Number One Overall Graft Pick? Hamstring vs Bone-Patellar-Tendon-Bone vs Quadriceps Tendon
Primary Purpose
Anterior Cruciate Ligament Rupture
Status
Active
Phase
Not Applicable
Locations
Canada
Study Type
Interventional
Intervention
ACL reconstruction - graft choice
Sponsored by
About this trial
This is an interventional treatment trial for Anterior Cruciate Ligament Rupture focused on measuring Graft choice, hamstring, quadriceps tendon
Eligibility Criteria
Inclusion Criteria:
- - confirmed diagnosis of a complete primary unilateral ACL rupture based on all of the following:
- history of a traumatic injury episode
- physical exam findings of increased anterior translation of the tibia on the femur (Lachman test and/or anterior drawer test)
- positive pivot shift test
- patients must be 14 to </= 50 years (at time of surgery)
- x-rays showing skeletal maturity (i.e. tibial tubercle fused) and no fractures
- MRI prior to surgery (note: if the radiologist's report states an incomplete or partial ACL on MRI but the surgeon diagnoses the patient with a complete unilateral tear based on the clinical criteria above, then the patient will be considered eligible. Final eligibility will be determined intra-operatively.)
Exclusion Criteria:
- - ACL rupture on contra-lateral limb
- Partially torn ACL *final determination made intra-operatively
- Concomitant medial collateral, lateral collateral, or posterior collateral ligament tears requiring surgical repair *final determination made intra-operatively
- Severe chondromalacia (Grade IV on the ICRS scale) *final determination made intra-operatively
- ACL reconstruction using allograft tissue
- Confirmed connective tissue disorder
- Unwillingness to be followed for 24 months post-operatively
- History of rheumatoid arthritis
- Pregnancy (at the time of surgery)
- Psychiatric illness that precludes informed consent
- Unable to speak, read or understand the English language
- Major medical illness (life expectancy less than 1 year or unacceptably high operative risk)
Sites / Locations
- Pan Am Clinic
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Active Comparator
Active Comparator
Active Comparator
Arm Label
Quads tendon
Hamstring
BPTB
Arm Description
The graft tissue will be quadriceps tendon
Semitendinosus and gracilis will be used for graft
Bone patellar tendon bone graft to be used.
Outcomes
Primary Outcome Measures
graft re-injury (re-rupture, partial tear) or graft failure
) Diagnosis of a complete graft re-rupture requires all of the following criteria to be met:
associated with an acute traumatic event
a definite loss of end point on manual Lachman testing
increased anterior translation >3 mm
> or = Grade 2 pivot shift
tear confirmed as complete on MRI or diagnostic arthroscopy
revision ACL reconstruction IS recommended or required
2) Diagnosis of a partial re-rupture requires all of the following criteria:
suspected meniscal injury or graft tear on history without the clinical characteristics of a complete rupture
tear confirmed as partial by MRI or diagnostic arthroscopy
revision ACL reconstruction is NOT recommended or required
3) Diagnosis of graft failure will be defined as:
>/= Gr. 2 pivot shift and/or >6 mm side-to-side difference on manual Lachman
Secondary Outcome Measures
SANE
Knee laxity
KT1000 Knee Laxity Arthrometer
Concentric maximal strength
Knee flexion and extension strength - biodex
Pain log
type and quantity of pain medication use
ACL-QOL
SF-12
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03671421
Brief Title
Number One Overall Graft Pick? Hamstring vs Bone-Patellar-Tendon-Bone vs Quadriceps Tendon
Official Title
Number One Overall Graft Pick? Hamstring vs Bone-Patellar-Tendon-Bone vs Quadriceps Tendon: A Prospective Cohort Study
Study Type
Interventional
2. Study Status
Record Verification Date
March 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 11, 2018 (Actual)
Primary Completion Date
November 30, 2024 (Anticipated)
Study Completion Date
November 30, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Panam Clinic
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The main purpose of this study is to determine if there is a difference in graft re-injury/failure rates between participants that have had an ACL reconstruction with a STG, BPTB or QT autograft. Additionally, to compare quality of life, patient reported outcomes and functional performance after ACL reconstruction with STG, BPTB and QT.
