Outcomes Following Combined Adductoplasty™ and Lapiplasty® (MTA3D) (MTA3D)
Primary Purpose
Metatarsus Adductus, Hallux Valgus
Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Treatment of metatarsus adductus and hallux valgus with the Adductoplasty™ Procedure in combination with the Lapiplasty® Procedure
Sponsored by
About this trial
This is an interventional treatment trial for Metatarsus Adductus focused on measuring Metatarsus Adductus, Hallux Valgus, MTA3D
Eligibility Criteria
Inclusion Criteria:
- Male and females between the ages 14 and 60 years at the time of consent
- Closed physeal plates at the time of consent
- Intermetatarsal angle is between 8.0˚ - 22.0˚; OR True IMA of >10°, (IMA+MTA-15=True IMA)
- Hallux valgus angle is between 12.0˚ - 50.0˚
- Metatarsus adductus angle based on Sgarlatos method >15° and <40°
- Willing and able to adhere to post-op care instructions
- Capable of completing self-administered questionnaires
- Acceptable surgical candidate, including use of general anesthesia
- Female patients must be of non-childbearing potential or have a negative pregnancy test in accordance with hospital standards prior to the Index Procedure
- Willing and able to schedule index procedure within 3 months of consent and able to return for scheduled follow-up visits
- Willing and able to provide written informed consent
- Patient agrees to refrain from any reconstructive procedures on contralateral foot for minimum of 6 months post index procedure
Exclusion Criteria:
- Previous surgery for hallux valgus on operative side
- Previous surgeries on operative foot involving fusion of foot or ankle joints (other than hammertoe or lesser toes/digits)
- Osteoarthritis of the foot or ankle outside of the 1st, 2nd or 3rd tarsometatarsal joints
- Moderate-severe osteoarthritis of the 1st, 2nd or 3rd tarsometatarsal joints
- Symptomatic flatfoot or asymptomatic flatfoot (defined as calcaneal inclination <5˚and talonavicular subluxation/uncovering >50%)
- BMI >40 kg/m²
- Current nicotine user in any form including vaping, smoking, oral ingestion or use of nicotine patch
- Current clinical diagnosis of diabetes or currently taking medication for treatment of diabetes
- Current clinical diagnosis of peripheral neuropathy
- Current clinical diagnosis of fibromyalgia
- Current clinical diagnosis of Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy (CRPS/RSD)
- Current uncontrolled hypothyroidism
- Current clinical diagnosis of chronic dependent edema
- Previously sensitized to titanium
- Currently taking oral steroids or rheumatoid biologics
- Currently taking immunosuppressant drugs
- Insufficient quantity or quality of bone to permit stabilization, conditions that inhibit healing (not including pathological fractures) and conditions causing poor blood supply such as peripheral vascular disease
- Active, suspected, or latent infection in the affected area
- Use of synthetic or allogenic bone graft substitutes
- Use of non-Treace products for Index Procedure
- Additional bone procedure needed during the index procedure to complete correction (additional metatarsal or tarsal bone osteotomy or fusion, first MTP fusion, calcaneal osteotomy, traditional medial eminence resection);
- Scheduled to undergo a same-day bilateral procedure
- Patient has previously been enrolled into this study for a contralateral procedure
- Scheduled for any concomitant procedure that would alter patient's ability to weight-bear post-procedure
- Patient is actively involved with a workman's compensation case or is currently involved in litigation
- Patient is currently in, or has participated in, a clinical study in the last 30 days prior to signing informed consent or is considering participation in another research protocol during this study. Exceptions to this include survey clinical studies with no treatment or if subject is greater than 12 months post procedure in either the Treace ALIGN3D™ or Mini3D™ Study without ongoing protocol defined AE
- Patient has a condition or finding that, in the opinion of the Investigator, may jeopardize the patient's well-being, the soundness of this clinical study, or could interfere with provision of informed consent, completion of tests, therapy, or follow-up
Sites / Locations
- Foot and Ankle Center of the RockiesRecruiting
- Foot and Ankle Center of IowaRecruiting
- Coastal Maine Foot and AnkleRecruiting
- JCMG - Jefferson City Medical GroupRecruiting
- Ohio Foot and Ankle CenterRecruiting
- Ohio Foot and Ankle CenterRecruiting
- Greater Pittsburgh Foot and Ankle CenterRecruiting
- Foot and Ankle Associates of North Texas - KellerRecruiting
Outcomes
Primary Outcome Measures
Sustained Radiographic Correction of the Following: Intermetatarsal Angle (IMA), Hallux Valgus Angle (HVA), Tibial Sesamoid Position (TSP), and Metatarsus Adductus Angle (MAA)
Sustained radiographic correction of hallux valgus deformity with metatarsus adductus. Sustained correction is defined by measured Intermetatarsal Angle (IMA) <12.0 degrees, Hallux Valgus Angle (HVA) <20.0 degrees, Tibial Sesamoid Position (TSP) as ≤3 and ≥50 percent Metatarsus Adductus (MAA) correction (compared to baseline) at 24 months.
