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OrthoPure™ XT Pilot Clinical Study

Primary Purpose

Knee Injuries, Anterior Cruciate Ligament (ACL) Reconstruction

Status
Withdrawn
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
OrthoPure™ XT
Sponsored by
TRX Orthopedics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Knee Injuries

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients who are skeletally mature, as evidenced by closed tibial and femoral epiphyses on x-rays at baseline.
  2. Patients who have been diagnosed with a partial or complete tear of the ACL as determined by MRI, require surgical reconstruction of the ACL, and are candidates for ACL surgery.
  3. Patients who have passive flexion ≥ 120°, and passive extension on the target knee is the same as the contralateral knee, in the judgment of the Investigator.
  4. Patients who have Medial Collateral Ligament (MCL) injury of Grade 2 or less.
  5. Patients with osteoarthritis of Grade 2 or less as defined radiographically on the Kellgren-Lawrence (K-L) scale.
  6. Patients who are able to give voluntary, written informed consent to participate and have signed an Informed Consent Form specific to this study.
  7. Patients who are willing and able to comply with all study procedures including all pre-operative, post-operative and rehabilitation requirements.
  8. If female and of child-bearing potential, patients who have a negative urine pregnancy test at Visit 2 and have no intention to become pregnant in the next 24 months.

Exclusion Criteria:

  1. Patients with Body Mass Index (BMI) greater than 35 kg/m2.
  2. Patients presenting with osteoarthritis of the target knee e.g. International Cartilage Repair Society (ICRS) Grade III or higher as determined by their baseline MRI scan.
  3. Patients who have had previous ACL reconstruction on the target knee.
  4. Patients who have had any other type of surgical procedure on the target knee in the 3 months prior to Visit 1.
  5. Patients with ligament instability, osteoarthritis greater than Grade 2 or a current ACL injury in the contralateral knee.
  6. Patients with a complete or partial Lateral Collateral Ligament (LCL) tear or Posterior Cruciate Ligament (PCL) tear on the target knee.
  7. Patients with meniscal repairs and tears requiring more than one third (1/3) removal of the meniscus on the target knee as determined during knee arthroscopy.
  8. Patients who have an active systemic infection, or an active local infection in or near the target knee, or have a previous history of joint infection.
  9. Patients who are participating concurrently in another clinical trial, or have participated in a clinical trial within the last 90 days, or intend to during the course of the study.
  10. Patients who have previously been implanted with any type of xenograft device.
  11. Patients with known immunodeficiency including patients who are receiving or have received corticosteroids, immunosuppressants, immunostimulating agents or radiation therapy within 6 months of Visit 1.
  12. Patients who have conditions that may be exacerbated by, or may interfere with the results of the skin prick test.
  13. Patients with significant comorbidities or conditions associated with high risk for surgical or anesthetic survival (e.g. renal failure, peripheral vascular disease, unstable cardiac disease, poorly controlled diabetes, immunosuppression, etc.).
  14. Patients with active neoplastic disease.
  15. Patients with known allergy to mammalian meat, porcine products or a religious objection to the use of implanted porcine material.
  16. Patients with current drug or alcohol abuse, or a history of the same within the last 6 months.
  17. Patients with local circulatory problems, (e.g. thrombophlebitis and lymphedema).
  18. Patients with any mental or psychological disorder that would impair their ability to complete the study questionnaires.
  19. Patients with any medical condition or other circumstances that might interfere with their ability to return for follow-up visits in the judgment of the Investigator, including any systemic illness, neuromuscular, neurosensory, or musculoskeletal deficiency that would render the patient unable to perform appropriate postoperative rehabilitation.
  20. Any condition which, in the judgment of the Investigator, would preclude adequate evaluation of device's safety and performance.

    -

Sites / Locations

  • St.Joseph's Outpatient Surgery Center
  • OrthoIndy Hospital South
  • Jewish Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Experimental

Arm Description

Reconstruction of the Anterior Cruciate Ligament (ACL) using OrthoPure™ XT in patients with a partial or complete tear of the Anterior Cruciate Ligament (ACL)

Outcomes

Primary Outcome Measures

Assessment of anti-Gal IgG antibody levels
Blood sample collection for measurement of immune response
Measurement of serum chemistry
Blood sample analysis
Incidence of secondary surgical interventions (SSIs)
The frequency and seriousness of any secondary surgical interventions will be assessed.
Incidence of individual Adverse Events
The frequency and seriousness of any adverse events or adverse device.effects will be assessed.

