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TerminatedNCT03303690ASUpdated Jul 15, 2020

AS: Ankle Spacer for Talar Osteochondral Defects

An interventional study of Ankle Spacer (AS) in Osteochondral Defect of Talus, sponsored by Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA). Terminated at 1 site in Netherlands. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2020-07-15.

Sponsored by Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA) · Not applicable, Interventional, and Treatment

Why this study was terminated
Arthrex stopped manufacturing the device
Phase
Not applicable
Study type
Interventional
Enrollment
2
Allocation
Not applicable
Ages
18 Years to 80 Years
Sex
All
01

Study summary

By means of the Ankle Spacer patients will be implanted, the clinical and radiological results of which will be prospectively recorded and analyzed at different points in time.

Read the detailed description

Ankle sprains can result in talar osteochondral defects (OCDs) which have a significant impact on the quality of life of patients. When these OCDs are of large nature (anterior-posterior or medial-lateral diameter >1.5cm in diameter), cystic, have failed prior surgical treatment, or when there are multiple present on the talar articular surface, surgical care by means of fixation or bone marrow stimulation is contra-indicated. An ankle arthrodesis or fusion can be considered, but this results in functional limitation due to a decreased range of motion (ROM). In order to serve for a bone sparing prosthesis procedure, preserve range of motion, optimize physical functioning and to resurface the talus, the Ankle Spacer has been developed. It is a one-piece implant system that replaces the articulating upper talus surface of the tibio-talar joint, and offers several implant sizes in order to fit to the different talus sizes. It is anatomically designed to the native upper talus surface to provide an optimal fit to the distal articular surface. It has a rough titanium plasma spray (TPS) coated under surface with two posts and spikes for implant fixation. The rough surface enables secondary fixation by means of bone ingrowth and the spikes at the posterior part of the prosthesis allowing for optimal adherence of the implant and for minimal iatrogenic damage upon fixation. By these means, the anatomical situation and the natural congruency of the ankle joint are mirrored to a optimal extent. Despite the fact that no clinical trials have been published on this specific implant, it is hypothesized that the 5-year postoperative clinical outcomes concerning pain and prosthesis survival will be considered good.

02

Conditions studied

  • Osteochondral Defect of Talus

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03

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • age ranging from 18 to 80 years
  • talar osteochondral defect (multiple degenerative talar cysts present, and/or prior failed surgical treatment and/or multiple defects and/or large (>15mm))
  • willing to receive surgical implantation of the Ankle Spacer
  • has been informed of the nature of the study and provided written consent
  • The subject and treating physician agree that the subject will return for all required post-procedure follow-up visits
  • failed previous conservative treatment
  • complaints for at least 6 months

Exclusion criteria

Exclusion Criteria:

  • -severe ankle malalignement.(> 5° varus/valgus).
  • fracture \< 6 months - tendinitis - diabetes mellitus / rheumathoid arthritis
  • advanced osteoporosis
  • grade two or higher (Kellgren-Lawrence-Score) ankle joint degeneration on the tibia side.
  • any ankle deformation that does not allow proper rasping of the cartilage and/or proper seating of the desired sized implant, as described in the surgical technique.
  • blood supply limitations and previous infections, which may retard healing.
  • foreign-body sensitivity. Where material sensitivity is suspected, appropriate tests should be made and sensitivity ruled out prior to implantation.
  • active infection or blood supply limitations.
  • conditions that tend to limit the patient's ability or willingness to restrict activities or follow directions during the healing period, including severe neuro-arthropathy.
  • pathological conditions, such as insufficient quantity or quality of bone (e.g., cystic changes or severe osteopenia), which may compromise implant fixation.
  • currently participating in an investigational drug or another device study that clinically interferes with the current study endpoints.
  • Inability to be brought back to the surgery site for long term follow-up evaluations or the subject is unwilling to fill out the appropriate evaluation forms
  • adiposity grade I (BMI > 30 kg/m2)
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
2 participants (actual)

Study arms

  • Experimental
    Ankle Spacer (AS)

    This arm will surgically receive the to be implanted ankle spacer in their ankle.

