The SUN Clinical Trial (Safety Utilizing NUsurface Meniscus Implant) (SUN)
Primary Purpose
Post-Meniscectomy Pain Syndrome, Osteoarthritis, Knee
Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
NUsurface® Meniscus Implant
Sponsored by
About this trial
This is an interventional treatment trial for Post-Meniscectomy Pain Syndrome focused on measuring NUsurface, Meniscus, prosthesis, KOOS
Eligibility Criteria
Inclusion Criteria:
- Had > 6 months ago a medial partial meniscectomy as confirmed by patient history and MRI
- Has a KOOS Pain of ≤ 75 (100 being the highest attainable and no pain)
- Is between age 30 and 75 years (inclusive) at the time of study treatment
- Has neutral alignment ±5º of the mechanical axis, as measured from the angle formed by a line drawn from the center of the femoral head to the medial tibial spine and a line drawn from the medial tibial spine and the center of the ankle joint
- Has ≥ 2 mm intact medial meniscal rim capable of being fitted with a NUsurface® device
- Is able to do the study required follow-up visits, questionnaires, X-rays and MRI's
- Is able to read and understand the English language if treated at a U.S. site or read and understand one of the official country languages if treated at a site Outside the U.S.
- Is able and willing to understand and sign the Informed Consent Form
Exclusion Criteria:
- Has a symptomatic knee because of a tear that could be addressed by a repeat partial meniscectomy leaving > 4 mm of medial meniscus rim
- Has evidence of a Outerbridge Grade IV cartilage loss on the medial tibial plateau or femoral condyle that potentially could contact a NUsurface implant (e.g., a focal lesion > 0.5 cm2 correlating to a circular defect of > 8 mm in diameter)
- Has complete disruption of the posterior root attachment of the meniscus
- Has lateral compartment pain and Grade III or Grade IV Outerbridge cartilage score in the lateral compartment
- Has a varus or valgus knee deformity > 5º requiring a tibial or femoral osteotomy
- Has a laxity level of more than Grade II (IKDC), primary or secondary to an injury of the anterior cruciate ligament (ACL) and/or posterior cruciate ligament (PCL) and/or lateral collateral ligament (LCL) and/or medial collateral ligament (MCL)
- Has significant trochlear dysplasia, patellar instability or symptomatic patellar misalignment
- Has patellar compartment pain and Grade III or Grade IV Outerbridge cartilage score in the patellar compartment.
- Compared to a normal knee, has obvious radiological evidence of medial femoral squaring, anatomical variance in the medial tibial plateau, or irregularly shaped cartilage surface
- Had an ACL reconstruction performed < 9 months prior to study treatment
- Has a BMI > 32.5 at the start of study treatment
- Decides to receive (if eligible and an option) allograft medial meniscus transplantation
- Received any type of prosthetic knee implant made of artificial non-resorbable plastic, metal or ceramic, not including the NUsurface® Meniscus Implant
- Has a knee flexion contracture > 10º
- Has flexion < 90º
- Had a previous medial femoral condyle surgery (not including microfracture) or High Tibial Osteotomy (HTO)
- Has insufficiency fractures or avascular necrosis of the medial compartment
- Has an active infection or tumor (local or systemic)
- Has any type of knee joint inflammatory disease including Sjogren's syndrome
- Has neuropathic knee osteoarthropathy, also known as Charcot joint
- Has any medical condition that does not allow possible arthroscopy of the knee
- Has neurological deficit (sensory, motor, or reflex)
- Is currently involved in another investigation of the lower extremity
- Anticipates having another lower extremity surgery during the study period
- Is contraindicated for hyaluronic acid injections (i.e., patients with known hypersensitivity [allergy] to hyaluronan [sodium hyaluoronate] preparations); patients having knee joint infections or skin diseases or infections in the site of possible injections
- Is contraindicated for corticosteroid injections (i.e., patients with allergy to any of the components or with idiopathic thrombocytopenic purpura)
- Has received any corticosteroid knee injections ≤ 3 months prior to study treatment
- Has chondrocalcinosis
- Is on immunostimulating or immunosuppressing agents
- Has ipsilateral or contralateral lower limb joint conditions that may affect ambulation or KOOS (e.g. have a leg length discrepancy > 2.5 cm [1 inch], causing a noticeable limp)
- Is a female who is lactating, expecting, or is intending to become pregnant during the study period
- Is an active smoker
- Is mentally incapacitated (incapable of appraising or controlling conduct) or have mental disability (e.g., dementia or Alzheimer's)
- Is a prisoner
- Is a patient who has economic incentive not to improve
- Certain patient populations that are at high risk for poor healing or outcomes such as patients who have a co-morbidity that reduces life expectancy to less than 36 months
- Patients who are contraindicated for MRI (i.e., pacemaker, defibrillator, cochlear implants, etc.)
