Safety and Effectiveness of Cartiva Implant in the Treatment of First CMC Joint Osteoarthritis Compared to LRTI (GRIP 2) (GRIP 2)

December 1, 2020 updated by: Cartiva, Inc.

A Prospective Study to Evaluate the Safety and Effectiveness of the Cartiva® Synthetic Cartilage Implant for CMC in the Treatment of First Carpometacarpal Joint Osteoarthritis as Compared to a Ligament Reconstruction Tendon Interposition (LRTI) Comparator

This study will evaluate whether Cartiva is an effective treatment for individuals with osteoarthritis of the first CMC joint in the hand compared to LRTI.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Detailed Description

This is a prospective, multicenter study with one treatment arm. Comparisons will be made to a performance target defined by subtracting a non-inferiority margin of 0.05 from an expected standard of care success rate of 0.55. The active treatment arm will receive a Cartiva® SCI for CMC.

A total of 74 subjects will be enrolled into the pivotal study.

Follow up visits will occur at the following time points after the surgical procedure: 2 week, 6 week, 3 month, 6 month, 1 year, 2 year, 3 year, 4 year and 5 year.

Study Type

Interventional

Enrollment (Actual)

74

Phase

  • Not Applicable

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

    • Derbyshire
      • Derby, Derbyshire, United Kingdom, DE22 3NE
        • Royal Derby Hospital
    • Dorset
      • Dorchester, Dorset, United Kingdom, DT2 8DH
        • Dorset County Hospital
    • Hampshire
      • Portsmouth, Hampshire, United Kingdom, PO6 3LY
        • Queen Alexandra Hospital
    • North Yorkshire
      • Middlesborough, North Yorkshire, United Kingdom, TS4 3BW
        • South Tees Hospitals
    • California
      • San Diego, California, United States, 92093
        • University of California, San Diego
    • Georgia
      • Atlanta, Georgia, United States, 30309
        • Georgia Hand, Shoulder & Elbow
    • Indiana
      • Indianapolis, Indiana, United States, 46202
        • Indiana Hand to Shoulder Center
    • New York
      • New York, New York, United States, 10021
        • Hospital for Specialty Surgery
      • Rochester, New York, United States, 14642
        • University of Rochester

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

Ages Eligible for Study

22 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • ≥ 22 years of age
  • Refractory to conservative non-operative standard of care treatment for first CMC OA lasting for at least 6 months that requires surgical intervention
  • Eaton classification stage II or III OA of the first CMC joint based on X-rays taken within 6 months of the Operative date and evidence of first CMC joint OA based on subjective review of associated clinical symptoms
  • Preoperative VAS Pain score of ≥ 40 in the treated hand
  • Preoperative 11 question QuickDASH score of ≥ 20
  • Presence of good bone stock - i.e., no need for bone graft
  • Capable of completing self-administered questionnaires
  • Be willing and able to return for all study-related follow up procedures
  • Have been informed of the nature of the study, agreeing to its requirements, and have signed the informed consent approved by the IRB/REB/Ethics Committee

Exclusion Criteria:

