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Comprehensive Shoulder System Nano IDE (Nano)

Primary Purpose

Joint Disease

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Mini Stem
Nano
Sponsored by
Zimmer Biomet
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Joint Disease focused on measuring Shoulder, Joint, Osteoarthritis

Eligibility Criteria

21 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients for whom the surgeon has confirmed intraoperatively, has no cyst > 1cm and not more than one cyst at the implantation site
  • Patients with non-inflammatory degenerative joint disease including osteoarthritis.
  • Patients where the device will be used in the correction of a functional deformity (deformities preventing congruent articulation of the glenohumeral joint)
  • Patients with pain and/or loss of function in the shoulder for whom other treatment modalities have been unsuccessful.
  • Patients requiring unilateral or staged bilateral shoulder arthroplasty
  • Patient must be anatomically and structurally suited to receive the implants (humeral neck must be of sufficient diameter to implant at least the smallest nano humeral component and the humeral neck is intact).
  • Patients who are 21-90 years of age at the time of surgery and have reached skeletal maturity.
  • Patients with an ASES score ≤ 40.

Exclusion Criteria:

  • Patients diagnosed with avascular necrosis or post-traumatic arthritis of the humeral head
  • Patients found at the time of intraoperative examination to have a single cyst >1 cm in size or multiple cysts at the implantation site
  • Patient presents with shoulder joint infection, sepsis, osteomyelitis or distant foci of infections which may spread to the implant site.
  • Patients with cuff tear arthropathy.
  • Patients who have undergone a Hemi-, Total, or Reverse Total Shoulder arthroplasty in the affected shoulder.
  • Patient presents with a malunion or non-union of the tuberosities of the proximal humerus.
  • Patients with osteoporosis, osteomalacia, rheumatoid arthritis, metabolic disorders of bone, muscle or connective tissue, gross deformity or any other condition of the proximal humerus (defined as severe destruction or deformity of the proximal humerus that precludes placement of the device) that in the Investigator's medical judgment could compromise implant fixation or bone healing.
  • Rapid bone destruction, marked bone loss or bone resorption apparent on roentgenogram.
  • Patients with neurologic or other disorders that would either affect the stability of the shoulder prosthesis, i.e., Charcot's joint, uncontrolled seizures, etc., or would affect their capability or willingness to return to the clinic for assessments and/or follow directions.
  • Bone cancer, either primary or secondary, that affects the shoulder.
  • Patients presenting with symptoms of chronic steroid use. (oral steroids for a chronic condition for 12 months prior to and including the date of surgery)
  • Patients with a life expectancy of less than three years.
  • Patients diagnosed with severe shoulder instability
  • Patients diagnosed with subscapularis incompetence
  • Patients diagnosed with any condition that may limit their ability to complete the consent form or would affect their capability or willingness to return to the clinic for assessments and/or follow directions (i.e. mental illness)
  • Patients with known metal allergy
  • Patients who refuse to sign the Institutional Review Board (IRB) approved consent form
  • Patients who are found intraoperatively to require a specific treatment and are unable to be randomized.

Sites / Locations

  • Arizona Institute for Sports, Knees, and Shoulders
  • Holy Cross Hospital
  • Ortho NorthEast
  • Orthopedic Clinic
  • Towson Orthopaedic Associates
  • William Beaumont Hospital
  • Mayo Clinic
  • University of Buffalo
  • Joint Implant Surgeons
  • Campbell Clinic Orthopaedics
  • University of Virginia
  • Bon Secours St. Francis Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Comprehensive Mini Humeral Stem

Comprehensive Nano Humeral Component

Arm Description

The Comprehensive® Shoulder System with mini stem component, which will be the control device for this clinical investigation and was 510(k) cleared under K060692 on May 30, 2006. The humeral stem component is manufactured from Ti6Al4V alloy. The taper has a machine finish and accepts the taper adaptor of the humeral head component. The proximal region of the bone-contacting outer surface features a porous coating of plasma-sprayed titanium alloy, while the distal portion is polished. Seventeen stem diameters are available - 4 mm to 20 mm, in 1-mm increments.

The stemless humeral component is manufactured from Ti6Al4V alloy. It consists of a central tapered region and six outer wings. The taper has a machine finish and accepts the taper adaptor of the humeral head component. A small groove is included just below the taper to accept an inserter/impactor. The bone-contacting outer surface features a porous coating of plasma-sprayed titanium alloy for cementless fixation in the proximal humerus. Six sizes are available - 30 mm, 32 mm, 34 mm, 36 mm, 38 mm, and 40 mm.