Sites / Locations
- Banner University Medical Center Phoenix
- Horizon Clinical Research
- Long Beach Memorial Medical Center
- St Mary's Medical Center
- CU Sports Medicine
- Advanced Orthopaedics & Sports Medicine Specialists
- OrthoIndy
- Baton Rouge Orthopaedic Clinic
- Ochsner Sports Medicine Institute
- Sports Medicine Oregon
- Arlington Orthopedic Associates, PA
- Comprehensive Orthopaedics & Sports Medicine
- OrthoVirginia
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
NUsurface Meniscus Implant
Arm Description
All eligible patients will receive the NUsurface® Meniscus Implant.
Outcomes
Primary Outcome Measures
Safety assessed by Serious and non-serious, device-related and non-device related adverse events
Safety assessed by Serious and non-serious, device-related and non-device related adverse events recorded during the implantation, up to 24 months following implantation
Clinical Performance
Evaluation of performance defined as NUsurface® Meniscus Implant providing knee pain reduction and improvement in functionality and quality of life up to 24 months post-implantation, as measured by KOOS Pain and KOOS 5
Secondary Outcome Measures
Safety assessed by Serious and non-serious, device-related and non-device related adverse events
Safety assessed by Serious and non-serious, device-related and non-device related adverse events occurring between 24 and 60 months following implantation
Clinical Performance
Evaluation of performance defined as NUsurface® Meniscus Implant providing knee pain reduction and improvement in functionality and quality of life up to 60 months post-implantation, as measured by KOOS Pain and KOOS 5
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02483988
Brief Title
The SUN Clinical Trial (Safety Utilizing NUsurface Meniscus Implant)
Acronym
SUN
Official Title
The SUN Clinical Trial (Safety Utilizing NUsurface Meniscus Implant). A Multi-center, Single-arm, Prospective, Open-label, Non-randomized, Observational Clinical Study
Study Type
Interventional
2. Study Status
Record Verification Date
March 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
December 2015 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Active Implants
4. Oversight
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The NUsurface® Meniscus Implant SUN Clinical Trial is a multi-center, single-arm, prospective, open label, non-randomized, observational clinical trial to gather safety and probable clinical benefit data on the NUsurface® Meniscus Implant in treated the target population.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Post-Meniscectomy Pain Syndrome, Osteoarthritis, Knee
Keywords
NUsurface, Meniscus, prosthesis, KOOS
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
115 (Actual)
8. Arms, Groups, and Interventions
Arm Title
NUsurface Meniscus Implant
Arm Type
Experimental
Arm Description
All eligible patients will receive the NUsurface® Meniscus Implant.
Intervention Type
Device
Intervention Name(s)
NUsurface® Meniscus Implant
Intervention Description
The NUsurface® Meniscus Implant is a Polycarbonate-Urethane (PCU)-based device reinforced with high tensile Ultra High Molecular Weight Polyethylene (UHMWPE) fibers. The product is available in different sizes, left and right, and with trials so as to allow the surgeon several size options for implantation. The NUsurface® Meniscus Implant, is designed to be conceptually analogous to the natural meniscus whose structural characteristics include a highly orientated collagen fiber network that supports the large hoop stresses to produce better distribution of contact pressures within the knee joint. Restoring the distribution of joint loads post-meniscectomy is thought to reducing joint overload and to reducing pain.