Secondary Outcome Measures

Improvement in knee stability - Pivot Shift Test
Measured by the assessment of change in the anterior cruciate instability in the treated knee
Improvement in knee stability - Lachman test
Measured by clinical examination of the treated knee (assessment of anterior translation), more than about 2 mm of anterior translation compared to the normal opposite knee suggests an ACL tear
Improvement in knee stability - Anterior Drawer Test
Clinical assessment of the treated knee, an increased amount of anterior tibial translation compared with the opposite, normal knee can indicate an ACL tear. If the tibia pulls forward or backward more than normal, the test is considered positive
Arthrometric measurement of knee joint laxity
Comparison of the side-to-side differences in mm between the treated knee and the opposite normal knee using an arthrometric ligament testing device
Improvement in pain and function of the knee measured by questionnaires
Patient's subjective score of 1 to 100 points, with 100 implying the best results and 1 the worse results
Evidence of integration of the investigational product
MRI assessments
Improvement in quality of life
A questionnaire on the self-assessment of health condition reflecting the physical condition and mental health
Assessment of investigational device usability
Surgeon assessment of the device (questionnaire), rate from excellent to poor
Assessment on Bone Tunnel Position
To be assessed via X Ray

Full Information

First Posted
May 18, 2018
Last Updated
November 19, 2018
Sponsor
TRX Orthopedics
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1. Study Identification

Unique Protocol Identification Number
NCT03562299
Brief Title
OrthoPure™ XT Pilot Clinical Study
Official Title
A Prospective, Non-comparative Pilot Clinical Study of a Novel Xenograft Device for Reconstruction of the Anterior Cruciate Ligament.
Study Type
Interventional

2. Study Status

Record Verification Date
November 2018
Overall Recruitment Status
Withdrawn
Why Stopped
Unspecified business decision/strategic reason.
Study Start Date
July 2018 (Anticipated)
Primary Completion Date
December 2020 (Anticipated)
Study Completion Date
December 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
TRX Orthopedics

4. Oversight

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

5. Study Description

Brief Summary
To evaluate the clinical safety and obtain preliminary effectiveness data for OrthoPure™ XT device in a small group of US patients at 12 and 24 months. The clinical experience obtained from this study will be used to develop a pivotal study for follow up in a larger patient population.
Detailed Description
The OrthoPure™ XT device is a decellularized, sterile, single use biological scaffold for use in the treatment of patients with a partial or complete tear of the Anterior Cruciate Ligament (ACL) who require surgical reconstruction of the ACL. This is a Pilot Safety Study. The primary objective of this study is to evaluate the clinical safety of the OrthoPure™ XT device in a small group of patients that require reconstruction of the Anterior Cruciate Ligament (ACL) due to partial or complete tear of the ACL. Clinical safety will be analyzed through measurement of immune response (alpha-Gal IgG), blood and urine analysis, incidence of secondary surgical interventions with the treated knee, and the incidence of individual adverse events. The second objectives of this study are to assess the efficacy endpoints, specifically: improvement in knee stability, function and pain; improvement in patient quality of life and radiographic analysis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Injuries, Anterior Cruciate Ligament (ACL) Reconstruction

