A Study Evaluating Amplex Compared To Autograft Bone In Foot and Ankle Fusion Surgery
Primary Purpose
Arthritis
Status
Unknown status
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
Amplex
Autograft bone
Sponsored by

About this trial
This is an interventional treatment trial for Arthritis focused on measuring foot ankle arthritis bone graft
Eligibility Criteria
Inclusion Criteria:
- Indicated for foot and ankle surgery described as either a single, double or triple arthrodesis of the ankle, subtalar, calcaneocuboid or talonavicular joints.
- Have the ability to understand the requirements of the study, to provide written informed consent, and to comply with the study protocol
- Have the ability to understand and provide written authorization for the use and disclosure of personal health information (PHI)
- Be a skeletally mature male or a non-pregnant, non-lactating female at least 18 years of age but not older than age 75
If a woman is of childbearing potential (not amenorrheic for the previous 24 months or not surgically sterile), then she must:
- Have a confirmed negative urine pregnancy test result prior to surgery and the administration of the study product
- Agree to use a medically approved method of contraception for the duration of the initial follow-up period of the study
- Agree to participate in postoperative clinical and radiographic evaluations and comply with the required study regimen
- Have not been sufficiently responsive to an adequate trial of non-operative treatment (e.g. modified activity, analgesics, anti-inflammatories, bracing, orthotics, physiotherapy, vitamin supplements, or injections etc. prior to study enrollment).
Exclusion Criteria:
- Has a large bone deficit requiring a structural graft
- Charcot joints from neuropathic destruction.
- Previous fusion or osteotomy of the proposed site
- Requires osteotomy or fusion of the midfoot joints
- Morbidly obese (BMI >45 kg/m2)
- Women planning to become pregnant during the first year (12 months) following the procedure
- Female subjects of childbearing potential unwilling to use medically acceptable contraceptive methods (e.g., surgical sterilization, hormonal contraceptives, barrier methods, or intrauterine devices) so as to prevent pregnancy for 12 months following the study procedure
- Have at the time of surgery a systemic infection or local infection at the site of surgery
- Have an active history of systemic malignancy.
- Currently has untreated malignant neoplasm(s), or is currently undergoing radio- or chemotherapy or has been diagnosed with hypercalcemia.
- Have a medical condition, serious intercurrent illness, or extenuating circumstance that, in the opinion of the Investigator, would preclude participation in the study or potentially decrease survival or interfere with ambulation or rehabilitation (e.g., histories of transient ischemic attack, stroke or liver disease)
- Has a known complication of diabetes (e.g. retinopathy, renal failure, neuropathic complication in lower limb).
- Uncontrolled diabetes. If the patient has been diagnosed with diabetes, they must have an Hgb A1C level less than 7 to participate.
- Have a known hypersensitivity to any of the components of the product [e.g., Hydroxyapatite (HA): Tricalcium Phosphate (TCP) ceramic granule] or a known titanium allergy
- Receiving active treatment with a drug known to interfere with bone metabolism (e.g. long-term steroid therapy, methotrexate).
- Have a history of any severe allergy or anaphylaxis, or a history of hypersensitivity to protein pharmaceuticals (e.g., monoclonal antibodies or gamma globulins, recombinant BMPs)
- Being treated with a bone growth stimulator
- Have a medical condition requiring radiation, chemotherapy or immunosuppression.
- Have obvious and/or documented alcohol or illicit drug addictions
- Are prisoners
- Have participated in clinical studies evaluating investigational devices, pharmaceuticals or biologics within 3 months of enrollment
- Have previously been treated with, or exposed to, therapeutic levels of Bone Morphogenetic Proteins (BMPs), i.e., synthetic or recombinant
- Have a documented medical history of or radiographic evidence of a metabolic bone disease (e.g., avascular necrosis, osteoporosis or osteopenia) or other condition that would negatively impact the bone healing process (e.g. history of Paget's disease, osteomalacia, or other osteodystrophy) or preclude the subject from receiving screw fixation.