Outcomes

Primary Outcome Measures

American Shoulder and Elbow Surgeon's Score (ASES)
The American Shoulder and Elbow Surgeon's (ASES) Score is a tool used to measure shoulder function. The ASES score is on a scale of 0 to 100, with 0 being the worst possible score and 100 the best. The score consists of two components - pain and activities of daily living.
Number of Shoulders With Absence of Revision/Removal/UADE/Fracture/Dislocation
This outcome measure calculates the proportion of subjects meeting a success criteria defined in the protocol as "No unanticipated device-related adverse event, and no fracture, perforation of the bone or joint dislocation, and no fracture, perforation or dissociation of the device, and no revision or removal of any component." All subject records were evaluated for each of the disqualifying factors, and all subjects that failed at least one of the endpoint measures were identified. The success rate is defined as the number of subjects at two years not meeting any of the disqualifying factors compared to the total number of cases present at two years plus all subjects considered failures without two year data.
Number of Shoulders With Radiographic Success
This outcome measure calculates the proportion of subjects meeting a success criteria defined in the protocol as "Subsidence of the humeral component <5 mm, and migration of the humeral component <5 mm, and no progressive lucency around the humeral component >2 mm in two or more contiguous zones, and migration of the glenoid component <5 mm, and no progressive lucency >2 mm around the entire glenoid component." All subject records were evaluated by an Independent Radiographic Reviewer (IRR) at each time point for radiographic success based on these criteria.

Secondary Outcome Measures

American Shoulder and Elbow Surgeon's Score (ASES)
The American Shoulder and Elbow Surgeon's (ASES) Score is a tool used to measure shoulder function. The ASES score is on a scale of 0 to 100, with 0 being the worst possible score and 100 the best. The score consists of two components - pain and activities of daily living.
Single Assessment Numeric Evaluation (SANE) Score
The Single Assessment Numeric Evaluation (SANE) Score is a tool used to assess the subject's perception of their affected joint. Participants are requested to rate their shoulder function on a scale of 0 to 100, with 0 as the worst option and 100 being normal shoulder function.
Constant Score Adjusted for Age and Gender
The Constant-Murley Shoulder Score is a scoring method used by clinicians to assess function of the shoulder. The standard score is on a scale of 0 to 100, with 0 being no shoulder function and 100 being excellent function. The age- and gender-adjusted Constant score normalizes the raw Constant score based on the subject's age and gender. The worst score on the adjusted scale is still 0, but the greatest scores can exceed 100 based on the calculations used for normalization. The scale used in this study was described by Katolik et al.
Number of Shoulders Passing Radiographic Assessment of Radiolucencies and Subsidence
All radiographs collected at all follow-up time points were analyzed by the Independent Radiographic reviewer. Subjects were assessed for the presence of radiolucencies considered to be failures of the radiographic co-primary endpoint (No progressive lucency around the humeral component >2 mm in two or more contiguous zones OR no progressive lucency >2 mm around the entire glenoid component) and for the presence of component subsidence. Subjects with the absence of failing radiolucencies and subsidence were considered successes.

Full Information

First Posted
August 23, 2013
Last Updated
January 7, 2020
Sponsor
Zimmer Biomet
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1. Study Identification

Unique Protocol Identification Number
NCT01936259
Brief Title
Comprehensive Shoulder System Nano IDE
Acronym
Nano
Official Title
A Study of the Comprehensive Shoulder System With Nano Humeral Component in Total Shoulder Arthroplasty
Study Type
Interventional

2. Study Status

Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
August 2013 (Actual)
Primary Completion Date
November 21, 2018 (Actual)
Study Completion Date
September 27, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Zimmer Biomet

4. Oversight

Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this clinical study is to determine the safety and efficacy of the Comprehensive® Shoulder System with Nano Humeral Component in Total Shoulder Arthroplasty (TSA).
Detailed Description
The purpose of this clinical investigation is to establish the safety and efficacy of the Comprehensive® Shoulder System with Nano Humeral Component in Total Shoulder Arthroplasty. Safety and efficacy of the device will be measured by collection and analysis of the following data at the two-year or greater time point (22 months post-operative or longer): American Shoulder and Elbow Surgeons (ASES) Score Single Assessment Numeric Evaluation (SANE) Constant Score Radiographic assessment of osteolysis, radiolucencies, migration, and subsidence Comparison of overall adverse event rates including rates of removal/revision and other serious adverse events.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Joint Disease
Keywords
Shoulder, Joint, Osteoarthritis