Secondary Outcome Measures
Union vs non-Union
Evaluate clinical/radiographic healing (union vs non-union).
Clinical Complications
Clinical complications due to system implants the post-op instructions or health conditions that could affect other outcome measures.
Weight-Bearing Recovery Time
Assessment of weight-bearing recovery time following the procedures. Weight-bearing will be measured in days and recorded based upon individual surgeon recovery protocol.
Time to Weight-Bear in Boot
Time to start of weight-bearing in boot, in days.
Time to Weight-Bear in Shoes
Time to start of weight-bearing in shoes, in days.
Time to Return to Unrestricted Activity
Time to return to full unrestricted activity, in days.
Change in Pain
Change in pain at the base of the big toe (bunion related), as well as the midfoot region for the operative foot only, assessed via the Visual Analog Scale (VAS) with 0-10 minimum and maximum values - with 0 being a better outcome and 10 being a worse outcome.
Change in Quality of Life
Change in Quality of Life, (PROMIS-29/PROMIS-25 and MOxFQ) defined as the total domain score measured.
Change in Range of Motion
Change in Range of Motion - 1st MTP dorsiflexion and plantarflexion
Change in Osseous Foot Width
Change in osseous foot width - radiographically
Full Information
NCT ID
NCT05587569
First Posted
October 10, 2022
Last Updated
October 3, 2023
Sponsor
Treace Medical Concepts, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT05587569
Brief Title
Outcomes Following Combined Adductoplasty™ and Lapiplasty® (MTA3D)
Acronym
MTA3D
Official Title
Radiographic and Patient Reported Outcomes Following Combined Adductoplasty™ and Lapiplasty® Procedures for Correction of Metatarsus Adductus and Hallux Valgus (MTA3D)
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 28, 2022 (Actual)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
December 31, 2029 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Treace Medical Concepts, Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Prospective, multicenter, unblinded study to evaluate outcomes of the Adductoplasty™ Procedure in combination with the Lapiplasty® Procedure for patients in need of metatarsus adductus and hallux valgus correction.
Up to 80 subjects will be treated in this study at up to 10 clinical sites. Patients 14 years through 65 years with symptomatic metatarsus adductus and hallux valgus will be eligible to participate based on the inclusion and exclusion criteria defined in the study protocol.
Detailed Description
The objectives of this study are to evaluate outcomes of the Adductoplasty™ Procedure combined with the Lapiplasty® Procedure for patients in need of hallux valgus and metatarsus adductus surgery:
To evaluate the quality of life and pain scores following the Adductoplasty™ Procedure in combination with the Lapiplasty® Procedure.
To determine whether the Adductoplasty™ Procedure in combination with the Lapiplasty® Procedure, effectively corrects and maintains triplane anatomical alignment of the 1st, 2nd and 3rd metatarsals, the hallux position, the sesamoid position, and the foot width.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Metatarsus Adductus, Hallux Valgus
Keywords
Metatarsus Adductus, Hallux Valgus, MTA3D
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
80 (Anticipated)
8. Arms, Groups, and Interventions
Intervention Type
Device
Intervention Name(s)
Treatment of metatarsus adductus and hallux valgus with the Adductoplasty™ Procedure in combination with the Lapiplasty® Procedure
Other Intervention Name(s)
Adductoplasty™ Procedure in combination with the Lapiplasty® Procedure
Intervention Description
Patients 14 years through 65 years with symptomatic metatarsus adductus and hallux valgus will be eligible to participate based on the inclusion/exclusion criteria established in the study protocol. Anticipated study duration will be 5 years post index procedure.
Primary Outcome Measure Information:
Title
Sustained Radiographic Correction of the Following: Intermetatarsal Angle (IMA), Hallux Valgus Angle (HVA), Tibial Sesamoid Position (TSP), and Metatarsus Adductus Angle (MAA)
Description
Sustained radiographic correction of hallux valgus deformity with metatarsus adductus. Sustained correction is defined by measured Intermetatarsal Angle (IMA) <12.0 degrees, Hallux Valgus Angle (HVA) <20.0 degrees, Tibial Sesamoid Position (TSP) as ≤3 and ≥50 percent Metatarsus Adductus (MAA) correction (compared to baseline) at 24 months.