  • Active systemic infection
  • Active infection at the site of surgery
  • Previous CMC implant, trapeziectomy, or LRTI to the affected joint to be treated
  • Inflammatory arthropathy and/or diagnosis of grout
  • History of or current diagnosis of rheumatoid arthritis
  • Any significant bone loss, avascular necrosis, or cyst > 8mm of the supporting bone structure
  • Eaton classification stage IV advanced OA of the first CMC joint based on X-rays taken within 6 months of the Operative date
  • Physical conditions that would tend to eliminate adequate implant support (e.g., inadequate cortical bone stock of at least 2mm circumferentially insufficient quality or quantity of bone resulting from cancer, congenital dislocation, or osteoporosis), systemic and metabolic disorders leading to progressive deterioration of bone (e.g., cortisone therapies or immunosuppressive therapies), and/or tumors and/or cysts of the supporting bone structures
  • OA of the scaphotrapeziotrapezoidal (STT) joint based on radiographic assessment in the hand to be treated
  • Any disease, including uncontrolled diabetes mellitus, which is clinically known to impact wound healing ability
  • Known or suspected allergic reaction to polyvinyl alcohol
  • Patient is on chronic anticoagulation due to a bleeding disorder or has taken anticoagulants within 3 days prior to surgery
  • Diagnosed with cancer in the last two years and received treatment with chemotherapy or received radiation to the upper extremity to be treated with Cartiva
  • Any medical condition that makes the subject unsuitable for inclusion in the study, including, but not limited to, patients with a diagnosis of concomitant injury that may interfere with healing; patients with clinically significant renal, hepatic, cardiac, endocrine, hematologic, autoimmune or any systemic disease or systemic infection which may make interpretation of the results difficult; patients who have undergone systemic administration within 30 days prior to implantation of any type of corticosteroid in the thumb, antineoplastic, immunostimulating or immunosuppressive agents
  • Have participated in any other investigational or invasive clinical trial within the last three months, and will not participate in any other investigational or invasive clinical trial during this study
  • Co-morbidity that reduces life expectancy to less than 12 months
  • If female, be pregnant, planning to become pregnant during the course of the study, breast-feeding, or if childbearing age, is not using contraception
  • Current or recent history of substance abuse (e.g., recreational drugs, narcotics, or alcohol) requiring intervention
  • Is a prisoner or ward of the state
  • Is unable to meet the treatment and follow up protocol requirements
  • Is being compensated under workers' compensation or are currently involved in litigation that is related to the musculoskeletal system

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

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Cartiva
Synthetic Cartilage Implant
Synthetic Cartilage Implant

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain measured by the Visual Analog Scale (VAS) scale
Time Frame: 1 year
Success criteria: ≥ 30% VAS decrease at 12 months. Visual Analog Scale (VAS) Pain score will be obtained from the subject for pain in the treated hand by completing a CRF, which has a 100 mm horizontal line on it, with the left end indicating that the subject has no pain and the right end of the line indicating a lot of pain. The subject will be instructed to place a mark on the horizontal line to rate the average pain in the treated thumb joint over the past week. The designated site staff will use a metric ruler to measure the markings made by the subject on the VAS to determine the VAS score.
1 year
Function measured by QuickDASH
Time Frame: 1 year
Success criteria: ≥ 15.9 point decrease at 12 months. QuickDASH functional score will be obtained from the subject. The QuickDASH, the shortened version of the DASH (Disabilities of the Arm, Shoulder, and Hand) Outcomes Measures, is a region-specific, self-reported questionnaire that uses 11 items to measure physical function and symptoms in people with any or multiple musculoskeletal disorders of the upper limb. Subjects are asked to circle the appropriate response to each question based on their condition in the past week.
1 year
Radiographic Findings
Time Frame: 1 year
Success criteria: Freedom from radiographic failures post-surgery through 12 months. Radiographic failures are defined as device dislocation, device fragmentation and/or development of avascular necrosis.
1 year
Key Subsequent Secondary Surgical Interventions (SSSIs)
Time Frame: 1 year
Success criteria: Freedom from Subsequent Secondary Surgical Interventions (SSSIs) through 12 months. SSSIs are defined as revisions, removals, reoperations, and/or supplemental fixations.
1 year

Collaborators and Investigators

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

Sponsor

Investigators

  • Principal Investigator: Scott Wolfe, MD, Hospital for Special Surgery, New York
  • Principal Investigator: Christopher Bainbridge, MB ChB, FRCSEd, CCST, Royal Derby Hospital

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)

December 22, 2017

Primary Completion (Actual)

October 30, 2020

Study Completion (Anticipated)

March 1, 2024

Study Registration Dates

First Submitted

August 4, 2017

First Submitted That Met QC Criteria

August 9, 2017

First Posted (Actual)

August 11, 2017

Study Record Updates

Last Update Posted (Actual)

December 3, 2020

Last Update Submitted That Met QC Criteria

December 1, 2020

Last Verified

December 1, 2020

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

Yes

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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