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Experimental
Arm Type
Experimental
Arm Description
Reconstruction of the Anterior Cruciate Ligament (ACL) using OrthoPure™ XT in patients with a partial or complete tear of the Anterior Cruciate Ligament (ACL)
Intervention Type
Device
Intervention Name(s)
OrthoPure™ XT
Intervention Description
A decellularized, sterile, single use, xenograft device for reconstruction of the anterior cruciate ligament
Primary Outcome Measure Information:
Title
Assessment of anti-Gal IgG antibody levels
Description
Blood sample collection for measurement of immune response
Time Frame
profile up to 24 months
Title
Measurement of serum chemistry
Description
Blood sample analysis
Time Frame
up to 24 months
Title
Incidence of secondary surgical interventions (SSIs)
Description
The frequency and seriousness of any secondary surgical interventions will be assessed.
Time Frame
up to 24 months
Title
Incidence of individual Adverse Events
Description
The frequency and seriousness of any adverse events or adverse device.effects will be assessed.
Time Frame
up to 24 months
Secondary Outcome Measure Information:
Title
Improvement in knee stability - Pivot Shift Test
Description
Measured by the assessment of change in the anterior cruciate instability in the treated knee
Time Frame
3, 6, 12 and 24 months
Title
Improvement in knee stability - Lachman test
Description
Measured by clinical examination of the treated knee (assessment of anterior translation), more than about 2 mm of anterior translation compared to the normal opposite knee suggests an ACL tear
Time Frame
3, 6, 12 and 24 months
Title
Improvement in knee stability - Anterior Drawer Test
Description
Clinical assessment of the treated knee, an increased amount of anterior tibial translation compared with the opposite, normal knee can indicate an ACL tear. If the tibia pulls forward or backward more than normal, the test is considered positive
Time Frame
3, 6, 12 and 24 months
Title
Arthrometric measurement of knee joint laxity
Description
Comparison of the side-to-side differences in mm between the treated knee and the opposite normal knee using an arthrometric ligament testing device
Time Frame
3, 6, 12 and 24 months
Title
Improvement in pain and function of the knee measured by questionnaires
Description
Patient's subjective score of 1 to 100 points, with 100 implying the best results and 1 the worse results
Time Frame
6,12 and 24 months
Title
Evidence of integration of the investigational product
Description
MRI assessments
Time Frame
3, 6, 12 and 24 months
Title
Improvement in quality of life
Description
A questionnaire on the self-assessment of health condition reflecting the physical condition and mental health
Time Frame
3, 6, 12 and 24 months
Title
Assessment of investigational device usability
Description
Surgeon assessment of the device (questionnaire), rate from excellent to poor
Time Frame
Day 0
Title
Assessment on Bone Tunnel Position
Description
To be assessed via X Ray
Time Frame
2 weeks, 6 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients who are skeletally mature, as evidenced by closed tibial and femoral epiphyses on x-rays at baseline. Patients who have been diagnosed with a partial or complete tear of the ACL as determined by MRI, require surgical reconstruction of the ACL, and are candidates for ACL surgery. Patients who have passive flexion ≥ 120°, and passive extension on the target knee is the same as the contralateral knee, in the judgment of the Investigator. Patients who have Medial Collateral Ligament (MCL) injury of Grade 2 or less. Patients with osteoarthritis of Grade 2 or less as defined radiographically on the Kellgren-Lawrence (K-L) scale. Patients who are able to give voluntary, written informed consent to participate and have signed an Informed Consent Form specific to this study. Patients who are willing and able to comply with all study procedures including all pre-operative, post-operative and rehabilitation requirements. If female and of child-bearing potential, patients who have a negative urine pregnancy test at Visit 2 and have no intention to become pregnant in the next 24 months. Exclusion Criteria: Patients with Body Mass Index (BMI) greater than 35 kg/m2. Patients presenting with osteoarthritis of the target knee e.g. International Cartilage Repair Society (ICRS) Grade III or higher as determined by their baseline MRI scan. Patients who have had previous ACL reconstruction on the target knee. Patients who have had any other type of surgical procedure on the target knee in the 3 months prior to Visit 1. Patients with ligament instability, osteoarthritis greater than Grade 2 or a current ACL injury in the contralateral knee. Patients with a complete or partial Lateral Collateral Ligament (LCL) tear or Posterior Cruciate Ligament (PCL) tear on the target knee. Patients with meniscal repairs and tears requiring more than one third (1/3) removal of the meniscus on the target knee as determined during knee arthroscopy. Patients who have an active systemic infection, or an active local infection in or near the target knee, or have a previous history of joint infection. Patients who are participating concurrently in another clinical trial, or have participated in a clinical trial within the last 90 days, or intend to during the course of the study. Patients who have previously been implanted with any type of xenograft device. Patients with known immunodeficiency including patients who are receiving or have received corticosteroids, immunosuppressants, immunostimulating agents or radiation therapy within 6 months of Visit 1. Patients who have conditions that may be exacerbated by, or may interfere with the results of the skin prick test. Patients with significant comorbidities or conditions associated with high risk for surgical or anesthetic survival (e.g. renal failure, peripheral vascular disease, unstable cardiac disease, poorly controlled diabetes, immunosuppression, etc.). Patients with active neoplastic disease. Patients with known allergy to mammalian meat, porcine products or a religious objection to the use of implanted porcine material. Patients with current drug or alcohol abuse, or a history of the same within the last 6 months. Patients with local circulatory problems, (e.g. thrombophlebitis and lymphedema). Patients with any mental or psychological disorder that would impair their ability to complete the study questionnaires. Patients with any medical condition or other circumstances that might interfere with their ability to return for follow-up visits in the judgment of the Investigator, including any systemic illness, neuromuscular, neurosensory, or musculoskeletal deficiency that would render the patient unable to perform appropriate postoperative rehabilitation. Any condition which, in the judgment of the Investigator, would preclude adequate evaluation of device's safety and performance. -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tom Carter
Organizational Affiliation
St. Joseph's Outpatient Surgery Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jack Farr
Organizational Affiliation
OrthoIndy Hospital South
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
David Caborn
Organizational Affiliation
Jewish Hospital and St. Mary's Healthcare
Official's Role
Principal Investigator
Facility Information:
Facility Name
St.Joseph's Outpatient Surgery Center
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85013
Country
United States
Facility Name
OrthoIndy Hospital South
City
Greenwood
State/Province
Indiana
ZIP/Postal Code
46143
Country
United States
Facility Name
Jewish Hospital
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States

12. IPD Sharing Statement

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OrthoPure™ XT Pilot Clinical Study

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