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
258 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Comprehensive Mini Humeral Stem
Arm Type
Active Comparator
Arm Description
The Comprehensive® Shoulder System with mini stem component, which will be the control device for this clinical investigation and was 510(k) cleared under K060692 on May 30, 2006. The humeral stem component is manufactured from Ti6Al4V alloy. The taper has a machine finish and accepts the taper adaptor of the humeral head component. The proximal region of the bone-contacting outer surface features a porous coating of plasma-sprayed titanium alloy, while the distal portion is polished. Seventeen stem diameters are available - 4 mm to 20 mm, in 1-mm increments.
Arm Title
Comprehensive Nano Humeral Component
Arm Type
Experimental
Arm Description
The stemless humeral component is manufactured from Ti6Al4V alloy. It consists of a central tapered region and six outer wings. The taper has a machine finish and accepts the taper adaptor of the humeral head component. A small groove is included just below the taper to accept an inserter/impactor. The bone-contacting outer surface features a porous coating of plasma-sprayed titanium alloy for cementless fixation in the proximal humerus. Six sizes are available - 30 mm, 32 mm, 34 mm, 36 mm, 38 mm, and 40 mm.
Intervention Type
Device
Intervention Name(s)
Mini Stem
Intervention Description
The humeral stem component is manufactured from Ti6Al4V alloy. The taper has a machine finish and accepts the taper adaptor of the humeral head component. The proximal region of the bone-contacting outer surface features a porous coating of plasma-sprayed titanium alloy, while the distal portion is polished. Seventeen stem diameters are available - 4 mm to 20 mm, in 1-mm increments.
Intervention Type
Device
Intervention Name(s)
Nano
Intervention Description
The stemless humeral component is manufactured from Ti6Al4V alloy. It consists of a central tapered region and six outer wings. The taper has a machine finish and accepts the taper adaptor of the humeral head component. A small groove is included just below the taper to accept an inserter/impactor. The bone-contacting outer surface features a porous coating of plasma-sprayed titanium alloy for cementless fixation in the proximal humerus. Six sizes are available - 30 mm, 32 mm, 34 mm, 36 mm, 38 mm, and 40 mm.
Primary Outcome Measure Information:
Title
American Shoulder and Elbow Surgeon's Score (ASES)
Description
The American Shoulder and Elbow Surgeon's (ASES) Score is a tool used to measure shoulder function. The ASES score is on a scale of 0 to 100, with 0 being the worst possible score and 100 the best. The score consists of two components - pain and activities of daily living.
Time Frame
22+ Months
Title
Number of Shoulders With Absence of Revision/Removal/UADE/Fracture/Dislocation
Description
This outcome measure calculates the proportion of subjects meeting a success criteria defined in the protocol as "No unanticipated device-related adverse event, and no fracture, perforation of the bone or joint dislocation, and no fracture, perforation or dissociation of the device, and no revision or removal of any component." All subject records were evaluated for each of the disqualifying factors, and all subjects that failed at least one of the endpoint measures were identified. The success rate is defined as the number of subjects at two years not meeting any of the disqualifying factors compared to the total number of cases present at two years plus all subjects considered failures without two year data.
Time Frame
2 years
Title
Number of Shoulders With Radiographic Success
Description
This outcome measure calculates the proportion of subjects meeting a success criteria defined in the protocol as "Subsidence of the humeral component <5 mm, and migration of the humeral component <5 mm, and no progressive lucency around the humeral component >2 mm in two or more contiguous zones, and migration of the glenoid component <5 mm, and no progressive lucency >2 mm around the entire glenoid component." All subject records were evaluated by an Independent Radiographic Reviewer (IRR) at each time point for radiographic success based on these criteria.
Time Frame
2 years
Secondary Outcome Measure Information:
Title
American Shoulder and Elbow Surgeon's Score (ASES)
Description
The American Shoulder and Elbow Surgeon's (ASES) Score is a tool used to measure shoulder function. The ASES score is on a scale of 0 to 100, with 0 being the worst possible score and 100 the best. The score consists of two components - pain and activities of daily living.
Time Frame
Pre-operative, 6 Weeks, 3 Months, 1 Year, 2 Years, 3 Years, 4 Years
Title
Single Assessment Numeric Evaluation (SANE) Score
Description
The Single Assessment Numeric Evaluation (SANE) Score is a tool used to assess the subject's perception of their affected joint. Participants are requested to rate their shoulder function on a scale of 0 to 100, with 0 as the worst option and 100 being normal shoulder function.
Time Frame
6 Weeks, 3 Months, 1 Year, 2 Years, 3 Years, 4 Years
Title
Constant Score Adjusted for Age and Gender
Description
The Constant-Murley Shoulder Score is a scoring method used by clinicians to assess function of the shoulder. The standard score is on a scale of 0 to 100, with 0 being no shoulder function and 100 being excellent function. The age- and gender-adjusted Constant score normalizes the raw Constant score based on the subject's age and gender. The worst score on the adjusted scale is still 0, but the greatest scores can exceed 100 based on the calculations used for normalization. The scale used in this study was described by Katolik et al.