- Require chronic SQ or IV heparin therapies
Sites / Locations
- Dr. Mark Glazebrook
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Amplex (synthetic bone graft)
Autograft bone
Arm Description
Outcomes
Primary Outcome Measures
Radiographic fusion
An independent radiologist will assess radiographic fusion based upon CT imaging.
Ankle Osteoarthritis Questionnaire
This is a questionnaire completed by the subject. It consists of a number of questions concerning the amount of pain in the foot and its effect on functional activities.
Secondary Outcome Measures
Ankle Osteoarthritis Questionnaire
The is a questionnaire completed by the subject. Its asks a series of questions about pain and function of the treated foot or ankle.
Radiographic fusion
Radiographic fusion will be assess by a blinded indpenendent radiologists, using CT and X-ray images. The investigator will also assess fusion based on the images and also the overall condition of the subject.
Various blood tests
Small amounts of blood will be collected at study visits to identify possible changes in blood chemistry, liver function and antibody formation.
Full Information
NCT ID
NCT01224119
First Posted
October 18, 2010
Last Updated
March 7, 2012
Sponsor
BioSurface Engineering Technologies, Inc
1. Study Identification
Unique Protocol Identification Number
NCT01224119
Brief Title
A Study Evaluating Amplex Compared To Autograft Bone In Foot and Ankle Fusion Surgery
Official Title
A Multi-Center, Randomized, Pilot Study Evaluating Amplex Compared To Autograft Bone In Foot and Ankle Fusion Surgery
Study Type
Interventional
2. Study Status
Record Verification Date
March 2012
Overall Recruitment Status
Unknown status
Study Start Date
January 2011 (undefined)
Primary Completion Date
April 2012 (Anticipated)
Study Completion Date
April 2012 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioSurface Engineering Technologies, Inc
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The current research study evaluates an investigational medical device called Amplex B2A(TM) Peptide Enhanced Ceramic Granules ("Amplex") for use in foot and ankle fusion. Amplex is a synthetic bone graft material. The most frequently used graft material is bone collected from the patient (autograft). Autograft involves a secondary incision with the risks of infection and lasting pain.
The purpose of this study is to determine if Amplex is a safe and effective alternative to autograft.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Arthritis
Keywords
foot ankle arthritis bone graft
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
24 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Amplex (synthetic bone graft)
Arm Type
Experimental
Arm Title
Autograft bone
Arm Type
Active Comparator
Intervention Type
Device
Intervention Name(s)
Amplex
Intervention Description
225 micrograms of B2A per cc of ceramic granules
Intervention Type
Procedure
Intervention Name(s)
Autograft bone
Intervention Description
Bone is collected through a separate incision at the iliac crest or tibia.
Primary Outcome Measure Information:
Title
Radiographic fusion
Description
An independent radiologist will assess radiographic fusion based upon CT imaging.
Time Frame
6 months
Title
Ankle Osteoarthritis Questionnaire
Description
This is a questionnaire completed by the subject. It consists of a number of questions concerning the amount of pain in the foot and its effect on functional activities.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Ankle Osteoarthritis Questionnaire
Description
The is a questionnaire completed by the subject. Its asks a series of questions about pain and function of the treated foot or ankle.
Time Frame
12 months
Title
Radiographic fusion
Description
Radiographic fusion will be assess by a blinded indpenendent radiologists, using CT and X-ray images. The investigator will also assess fusion based on the images and also the overall condition of the subject.
Time Frame
9-12 months
Title
Various blood tests
Description
Small amounts of blood will be collected at study visits to identify possible changes in blood chemistry, liver function and antibody formation.
Time Frame
PreOp through 6 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Indicated for foot and ankle surgery described as either a single, double or triple arthrodesis of the ankle, subtalar, calcaneocuboid or talonavicular joints.
