0 (severe hip arthritis) to 48 ( satisfactory joint function)]
Time Frame: at 6 weeks, 3 months, 6 months and 1-year
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Hip function
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at 6 weeks, 3 months, 6 months and 1-year
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
re-fracture rates
Time Frame: at 6 weeks, 3 months, 6 months and 1-year
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re-fracture rates
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at 6 weeks, 3 months, 6 months and 1-year
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Christian Candrian, MD, Ente Ospedaliero Cantonale, Bellinzona
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
- ORL-ORT-015
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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.
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