Time Frame
24 Months
Secondary Outcome Measure Information:
Title
Union vs non-Union
Description
Evaluate clinical/radiographic healing (union vs non-union).
Time Frame
12 Months
Title
Clinical Complications
Description
Clinical complications due to system implants the post-op instructions or health conditions that could affect other outcome measures.
Time Frame
60 Months
Title
Weight-Bearing Recovery Time
Description
Assessment of weight-bearing recovery time following the procedures. Weight-bearing will be measured in days and recorded based upon individual surgeon recovery protocol.
Time Frame
12 Months
Title
Time to Weight-Bear in Boot
Description
Time to start of weight-bearing in boot, in days.
Time Frame
6 Weeks
Title
Time to Weight-Bear in Shoes
Description
Time to start of weight-bearing in shoes, in days.
Time Frame
8 Weeks
Title
Time to Return to Unrestricted Activity
Description
Time to return to full unrestricted activity, in days.
Time Frame
6 weeks - 6 months, post Lapiplasty® Procedure
Title
Change in Pain
Description
Change in pain at the base of the big toe (bunion related), as well as the midfoot region for the operative foot only, assessed via the Visual Analog Scale (VAS) with 0-10 minimum and maximum values - with 0 being a better outcome and 10 being a worse outcome.
Time Frame
0-3 weeks, 6 weeks, 4 months, 6 months, 12 months, 24 months, 36 months, 48 months and 60 months post- Adductoplasty™ Procedure in combination with the Lapiplasty® Procedure, in comparison to baseline visit pain.
Title
Change in Quality of Life
Description
Change in Quality of Life, (PROMIS-29/PROMIS-25 and MOxFQ) defined as the total domain score measured.
Time Frame
6 months, 12 months, 24 months, 36 months, 48 months and 60 months post-Adductoplasty™ Procedure and Lapiplasty® Procedure, in comparison to baseline visit
Title
Change in Range of Motion
Description
Change in Range of Motion - 1st MTP dorsiflexion and plantarflexion
Time Frame
12 months, 24 months, 36 months, 48 months and 60 months post- Adductoplasty™ Procedure and Lapiplasty® Procedure, in comparison to baseline visit
Title
Change in Osseous Foot Width
Description
Change in osseous foot width - radiographically
Time Frame
12 months and 24 months post - Adductoplasty™ Procedure and Lapiplasty® Procedure, in comparison to baseline visit
10. Eligibility
Sex
All
Minimum Age & Unit of Time
14 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Male and females between the ages 14 and 65 years at the time of consent
Closed physeal plates at the time of consent
Intermetatarsal angle is between 8.0˚ - 22.0˚; OR True IMA of >10°, (IMA+MTA-15=True IMA)
Hallux valgus angle is between 12.0˚ - 50.0˚
Metatarsus adductus angle based on Sgarlatos method >15° and <40°
Willing and able to adhere to post-op care instructions
Capable of completing self-administered questionnaires
Acceptable surgical candidate, including use of general anesthesia
Female patients must be of non-childbearing potential or have a negative pregnancy test in accordance with hospital standards prior to the Index Procedure
Willing and able to schedule index procedure within 3 months of consent and able to return for scheduled follow-up visits
Willing and able to provide written informed consent
Patient agrees to refrain from any reconstructive procedures on contralateral foot for minimum of 6 months post index procedure
Exclusion Criteria:
Previous surgery for hallux valgus on operative side
Previous surgeries on operative foot involving fusion of foot or ankle joints (other than hammertoe or lesser toes/digits)
Moderate-severe osteoarthritis of the foot or ankle outside of the 1st, 2nd or 3rd tarsometatarsal joints
Moderate-severe osteoarthritis of the 1st, 2nd or 3rd tarsometatarsal joints
Symptomatic flatfoot or asymptomatic flatfoot (defined as calcaneal inclination <5˚and talonavicular subluxation/uncovering >50%)
BMI >40 kg/m²
Current nicotine user in any form including vaping, smoking, oral ingestion or use of nicotine patch
Current clinical diagnosis of diabetes or currently taking medication for treatment of diabetes
Current clinical diagnosis of peripheral neuropathy
Current clinical diagnosis of fibromyalgia
Current clinical diagnosis of Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy (CRPS/RSD)
Current uncontrolled hypothyroidism
Current clinical diagnosis of chronic dependent edema
Previously sensitized to titanium
Currently taking oral steroids or rheumatoid biologics
Currently taking immunosuppressant drugs
Insufficient quantity or quality of bone to permit stabilization, conditions that inhibit healing (not including pathological fractures) and conditions causing poor blood supply such as peripheral vascular disease
Active, suspected, or latent infection in the affected area