Have the ability to understand the requirements of the study, to provide written informed consent, and to comply with the study protocol
Have the ability to understand and provide written authorization for the use and disclosure of personal health information (PHI)
Be a skeletally mature male or a non-pregnant, non-lactating female at least 18 years of age but not older than age 75
If a woman is of childbearing potential (not amenorrheic for the previous 24 months or not surgically sterile), then she must:
Have a confirmed negative urine pregnancy test result prior to surgery and the administration of the study product
Agree to use a medically approved method of contraception for the duration of the initial follow-up period of the study
Agree to participate in postoperative clinical and radiographic evaluations and comply with the required study regimen
Have not been sufficiently responsive to an adequate trial of non-operative treatment (e.g. modified activity, analgesics, anti-inflammatories, bracing, orthotics, physiotherapy, vitamin supplements, or injections etc. prior to study enrollment).
Exclusion Criteria:
Has a large bone deficit requiring a structural graft
Charcot joints from neuropathic destruction.
Previous fusion or osteotomy of the proposed site
Requires osteotomy or fusion of the midfoot joints
Morbidly obese (BMI >45 kg/m2)
Women planning to become pregnant during the first year (12 months) following the procedure
Female subjects of childbearing potential unwilling to use medically acceptable contraceptive methods (e.g., surgical sterilization, hormonal contraceptives, barrier methods, or intrauterine devices) so as to prevent pregnancy for 12 months following the study procedure
Have at the time of surgery a systemic infection or local infection at the site of surgery
Have an active history of systemic malignancy.
Currently has untreated malignant neoplasm(s), or is currently undergoing radio- or chemotherapy or has been diagnosed with hypercalcemia.
Have a medical condition, serious intercurrent illness, or extenuating circumstance that, in the opinion of the Investigator, would preclude participation in the study or potentially decrease survival or interfere with ambulation or rehabilitation (e.g., histories of transient ischemic attack, stroke or liver disease)
Has a known complication of diabetes (e.g. retinopathy, renal failure, neuropathic complication in lower limb).
Uncontrolled diabetes. If the patient has been diagnosed with diabetes, they must have an Hgb A1C level less than 7 to participate.
Have a known hypersensitivity to any of the components of the product [e.g., Hydroxyapatite (HA): Tricalcium Phosphate (TCP) ceramic granule] or a known titanium allergy
Receiving active treatment with a drug known to interfere with bone metabolism (e.g. long-term steroid therapy, methotrexate).
Have a history of any severe allergy or anaphylaxis, or a history of hypersensitivity to protein pharmaceuticals (e.g., monoclonal antibodies or gamma globulins, recombinant BMPs)
Being treated with a bone growth stimulator
Have a medical condition requiring radiation, chemotherapy or immunosuppression.
Have obvious and/or documented alcohol or illicit drug addictions
Are prisoners
Have participated in clinical studies evaluating investigational devices, pharmaceuticals or biologics within 3 months of enrollment
Have previously been treated with, or exposed to, therapeutic levels of Bone Morphogenetic Proteins (BMPs), i.e., synthetic or recombinant
Have a documented medical history of or radiographic evidence of a metabolic bone disease (e.g., avascular necrosis, osteoporosis or osteopenia) or other condition that would negatively impact the bone healing process (e.g. history of Paget's disease, osteomalacia, or other osteodystrophy) or preclude the subject from receiving screw fixation.
Require chronic SQ or IV heparin therapies
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David M Hooper, PhD
Organizational Affiliation
BioSurface Engineering Technologies, Inc
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Mark Glazebrook, MD
Organizational Affiliation
Queen Elizabeth II Health Sciences Center Halifax Infirmary
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dr. Mark Glazebrook
City
Halifax
State/Province
Nova Scotia
Country
Canada
12. IPD Sharing Statement
Citations:
PubMed Identifier
23463779
Citation
Glazebrook M, Younger A, Wing K, Lalonde KA. A prospective pilot study of B2A-coated ceramic granules (Amplex) compared to autograft for ankle and hindfoot arthrodesis. Foot Ankle Int. 2013 Aug;34(8):1055-63. doi: 10.1177/1071100713481459. Epub 2013 Mar 5.
Results Reference
derived
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A Study Evaluating Amplex Compared To Autograft Bone In Foot and Ankle Fusion Surgery
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