Safety and Effectiveness of Cartiva Implant in the Treatment of First CMC Joint Osteoarthritis Compared to LRTI (GRIP 2) (GRIP 2)
Primary Purpose
Osteoarthritis
Status
Active
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Cartiva
Sponsored by
About this trial
This is an interventional treatment trial for Osteoarthritis focused on measuring CMC Joint, Osteoarthritis, Cartilage Replacement, First CMC Joint Osteoarthritis, Damaged Articular Surface, LRTI, Ligament Reconstruction Tendon Interposition
Eligibility Criteria
Inclusion Criteria:
- ≥ 22 years of age
- Refractory to conservative non-operative standard of care treatment for first CMC OA lasting for at least 6 months that requires surgical intervention
- Eaton classification stage II or III OA of the first CMC joint based on X-rays taken within 6 months of the Operative date and evidence of first CMC joint OA based on subjective review of associated clinical symptoms
- Preoperative VAS Pain score of ≥ 40 in the treated hand
- Preoperative 11 question QuickDASH score of ≥ 20
- Presence of good bone stock - i.e., no need for bone graft
- Capable of completing self-administered questionnaires
- Be willing and able to return for all study-related follow up procedures
- Have been informed of the nature of the study, agreeing to its requirements, and have signed the informed consent approved by the IRB/REB/Ethics Committee
Exclusion Criteria:
- Active systemic infection
- Active infection at the site of surgery
- Previous CMC implant, trapeziectomy, or LRTI to the affected joint to be treated
- Inflammatory arthropathy and/or diagnosis of grout
- History of or current diagnosis of rheumatoid arthritis
- Any significant bone loss, avascular necrosis, or cyst > 8mm of the supporting bone structure
- Eaton classification stage IV advanced OA of the first CMC joint based on X-rays taken within 6 months of the Operative date
- Physical conditions that would tend to eliminate adequate implant support (e.g., inadequate cortical bone stock of at least 2mm circumferentially insufficient quality or quantity of bone resulting from cancer, congenital dislocation, or osteoporosis), systemic and metabolic disorders leading to progressive deterioration of bone (e.g., cortisone therapies or immunosuppressive therapies), and/or tumors and/or cysts of the supporting bone structures
- OA of the scaphotrapeziotrapezoidal (STT) joint based on radiographic assessment in the hand to be treated
- Any disease, including uncontrolled diabetes mellitus, which is clinically known to impact wound healing ability
- Known or suspected allergic reaction to polyvinyl alcohol
- Patient is on chronic anticoagulation due to a bleeding disorder or has taken anticoagulants within 3 days prior to surgery
- Diagnosed with cancer in the last two years and received treatment with chemotherapy or received radiation to the upper extremity to be treated with Cartiva
- Any medical condition that makes the subject unsuitable for inclusion in the study, including, but not limited to, patients with a diagnosis of concomitant injury that may interfere with healing; patients with clinically significant renal, hepatic, cardiac, endocrine, hematologic, autoimmune or any systemic disease or systemic infection which may make interpretation of the results difficult; patients who have undergone systemic administration within 30 days prior to implantation of any type of corticosteroid in the thumb, antineoplastic, immunostimulating or immunosuppressive agents
- Have participated in any other investigational or invasive clinical trial within the last three months, and will not participate in any other investigational or invasive clinical trial during this study
- Co-morbidity that reduces life expectancy to less than 12 months
- If female, be pregnant, planning to become pregnant during the course of the study, breast-feeding, or if childbearing age, is not using contraception
- Current or recent history of substance abuse (e.g., recreational drugs, narcotics, or alcohol) requiring intervention
- Is a prisoner or ward of the state
- Is unable to meet the treatment and follow up protocol requirements
- Is being compensated under workers' compensation or are currently involved in litigation that is related to the musculoskeletal system
Sites / Locations
- University of California, San Diego
- Georgia Hand, Shoulder & Elbow
- Indiana Hand to Shoulder Center
- Hospital for Specialty Surgery
- University of Rochester
- Royal Derby Hospital
- Dorset County Hospital
- Queen Alexandra Hospital
- South Tees Hospitals
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Cartiva
Arm Description
Synthetic Cartilage Implant
Outcomes
Primary Outcome Measures
Pain measured by the Visual Analog Scale (VAS) scale
Success criteria: ≥ 30% VAS decrease at 12 months. Visual Analog Scale (VAS) Pain score will be obtained from the subject for pain in the treated hand by completing a CRF, which has a 100 mm horizontal line on it, with the left end indicating that the subject has no pain and the right end of the line indicating a lot of pain. The subject will be instructed to place a mark on the horizontal line to rate the average pain in the treated thumb joint over the past week. The designated site staff will use a metric ruler to measure the markings made by the subject on the VAS to determine the VAS score.