Primary Outcome Measure Information:
Title
Safety assessed by Serious and non-serious, device-related and non-device related adverse events
Description
Safety assessed by Serious and non-serious, device-related and non-device related adverse events recorded during the implantation, up to 24 months following implantation
Time Frame
2 years
Title
Clinical Performance
Description
Evaluation of performance defined as NUsurface® Meniscus Implant providing knee pain reduction and improvement in functionality and quality of life up to 24 months post-implantation, as measured by KOOS Pain and KOOS 5
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Safety assessed by Serious and non-serious, device-related and non-device related adverse events
Description
Safety assessed by Serious and non-serious, device-related and non-device related adverse events occurring between 24 and 60 months following implantation
Time Frame
5 years
Title
Clinical Performance
Description
Evaluation of performance defined as NUsurface® Meniscus Implant providing knee pain reduction and improvement in functionality and quality of life up to 60 months post-implantation, as measured by KOOS Pain and KOOS 5
Time Frame
5 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Had > 6 months ago a medial partial meniscectomy as confirmed by patient history and MRI
Has a KOOS Pain of ≤ 75 (100 being the highest attainable and no pain)
Is between age 30 and 75 years (inclusive) at the time of study treatment
Has neutral alignment ±5º of the mechanical axis, as measured from the angle formed by a line drawn from the center of the femoral head to the medial tibial spine and a line drawn from the medial tibial spine and the center of the ankle joint
Has ≥ 2 mm intact medial meniscal rim capable of being fitted with a NUsurface® device
Is able to do the study required follow-up visits, questionnaires, X-rays and MRI's
Is able to read and understand the English language if treated at a U.S. site or read and understand one of the official country languages if treated at a site Outside the U.S.
Is able and willing to understand and sign the Informed Consent Form
Exclusion Criteria:
Has a symptomatic knee because of a tear that could be addressed by a repeat partial meniscectomy leaving > 4 mm of medial meniscus rim
Has evidence of a Outerbridge Grade IV cartilage loss on the medial tibial plateau or femoral condyle that potentially could contact a NUsurface implant (e.g., a focal lesion > 0.5 cm2 correlating to a circular defect of > 8 mm in diameter)
Has complete disruption of the posterior root attachment of the meniscus
Has lateral compartment pain and Grade III or Grade IV Outerbridge cartilage score in the lateral compartment
Has a varus or valgus knee deformity > 5º requiring a tibial or femoral osteotomy
Has a laxity level of more than Grade II (IKDC), primary or secondary to an injury of the anterior cruciate ligament (ACL) and/or posterior cruciate ligament (PCL) and/or lateral collateral ligament (LCL) and/or medial collateral ligament (MCL)
Has significant trochlear dysplasia, patellar instability or symptomatic patellar misalignment
Has patellar compartment pain and Grade III or Grade IV Outerbridge cartilage score in the patellar compartment.
Compared to a normal knee, has obvious radiological evidence of medial femoral squaring, anatomical variance in the medial tibial plateau, or irregularly shaped cartilage surface
Had an ACL reconstruction performed < 9 months prior to study treatment
Has a BMI > 32.5 at the start of study treatment
Decides to receive (if eligible and an option) allograft medial meniscus transplantation
Received any type of prosthetic knee implant made of artificial non-resorbable plastic, metal or ceramic, not including the NUsurface® Meniscus Implant
Has a knee flexion contracture > 10º
Has flexion < 90º
Had a previous medial femoral condyle surgery (not including microfracture) or High Tibial Osteotomy (HTO)
Has insufficiency fractures or avascular necrosis of the medial compartment
Has an active infection or tumor (local or systemic)
Has any type of knee joint inflammatory disease including Sjogren's syndrome
Has neuropathic knee osteoarthropathy, also known as Charcot joint
Has any medical condition that does not allow possible arthroscopy of the knee
Has neurological deficit (sensory, motor, or reflex)
Is currently involved in another investigation of the lower extremity
Anticipates having another lower extremity surgery during the study period
Is contraindicated for hyaluronic acid injections (i.e., patients with known hypersensitivity [allergy] to hyaluronan [sodium hyaluoronate] preparations); patients having knee joint infections or skin diseases or infections in the site of possible injections
Is contraindicated for corticosteroid injections (i.e., patients with allergy to any of the components or with idiopathic thrombocytopenic purpura)
Has received any corticosteroid knee injections ≤ 3 months prior to study treatment
Has chondrocalcinosis
Is on immunostimulating or immunosuppressing agents