Time Frame
Pre-operative, 3 Months, 1 Year, 2 Years, 3 Years, 4 Years
Title
Number of Shoulders Passing Radiographic Assessment of Radiolucencies and Subsidence
Description
All radiographs collected at all follow-up time points were analyzed by the Independent Radiographic reviewer. Subjects were assessed for the presence of radiolucencies considered to be failures of the radiographic co-primary endpoint (No progressive lucency around the humeral component >2 mm in two or more contiguous zones OR no progressive lucency >2 mm around the entire glenoid component) and for the presence of component subsidence. Subjects with the absence of failing radiolucencies and subsidence were considered successes.
Time Frame
2+ years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients for whom the surgeon has confirmed intraoperatively, has no cyst > 1cm and not more than one cyst at the implantation site Patients with non-inflammatory degenerative joint disease including osteoarthritis. Patients where the device will be used in the correction of a functional deformity (deformities preventing congruent articulation of the glenohumeral joint) Patients with pain and/or loss of function in the shoulder for whom other treatment modalities have been unsuccessful. Patients requiring unilateral or staged bilateral shoulder arthroplasty Patient must be anatomically and structurally suited to receive the implants (humeral neck must be of sufficient diameter to implant at least the smallest nano humeral component and the humeral neck is intact). Patients who are 21-90 years of age at the time of surgery and have reached skeletal maturity. Patients with an ASES score ≤ 40. Exclusion Criteria: Patients diagnosed with avascular necrosis or post-traumatic arthritis of the humeral head Patients found at the time of intraoperative examination to have a single cyst >1 cm in size or multiple cysts at the implantation site Patient presents with shoulder joint infection, sepsis, osteomyelitis or distant foci of infections which may spread to the implant site. Patients with cuff tear arthropathy. Patients who have undergone a Hemi-, Total, or Reverse Total Shoulder arthroplasty in the affected shoulder. Patient presents with a malunion or non-union of the tuberosities of the proximal humerus. Patients with osteoporosis, osteomalacia, rheumatoid arthritis, metabolic disorders of bone, muscle or connective tissue, gross deformity or any other condition of the proximal humerus (defined as severe destruction or deformity of the proximal humerus that precludes placement of the device) that in the Investigator's medical judgment could compromise implant fixation or bone healing. Rapid bone destruction, marked bone loss or bone resorption apparent on roentgenogram. Patients with neurologic or other disorders that would either affect the stability of the shoulder prosthesis, i.e., Charcot's joint, uncontrolled seizures, etc., or would affect their capability or willingness to return to the clinic for assessments and/or follow directions. Bone cancer, either primary or secondary, that affects the shoulder. Patients presenting with symptoms of chronic steroid use. (oral steroids for a chronic condition for 12 months prior to and including the date of surgery) Patients with a life expectancy of less than three years. Patients diagnosed with severe shoulder instability Patients diagnosed with subscapularis incompetence Patients diagnosed with any condition that may limit their ability to complete the consent form or would affect their capability or willingness to return to the clinic for assessments and/or follow directions (i.e. mental illness) Patients with known metal allergy Patients who refuse to sign the Institutional Review Board (IRB) approved consent form Patients who are found intraoperatively to require a specific treatment and are unable to be randomized.
Facility Information:
Facility Name
Arizona Institute for Sports, Knees, and Shoulders
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85255
Country
United States
Facility Name
Holy Cross Hospital
City
Fort Lauderdale
State/Province
Florida
ZIP/Postal Code
33308
Country
United States
Facility Name
Ortho NorthEast
City
Fort Wayne
State/Province
Indiana
ZIP/Postal Code
46825
Country
United States
Facility Name
Orthopedic Clinic
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71105
Country
United States
Facility Name
Towson Orthopaedic Associates
City
Towson
State/Province
Maryland
ZIP/Postal Code
21204
Country
United States
Facility Name
William Beaumont Hospital
City
Royal Oak
State/Province
Michigan
ZIP/Postal Code
48073
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
University of Buffalo
City
Buffalo
State/Province
New York
ZIP/Postal Code
14214
Country
United States
Facility Name
Joint Implant Surgeons
City
New Albany
State/Province
Ohio
ZIP/Postal Code
43054
Country
United States
Facility Name
Campbell Clinic Orthopaedics
City
Germantown
State/Province
Tennessee
ZIP/Postal Code
38138
Country
United States
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22903
Country
United States
Facility Name
Bon Secours St. Francis Medical Center
City
Midlothian
State/Province
Virginia
ZIP/Postal Code
23114
Country
United States

12. IPD Sharing Statement

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Comprehensive Shoulder System Nano IDE

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