Function measured by QuickDASH
Success criteria: ≥ 15.9 point decrease at 12 months. QuickDASH functional score will be obtained from the subject. The QuickDASH, the shortened version of the DASH (Disabilities of the Arm, Shoulder, and Hand) Outcomes Measures, is a region-specific, self-reported questionnaire that uses 11 items to measure physical function and symptoms in people with any or multiple musculoskeletal disorders of the upper limb. Subjects are asked to circle the appropriate response to each question based on their condition in the past week.
Radiographic Findings
Success criteria: Freedom from radiographic failures post-surgery through 12 months. Radiographic failures are defined as device dislocation, device fragmentation and/or development of avascular necrosis.
Key Subsequent Secondary Surgical Interventions (SSSIs)
Success criteria: Freedom from Subsequent Secondary Surgical Interventions (SSSIs) through 12 months. SSSIs are defined as revisions, removals, reoperations, and/or supplemental fixations.
Secondary Outcome Measures
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03247439
Brief Title
Safety and Effectiveness of Cartiva Implant in the Treatment of First CMC Joint Osteoarthritis Compared to LRTI (GRIP 2)
Acronym
GRIP 2
Official Title
A Prospective Study to Evaluate the Safety and Effectiveness of the Cartiva® Synthetic Cartilage Implant for CMC in the Treatment of First Carpometacarpal Joint Osteoarthritis as Compared to a Ligament Reconstruction Tendon Interposition (LRTI) Comparator
Study Type
Interventional
2. Study Status
Record Verification Date
December 2020
Overall Recruitment Status
Active, not recruiting
Study Start Date
December 22, 2017 (Actual)
Primary Completion Date
October 30, 2020 (Actual)
Study Completion Date
March 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cartiva, Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This study will evaluate whether Cartiva is an effective treatment for individuals with osteoarthritis of the first CMC joint in the hand compared to LRTI.
Detailed Description
This is a prospective, multicenter study with one treatment arm. Comparisons will be made to a performance target defined by subtracting a non-inferiority margin of 0.05 from an expected standard of care success rate of 0.55. The active treatment arm will receive a Cartiva® SCI for CMC.
A total of 74 subjects will be enrolled into the pivotal study.
Follow up visits will occur at the following time points after the surgical procedure: 2 week, 6 week, 3 month, 6 month, 1 year, 2 year, 3 year, 4 year and 5 year.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis
Keywords
CMC Joint, Osteoarthritis, Cartilage Replacement, First CMC Joint Osteoarthritis, Damaged Articular Surface, LRTI, Ligament Reconstruction Tendon Interposition
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
74 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Cartiva
Arm Type
Experimental
Arm Description
Synthetic Cartilage Implant
Intervention Type
Device
Intervention Name(s)
Cartiva
Intervention Description
Synthetic Cartilage Implant
Primary Outcome Measure Information:
Title
Pain measured by the Visual Analog Scale (VAS) scale
Description
Success criteria: ≥ 30% VAS decrease at 12 months. Visual Analog Scale (VAS) Pain score will be obtained from the subject for pain in the treated hand by completing a CRF, which has a 100 mm horizontal line on it, with the left end indicating that the subject has no pain and the right end of the line indicating a lot of pain. The subject will be instructed to place a mark on the horizontal line to rate the average pain in the treated thumb joint over the past week. The designated site staff will use a metric ruler to measure the markings made by the subject on the VAS to determine the VAS score.
Time Frame
1 year
Title
Function measured by QuickDASH
Description
Success criteria: ≥ 15.9 point decrease at 12 months. QuickDASH functional score will be obtained from the subject. The QuickDASH, the shortened version of the DASH (Disabilities of the Arm, Shoulder, and Hand) Outcomes Measures, is a region-specific, self-reported questionnaire that uses 11 items to measure physical function and symptoms in people with any or multiple musculoskeletal disorders of the upper limb. Subjects are asked to circle the appropriate response to each question based on their condition in the past week.
Time Frame
1 year
Title
Radiographic Findings
Description
Success criteria: Freedom from radiographic failures post-surgery through 12 months. Radiographic failures are defined as device dislocation, device fragmentation and/or development of avascular necrosis.
Time Frame
1 year
Title
Key Subsequent Secondary Surgical Interventions (SSSIs)
Description
Success criteria: Freedom from Subsequent Secondary Surgical Interventions (SSSIs) through 12 months. SSSIs are defined as revisions, removals, reoperations, and/or supplemental fixations.