Detailed Description
The main purpose of this study is to determine if there is a difference in graft re-injury/failure rates between participants that have had an ACL reconstruction with a STG, BPTB or QT autograft. Additionally, to compare quality of life, patient reported outcomes and functional performance after ACL reconstruction with STG, BPTB and QT.
Quasi-randomized clinical trial
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Anterior Cruciate Ligament Rupture
Keywords
Graft choice, hamstring, quadriceps tendon
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Prospective quasi-randomized clinical trial
Masking
Outcomes Assessor
Masking Description
The clinical assessments will be done by someone blinded to the arm of the study the patient is in.
Allocation
Non-Randomized
Enrollment
297 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Quads tendon
Arm Type
Active Comparator
Arm Description
The graft tissue will be quadriceps tendon
Arm Title
Hamstring
Arm Type
Active Comparator
Arm Description
Semitendinosus and gracilis will be used for graft
Arm Title
BPTB
Arm Type
Active Comparator
Arm Description
Bone patellar tendon bone graft to be used.
Intervention Type
Procedure
Intervention Name(s)
ACL reconstruction - graft choice
Intervention Description
Use of 3 different ipsilateral autograft options
Primary Outcome Measure Information:
Title
graft re-injury (re-rupture, partial tear) or graft failure
Description
) Diagnosis of a complete graft re-rupture requires all of the following criteria to be met:
associated with an acute traumatic event
a definite loss of end point on manual Lachman testing
increased anterior translation >3 mm
> or = Grade 2 pivot shift
tear confirmed as complete on MRI or diagnostic arthroscopy
revision ACL reconstruction IS recommended or required
2) Diagnosis of a partial re-rupture requires all of the following criteria:
suspected meniscal injury or graft tear on history without the clinical characteristics of a complete rupture
tear confirmed as partial by MRI or diagnostic arthroscopy
revision ACL reconstruction is NOT recommended or required
3) Diagnosis of graft failure will be defined as:
>/= Gr. 2 pivot shift and/or >6 mm side-to-side difference on manual Lachman
Time Frame
24 months
Secondary Outcome Measure Information:
Title
SANE
Time Frame
24 months
Title
Knee laxity
Description
KT1000 Knee Laxity Arthrometer
Time Frame
24 months
Title
Concentric maximal strength
Description
Knee flexion and extension strength - biodex
Time Frame
24 months
Title
Pain log
Description
type and quantity of pain medication use
Time Frame
3 weeks post operative
Title
ACL-QOL
Time Frame
24 months
Title
SF-12
Time Frame
24 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
14 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
- confirmed diagnosis of a complete primary unilateral ACL rupture based on all of the following:
history of a traumatic injury episode
physical exam findings of increased anterior translation of the tibia on the femur (Lachman test and/or anterior drawer test)
positive pivot shift test
patients must be 14 to </= 50 years (at time of surgery)
x-rays showing skeletal maturity (i.e. tibial tubercle fused) and no fractures
MRI prior to surgery (note: if the radiologist's report states an incomplete or partial ACL on MRI but the surgeon diagnoses the patient with a complete unilateral tear based on the clinical criteria above, then the patient will be considered eligible. Final eligibility will be determined intra-operatively.)
Exclusion Criteria:
- ACL rupture on contra-lateral limb
Partially torn ACL *final determination made intra-operatively
Concomitant medial collateral, lateral collateral, or posterior collateral ligament tears requiring surgical repair *final determination made intra-operatively
Severe chondromalacia (Grade IV on the ICRS scale) *final determination made intra-operatively
ACL reconstruction using allograft tissue
Confirmed connective tissue disorder
Unwillingness to be followed for 24 months post-operatively
History of rheumatoid arthritis
Pregnancy (at the time of surgery)
Psychiatric illness that precludes informed consent
Unable to speak, read or understand the English language
Major medical illness (life expectancy less than 1 year or unacceptably high operative risk)
Facility Information:
Facility Name
Pan Am Clinic
City
Winnipeg
State/Province
Manitoba
ZIP/Postal Code
R3M3E4
Country
Canada
12. IPD Sharing Statement
Plan to Share IPD
No
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Number One Overall Graft Pick? Hamstring vs Bone-Patellar-Tendon-Bone vs Quadriceps Tendon
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