Has ipsilateral or contralateral lower limb joint conditions that may affect ambulation or KOOS (e.g. have a leg length discrepancy > 2.5 cm [1 inch], causing a noticeable limp)
Is a female who is lactating, expecting, or is intending to become pregnant during the study period
Is an active smoker
Is mentally incapacitated (incapable of appraising or controlling conduct) or have mental disability (e.g., dementia or Alzheimer's)
Is a prisoner
Is a patient who has economic incentive not to improve
Certain patient populations that are at high risk for poor healing or outcomes such as patients who have a co-morbidity that reduces life expectancy to less than 36 months
Patients who are contraindicated for MRI (i.e., pacemaker, defibrillator, cochlear implants, etc.)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Richard W Treharne, PhD
Organizational Affiliation
Active Implants LLC
Official's Role
Study Director
Facility Information:
Facility Name
Banner University Medical Center Phoenix
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85006
Country
United States
Facility Name
Horizon Clinical Research
City
La Mesa
State/Province
California
ZIP/Postal Code
91942
Country
United States
Facility Name
Long Beach Memorial Medical Center
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
St Mary's Medical Center
City
San Francisco
State/Province
California
ZIP/Postal Code
94117
Country
United States
Facility Name
CU Sports Medicine
City
Boulder
State/Province
Colorado
ZIP/Postal Code
80309, 80222, 80045
Country
United States
Facility Name
Advanced Orthopaedics & Sports Medicine Specialists
City
Denver
State/Province
Colorado
ZIP/Postal Code
80230
Country
United States
Facility Name
OrthoIndy
City
Greenwood
State/Province
Indiana
ZIP/Postal Code
46143
Country
United States
Facility Name
Baton Rouge Orthopaedic Clinic
City
Baton Rouge
State/Province
Louisiana
ZIP/Postal Code
70810
Country
United States
Facility Name
Ochsner Sports Medicine Institute
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70121
Country
United States
Facility Name
Sports Medicine Oregon
City
Portland
State/Province
Oregon
ZIP/Postal Code
97224
Country
United States
Facility Name
Arlington Orthopedic Associates, PA
City
Arlington
State/Province
Texas
ZIP/Postal Code
76015
Country
United States
Facility Name
Comprehensive Orthopaedics & Sports Medicine
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84102
Country
United States
Facility Name
OrthoVirginia
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23294
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
25238685
Citation
De Coninck T, Elsner JJ, Linder-Ganz E, Cromheecke M, Shemesh M, Huysse W, Verdonk R, Verstraete K, Verdonk P. In-vivo evaluation of the kinematic behavior of an artificial medial meniscus implant: A pilot study using open-MRI. Clin Biomech (Bristol, Avon). 2014 Sep;29(8):898-905. doi: 10.1016/j.clinbiomech.2014.07.001. Epub 2014 Jul 17.
Results Reference
background
PubMed Identifier
24055793
Citation
Shemesh M, Asher R, Zylberberg E, Guilak F, Linder-Ganz E, Elsner JJ. Viscoelastic properties of a synthetic meniscus implant. J Mech Behav Biomed Mater. 2014 Jan;29:42-55. doi: 10.1016/j.jmbbm.2013.08.021. Epub 2013 Sep 3.
Results Reference
background
PubMed Identifier
20635076
Citation
Zur G, Linder-Ganz E, Elsner JJ, Shani J, Brenner O, Agar G, Hershman EB, Arnoczky SP, Guilak F, Shterling A. Chondroprotective effects of a polycarbonate-urethane meniscal implant: histopathological results in a sheep model. Knee Surg Sports Traumatol Arthrosc. 2011 Feb;19(2):255-63. doi: 10.1007/s00167-010-1210-5. Epub 2010 Jul 16.
Results Reference
background
PubMed Identifier
20887018
Citation
Elsner JJ, Portnoy S, Guilak F, Shterling A, Linder-Ganz E. MRI-based characterization of bone anatomy in the human knee for size matching of a medial meniscal implant. J Biomech Eng. 2010 Oct;132(10):101008. doi: 10.1115/1.4002490.
Results Reference
background
PubMed Identifier
20815651
Citation
Elsner JJ, Portnoy S, Zur G, Guilak F, Shterling A, Linder-Ganz E. Design of a free-floating polycarbonate-urethane meniscal implant using finite element modeling and experimental validation. J Biomech Eng. 2010 Sep;132(9):095001. doi: 10.1115/1.4001892.
Results Reference
background
PubMed Identifier
20370247
Citation
Linder-Ganz E, Elsner JJ, Danino A, Guilak F, Shterling A. A novel quantitative approach for evaluating contact mechanics of meniscal replacements. J Biomech Eng. 2010 Feb;132(2):024501. doi: 10.1115/1.4000407.
Results Reference
background
PubMed Identifier
26057364
Citation
Elsner JJ, Shemesh M, Shefy-Peleg A, Gabet Y, Zylberberg E, Linder-Ganz E. Quantification of in vitro wear of a synthetic meniscus implant using gravimetric and micro-CT measurements. J Mech Behav Biomed Mater. 2015 Sep;49:310-20. doi: 10.1016/j.jmbbm.2015.05.017. Epub 2015 May 28.
Results Reference
background
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The SUN Clinical Trial (Safety Utilizing NUsurface Meniscus Implant)
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