Local Antibiotic Delivery From an Intramedullary Nail After Surgical Treatment of Tibial Fractures at High Risk of Infection (RESELUTE)
Local Antibiotic Delivery From an Intramedullary Nail After Surgical Treatment of Tibial Fractures at High Risk of Infection: A Multicenter, Prospective, Open-Label Clinical Trial (RESELUTE Study)
The goal of this clinical trial is to learn whether an antibiotic-releasing nail placed inside the shinbone (tibia) helps prevent infection and supports bone healing in adults with an open shinbone fracture. The study will test two versions of the Reselution Tibial Intramedullary Fixation System: one that releases vancomycin (Reselution V) and one that releases vancomycin and tobramycin (Reselution VT).
The main question it aims to answer is: within 12 months of surgery, how many participants heal without unplanned repeat surgery on the injured leg, have a healed bone on X-ray, and have no serious device-related side effects?
Participants will:
- Have surgery to fix their shinbone with the Reselution nail
- Have blood tests in the first 2 weeks after surgery (this testing may be stopped for later participants after an independent safety review)
- Attend follow-up visits for up to 24 months, including X-rays and questionnaires
Studieöversikt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Studietyp
Studietyp
Inskrivning (Beräknad)
Inskrivning
Fas
Fas
- Inte tillämpbar
Kontakter och platser
Studiekontakt
Studiekontakt
- Namn: SiNing Zhao, DrPh
- Telefonnummer: 443-842-9704
- E-post: szhao39@jh.edu
Studieorter
-
-
Maryland
-
Baltimore, Maryland, Förenta staterna, 21201
- University of Maryland, Baltimore
-
Huvudutredare:
- Robert O'Toole, MD
-
Kontakt:
- Heather Phipps
- Telefonnummer: 410-706-2492
- E-post: HPhipps@som.umaryland.edu
-
-
Deltagandekriterier
Urvalskriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- Age 22 to 80 years
- Open tibial shaft fracture, Gustilo-Anderson Type I, II, or IIIA, treated with intramedullary nail fixation (prior temporary fixation allowed)
- Adequate soft tissue coverage by primary closure or skin graft, without need for local or free flap
- Intramedullary nail placed within 14 days of injury
- Willing and able to comply with study procedures and follow-up
- Provides written informed consent
Exclusion Criteria:
- Gustilo-Anderson Type IIIB or IIIC fracture
- Fracture requiring more than one operative washout
- Bone defect of 1 cm or more
- Extensive contamination or muscle damage precluding fixation at initial debridement
- Fasciotomy wounds requiring skin grafting
- Infection at the fracture site at enrollment
- Fracture not amenable to intramedullary nailing with at least two proximal and two distal interlocking screws
- Displaced intra-articular tibial plateau or pilon fracture on the same limb
- Definitive fracture fixation before enrollment
- Planned staged bone grafting, cement spacer, or use of osteobiologics
- Chronic kidney disease with eGFR below 60 mL/min/1.73 m² or acute kidney injury requiring dialysis
- Calcium metabolism disorder
- Allergy or sensitivity to vancomycin, tobramycin, titanium, vanadium, aluminum, or calcium sulfate
- Pregnancy
- Endocrine or metabolic disorder affecting bone healing (osteoporosis allowed)
- Current use of systemic immunosuppressive, immunomodulatory (including systemic steroids), or chemotherapy agents
- Likely barriers to follow-up, such as severe psychiatric condition, cognitive impairment without family support, residence outside the catchment area, planned care elsewhere, incarceration, or homelessness
- Inadequate site resources to address low English literacy
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Icke-randomiserad
- Interventionsmodell: Sekventiell tilldelning
- Maskning: Ingen (Open Label)
Antal vapen
Vapen och interventioner
Deltagargrupp / ArmDeltagargrupp / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Experimentell: Reselution V
Definitive fixation of the open tibial fracture with the Reselution V Tibial Intramedullary Fixation System (vancomycin). |
Device-led combination product: titanium tibial intramedullary nail with an internal core loaded with vancomycin for local sustained antibiotic delivery. |
|
Experimentell: Reselution VT
Definitive fixation of the open tibial fracture with the Reselution VT Tibial Intramedullary Fixation System (vancomycin and tobramycin). |
Device-led combination product: titanium tibial intramedullary nail with an internal core loaded with vancomycin and tobramycin for local sustained antibiotic delivery. |
Vad mäter studien?
Primära resultatmått
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Percentage of Participants With Composite Success at 12 Months
Tidsram: 12 months after surgery
|
Composite success requires all of the following through 12 months: (1) no unplanned repeat surgery on the study injury for deep surgical site infection, to promote fracture union, for nail construct removal due to implant failure or migration, or amputation; (2) radiographic fracture union, defined as a modified Radiographic Union Score for Tibial fractures (mRUST) of 10 or greater; and (3) no device-related serious adverse events or device-related serious suspected adverse reactions. |
12 months after surgery
|
Sekundära resultatmått
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Percentage of Participants Without Unplanned Repeat Surgery
Tidsram: 12 and 24 months after surgery
|
Unplanned repeat surgery on the study injury to address infection, wound healing, or fracture union, excluding implant removal for prominence or irritation. |
12 and 24 months after surgery
|
|
Percentage of Participants With Radiographic Fracture Union
Tidsram: 12 months after surgery
|
Union defined as a modified Radiographic Union Score for Tibial fractures (mRUST) of 10 or greater. |
12 months after surgery
|
|
Percentage of Participants Without Device-Related Serious Adverse Events
Tidsram: Through 12 and 24 months after surgery
|
Includes device-related serious adverse events and device-related serious suspected adverse reactions. |
Through 12 and 24 months after surgery
|
|
Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Score
Tidsram: 12 and 24 months after surgery
|
Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (lower extremity) T-score. Higher scores indicate better function. |
12 and 24 months after surgery
|
|
Brief Pain Inventory Score
Tidsram: 12 and 24 months after surgery
|
Brief Pain Inventory scores range from 0 to 10. Higher scores indicate worse pain. |
12 and 24 months after surgery
|
|
Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities Score
Tidsram: 12 and 24 months after surgery
|
Patient-Reported Outcomes Measurement Information System (PROMIS) Ability to Participate in Social Roles and Activities T-score. Higher scores indicate better ability to participate. |
12 and 24 months after surgery
|
Samarbetspartners och utredare
Sponsor
Sponsor
Samarbetspartners
Samarbetspartners
Utredare
Utredare
- Huvudutredare: Robert O'Toole, MD, University of Maryland, Baltimore
Studieavstämningsdatum
Studera stora datum
Studiestart (Beräknad)
Studiestart
Primärt slutförande (Beräknad)
Primärt slutförande
Avslutad studie (Beräknad)
Avslutad studie
Studieregistreringsdatum
Först inskickad
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Första postat
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste uppdatering publicerad
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
Andra studie-ID-nummer
- RES-CT-001
- G260056 (Annan identifierare: U.S. Food and Drug Administration (FDA) - Investigational Device Exemption (IDE))
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
Läkemedels- och apparatinformation, studiedokument
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