Time Frame
1 year
10. Eligibility
Sex
All
Minimum Age & Unit of Time
22 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
≥ 22 years of age
Refractory to conservative non-operative standard of care treatment for first CMC OA lasting for at least 6 months that requires surgical intervention
Eaton classification stage II or III OA of the first CMC joint based on X-rays taken within 6 months of the Operative date and evidence of first CMC joint OA based on subjective review of associated clinical symptoms
Preoperative VAS Pain score of ≥ 40 in the treated hand
Preoperative 11 question QuickDASH score of ≥ 20
Presence of good bone stock - i.e., no need for bone graft
Capable of completing self-administered questionnaires
Be willing and able to return for all study-related follow up procedures
Have been informed of the nature of the study, agreeing to its requirements, and have signed the informed consent approved by the IRB/REB/Ethics Committee
Exclusion Criteria:
Active systemic infection
Active infection at the site of surgery
Previous CMC implant, trapeziectomy, or LRTI to the affected joint to be treated
Inflammatory arthropathy and/or diagnosis of grout
History of or current diagnosis of rheumatoid arthritis
Any significant bone loss, avascular necrosis, or cyst > 8mm of the supporting bone structure
Eaton classification stage IV advanced OA of the first CMC joint based on X-rays taken within 6 months of the Operative date
Physical conditions that would tend to eliminate adequate implant support (e.g., inadequate cortical bone stock of at least 2mm circumferentially insufficient quality or quantity of bone resulting from cancer, congenital dislocation, or osteoporosis), systemic and metabolic disorders leading to progressive deterioration of bone (e.g., cortisone therapies or immunosuppressive therapies), and/or tumors and/or cysts of the supporting bone structures
OA of the scaphotrapeziotrapezoidal (STT) joint based on radiographic assessment in the hand to be treated
Any disease, including uncontrolled diabetes mellitus, which is clinically known to impact wound healing ability
Known or suspected allergic reaction to polyvinyl alcohol
Patient is on chronic anticoagulation due to a bleeding disorder or has taken anticoagulants within 3 days prior to surgery
Diagnosed with cancer in the last two years and received treatment with chemotherapy or received radiation to the upper extremity to be treated with Cartiva
Any medical condition that makes the subject unsuitable for inclusion in the study, including, but not limited to, patients with a diagnosis of concomitant injury that may interfere with healing; patients with clinically significant renal, hepatic, cardiac, endocrine, hematologic, autoimmune or any systemic disease or systemic infection which may make interpretation of the results difficult; patients who have undergone systemic administration within 30 days prior to implantation of any type of corticosteroid in the thumb, antineoplastic, immunostimulating or immunosuppressive agents
Have participated in any other investigational or invasive clinical trial within the last three months, and will not participate in any other investigational or invasive clinical trial during this study
Co-morbidity that reduces life expectancy to less than 12 months
If female, be pregnant, planning to become pregnant during the course of the study, breast-feeding, or if childbearing age, is not using contraception
Current or recent history of substance abuse (e.g., recreational drugs, narcotics, or alcohol) requiring intervention
Is a prisoner or ward of the state
Is unable to meet the treatment and follow up protocol requirements
Is being compensated under workers' compensation or are currently involved in litigation that is related to the musculoskeletal system
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Scott Wolfe, MD
Organizational Affiliation
Hospital for Special Surgery, New York
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Christopher Bainbridge, MB ChB, FRCSEd, CCST
Organizational Affiliation
Royal Derby Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California, San Diego
City
San Diego
State/Province
California
ZIP/Postal Code
92093
Country
United States
Facility Name
Georgia Hand, Shoulder & Elbow
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30309
Country
United States
Facility Name
Indiana Hand to Shoulder Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Hospital for Specialty Surgery
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
University of Rochester
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States
Facility Name
Royal Derby Hospital
City
Derby
State/Province
Derbyshire
ZIP/Postal Code
DE22 3NE
Country
United Kingdom
Facility Name
Dorset County Hospital
City
Dorchester
State/Province
Dorset
ZIP/Postal Code
DT2 8DH
Country
United Kingdom
Facility Name
Queen Alexandra Hospital
City
Portsmouth
State/Province
Hampshire
ZIP/Postal Code
PO6 3LY
Country
United Kingdom
Facility Name
South Tees Hospitals
City
Middlesborough
State/Province
North Yorkshire
ZIP/Postal Code
TS4 3BW
Country
United Kingdom
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Safety and Effectiveness of Cartiva Implant in the Treatment of First CMC Joint Osteoarthritis Compared to LRTI (GRIP 2)
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