Use of synthetic or allogenic bone graft substitutes
Use of non-Treace products for Index Procedure
Additional bone procedure needed during the index procedure to complete correction (additional metatarsal or tarsal bone osteotomy or fusion, first MTP fusion, calcaneal osteotomy, traditional medial eminence resection);
Scheduled to undergo a same-day bilateral procedure
Patient has previously been enrolled into this study for a contralateral procedure
Scheduled for any concomitant procedure that would alter patient's ability to weight-bear post-procedure
Patient is actively involved with a workman's compensation case or is currently involved in litigation
Patient is currently in, or has participated in, a clinical study in the last 30 days prior to signing informed consent or is considering participation in another research protocol during this study. Exceptions to this include survey clinical studies with no treatment or if subject is greater than 12 months post procedure in either the Treace ALIGN3D™ or Mini3D™ Study without ongoing protocol defined AE
Patient has a condition or finding that, in the opinion of the Investigator, may jeopardize the patient's well-being, the soundness of this clinical study, or could interfere with provision of informed consent, completion of tests, therapy, or follow-up
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Cara Bethell
Phone
(904) 373-5940
Ext
1317
Email
cbethell@treace.net
First Name & Middle Initial & Last Name or Official Title & Degree
Shana Zink
Phone
(513) 265-0621
Email
szink@treace.net
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Paul Dayton, DPM
Organizational Affiliation
Foot and Ankle Center of Iowa
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Mark Easley, MD
Organizational Affiliation
Duke University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Foot and Ankle Center of the Rockies
City
Greeley
State/Province
Colorado
ZIP/Postal Code
80634
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Daniel Hatch, DPM
Phone
970-351-0900
Email
dhatch@facrockies.com
First Name & Middle Initial & Last Name & Degree
Kendi Randolph
Phone
(970) 351-0900
Email
kendirandolph@ankleandfootcenters.com
Facility Name
Foot and Ankle Center of Iowa
City
Ankeny
State/Province
Iowa
ZIP/Postal Code
50023
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mindi Dayton, DPM
Phone
515-639-3775
Email
mindi.dayton@icloud.com
First Name & Middle Initial & Last Name & Degree
Paul Dayton, DPM
First Name & Middle Initial & Last Name & Degree
Mindi Dayton, DPM
First Name & Middle Initial & Last Name & Degree
Jesseka Kaldenberg-Leppert, DPM
Facility Name
Coastal Maine Foot and Ankle
City
Yarmouth
State/Province
Maine
ZIP/Postal Code
04096
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Barry White, DPM
Phone
207-888-3640
Email
Footdocbmw@outlook.com
First Name & Middle Initial & Last Name & Degree
Barry White, DPM
Facility Name
JCMG - Jefferson City Medical Group
City
Jefferson City
State/Province
Missouri
ZIP/Postal Code
65019
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jody McAleer, DPM
Phone
573-556-7724
Email
jmcaleer@jcmg.org
First Name & Middle Initial & Last Name & Degree
Lisa Bruns
Phone
(573) 556-7724
Email
lisa.bruns@avacare.com
First Name & Middle Initial & Last Name & Degree
Jody McAleer, DPM
Facility Name
Ohio Foot and Ankle Center
City
Canton
State/Province
Ohio
ZIP/Postal Code
44708
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Aaron Chokan, DPM
Phone
330-447-4400
Email
drchokan@gmail.com
First Name & Middle Initial & Last Name & Degree
Aaron Chokan, DPM
Facility Name
Ohio Foot and Ankle Center
City
Stow
State/Province
Ohio
ZIP/Postal Code
44224
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Aaron Chokan, DPM
Phone
330-929-3331
Email
drchokan@gmail.com
First Name & Middle Initial & Last Name & Degree
Aaron Chokan, DPM
Facility Name
Greater Pittsburgh Foot and Ankle Center
City
Wexford
State/Province
Pennsylvania
ZIP/Postal Code
15090
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
William DeCarbo, DPM
Phone
724-799-8727
Email
wdecarbo@yahoo.com
First Name & Middle Initial & Last Name & Degree
Shannon Litton
Phone
(724) 799-8727
Email
slitton@gpfootankle.com
First Name & Middle Initial & Last Name & Degree
William DeCarbo, DPM
Facility Name
Foot and Ankle Associates of North Texas - Keller
City
Keller
State/Province
Texas
ZIP/Postal Code
76248
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Paul Steinke, DPM
Phone
817-416-6155
Email
steinke@faant.com
First Name & Middle Initial & Last Name & Degree
Paul Steinke, DPM
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Outcomes Following Combined Adductoplasty™ and Lapiplasty® (MTA3D)
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