    Procedure: Ankle Spacer (AS)

Interventions

  • ProcedureAnkle Spacer (AS)

    All included patients will be treated by means of surgical implantation of the Ankle Spacer prosthesis in an open manner replacing the talar side of the tibiotalar joint.

05

What researchers measure

Primary outcomes

  1. NRS during walking/weightbearing

    The primary study parameter is the measurement of the NRS

    Time frame: 2 years postoperatively

Secondary outcomes

  1. NRS at rest and during stairclimbing

    Other outcome measures will include pain evaluation using the NRS pain at rest and during stair climbing

    Time frame: pre-operatively, follow-ups at 2 weeks, 6 weeks, 3 months, 6 months, 1,2,3,4,5 year postop.

  2. NRS during stairclimbing

    Other outcome measures will include pain evaluation using the NRS pain at rest and during stair climbing

    Time frame: pre-operatively, follow-ups at 2 weeks, 6 weeks, 3 months, 6 months, 1,2,3,4,5 year postop.

  3. AOFAS (American Orthopedic Foot and Ankle Score)

    Other outcome measures will include the AOFAS.

    Time frame: pre-operatively, follow-ups at 2 weeks, 6 weeks, 3 months, 6 months, 1,2,3,4,5 year postop.

  4. FAOS (Foot and Ankle Outcome Score)

    Other outcome measures will include FAOS

    Time frame: pre-operatively, follow-ups at 2 weeks, 6 weeks, 3 months, 6 months, 1,2,3,4,5 year postop.

  5. SF-36 (Short-Form 36) Physical Component Scale

    Other outcome measures will include SF-36 Physical Component Scale

    Time frame: pre-operatively, follow-ups at 2 weeks, 6 weeks, 3 months, 6 months, 1,2,3,4,5 year postop.

  6. SF-36 (Short-Form 36) Mental Component Scale

    Other outcome measures will include SF-36 Mental Component Scale

    Time frame: pre-operatively, follow-ups at 2 weeks, 6 weeks, 3 months, 6 months, 1,2,3,4,5 year postop.

  7. ROM (range of motion)

    Other outcome measures will include Range of Motion (ROM) in degrees of dorsi- and plantarflexion and will be measured using a goniometer

    Time frame: pre-operatively, follow-ups at 2 weeks, 6 weeks, 3 months, 6 months, 1,2,3,4,5 year postop.

  8. demographic data: sex

    Other study parameters that will be recorded are demographic data and also radiographic evaluations to evaluate loosening and subsidence (radiographs). Complications, implant survivorship (revision rate), operation time, adverse events, and length of hospital stay will also be recorded.

    Time frame: pre-operatively, follow-ups at 2 weeks, 6 weeks, 3 months, 6 months, 1,2,3,4,5 year postop.

  9. demographic data: age

    Other study parameters that will be recorded are demographic data and also radiographic evaluations to evaluate loosening and subsidence (radiographs). Complications, implant survivorship (revision rate), operation time, adverse events, and length of hospital stay will also be recorded.

    Time frame: pre-operatively, follow-ups at 2 weeks, 6 weeks, 3 months, 6 months, 1,2,3,4,5 year postop.

  10. Radiographic evaluation

    Radiographic evaluations to evaluate loosening and subsidence (radiographs). Complications, implant survivorship (revision rate), operation time, adverse events, and length of hospital stay will also be recorded.

    Time frame: pre-operatively, follow-ups at 2 weeks, 6 weeks, 3 months, 6 months, 1,2,3,4,5 year postop.

06

Study locations

1 site
  • Academic Medical Center
    Amsterdam, Noord Holland 1105AZ, Netherlands
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03303690
Lead sponsor
Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
Responsible party
Jari Dahmen (Local Study Investigator, Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)) — Principal investigator
First posted
Oct 6, 2017
Start date
Dec 5, 2017
Primary completion
Mar 11, 2020
Completion
Mar 11, 2020
Last update
Jul 15, 2020

Study contacts

G.M.M.J. Kerkhoffs, MD PhD
principal investigator · Academic Medical Center (AMC Amsterdam)

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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