Antimicrobial Synthetic Bone Grafts
Primary Purpose
Bone Infection, Bone Graft Infection
Status
Completed
Phase
Phase 1
Locations
Turkey
Study Type
Interventional
Intervention
antimicrobial synthetic bone graft
parentaral antimicrobials and pure bone grafts
Sponsored by
About this trial
This is an interventional treatment trial for Bone Infection
Eligibility Criteria
Inclusion Criteria:
- Patients with chronic osteomyelitis, infected non-union or implant-associated infection with an indication for artificial bone grafting who read and accept the Informed consent.
- Male and female patients older than 18 years
- Patients without heart, lung, renal or hepatic failure, epilepsy, cerebrovascular attack or ischemia
- Patients who are not allergic to antibiotics
- Patients with additional immunosuppression such as malignancy, diabetes mellitus, poly travma and open fractures
- Patients using oral or parenteral corticosteroids, methotrexate, cyclosporine or other immunosuppressive drugs
Exclusion Criteria:
- Patients who have not accepted the method.
- Patients outside the working age range
- Pregnant women
- Patients with heart, lung, renal, hepatic failure, epilepsy, cerebrovascular attack or ischemia
- Patients with allergy to antibiotics
- Patients with another silvery implant in the body like a silver-coated implant
- Patients with a history of known allergies or hypersensitivity to silver
Sites / Locations
- Eskisehir Osmangazi University Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
antimicrobial synthetic bone graft
parenteral antibiotics with pure synthetic bone graft
Arm Description
This group will have parenteral antibiotics and antimicrobial (silver ions) synthetic bone graft
This group will have parenteral antibiotics and pure synthetic bone graft
Outcomes
Primary Outcome Measures
bony healing of the cavities in the bone
Number of Participants with bony healing of the cavities in the bone by x-ray
Secondary Outcome Measures
Full Information
NCT ID
NCT03945864
First Posted
March 31, 2019
Last Updated
July 27, 2022
Sponsor
Eskisehir Osmangazi University
1. Study Identification
Unique Protocol Identification Number
NCT03945864
Brief Title
Antimicrobial Synthetic Bone Grafts
Official Title
The Use of Antimicrobial Synthetic Bone Grafts in the Treatment of Bone Infection
Study Type
Interventional
2. Study Status
Record Verification Date
July 2022
Overall Recruitment Status
Completed
Study Start Date
June 1, 2019 (Actual)
Primary Completion Date
September 1, 2020 (Actual)
Study Completion Date
August 15, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Eskisehir Osmangazi University
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
This project aims to produce synthetic bone tissue graft that supports bone regeneration and combats infection simultaneously, according to industry standards and regulations. This original and high value added biomaterial "silver doped calcium phosphate based synthetic bone tissue " will be used in clinical trials in patients with osteomyelitis and implant-related infections for the treatment.
Chronic bone infections are one of the most important problems in orthopedic surgery and are not just a problem of developed societies. When open fracture cases, which may get infected in 1-50%, implant-related infections and diabetic foot ulcer cases are taken into consideration, osteomyelitis will be seen as a very common problem all over the world. Multiple surgeries, long-term use of antibiotics and the high costs affects all societies. The use of synthetic bone grafts is growing faster than the natural bone grafts in the world. USA has spent 246 million US dollars for the use of synthetic bone graft in 2010. For the treatment of bone infections antibiotic impregnated synthetic bone grafts with different characteristics are used. Although these antibiotic impregnated synthetic bone grafts are superior compared to antibiotic bone cement with the implementation of different antibiotics and to be absorbable but they cannot show optimum benefit because the release of antibiotics is not due to host matrix degradation but diffusion control. The other issue to be considered as this regard that the development of microbial resistance to these antibiotics which is also a serious problem. Innovative synthetic bone graft with better contribution of the needs of mechanical properties, depending on the applied bone region, optimized antimicrobial activity and bone tissue regeneration are needed.
In this study, it will be determined whether this silver ion -doped antimicrobial synthetic bone graft that has the capacity to fill the bone voids that may occur in chronic bone infection during disease process or after surgical debridement, also has the capacity to treat the infection in the bone will be used in 12 patients who had been diagnosed as chronic osteomyelitis to see if it cause any unwanted side effect in normal usage conditions and generates unacceptable risks. Clinical, laboratory and radiological investigations will be used to demonstrate the healing of the infections and the cavities in the bone. Blood and urine levels of silver will be detected from patients.
Antimicrobial activity of silver is well-known. The effectiveness of the silver and potential toxicity is related to the dose of silver and application form. In orthopedics, the use of silver is mostly limited to elemental silver coating of metal implants. There is no biotechnologic approach manufactured silver ion -doped calcium phosphate -based synthetic bone graft in the health sector yet. Ionic silver has advantages such as low toxicity, no tolerance of silver against bacteria, and strong antibacterial activity. The trapping of silver ions in the calcium phosphate based ceramic structure overcomes the other systems with its controlled release and its ability to be effective at minimum doses. The project is an original work since it will contribute to bone regeneration while at the same time removing the infection.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Bone Infection, Bone Graft Infection
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Model Description
experimental group will be compared with parental antibiotics group
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
12 (Actual)
8. Arms, Groups, and Interventions
Arm Title
antimicrobial synthetic bone graft
Arm Type
Experimental
Arm Description
This group will have parenteral antibiotics and antimicrobial (silver ions) synthetic bone graft
Arm Title
parenteral antibiotics with pure synthetic bone graft
Arm Type
Active Comparator
Arm Description
This group will have parenteral antibiotics and pure synthetic bone graft
Intervention Type
Device
Intervention Name(s)
antimicrobial synthetic bone graft
Intervention Description
It will be determined whether the silver ion-doped antimicrobial synthetic bone graft that has the capacity to fill the bone voids also has the capacity to treat the infection in the bone in 12 patients with chronic osteomyelitis
Intervention Type
Device
Intervention Name(s)
parentaral antimicrobials and pure bone grafts
Intervention Description
Historical data of the department will be used for comparison of the results
Primary Outcome Measure Information:
Title
bony healing of the cavities in the bone
Description
Number of Participants with bony healing of the cavities in the bone by x-ray
Time Frame
12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with chronic osteomyelitis, infected non-union or implant-associated infection with an indication for artificial bone grafting who read and accept the Informed consent.
Male and female patients older than 18 years
Patients without heart, lung, renal or hepatic failure, epilepsy, cerebrovascular attack or ischemia
Patients who are not allergic to antibiotics
Patients with additional immunosuppression such as malignancy, diabetes mellitus, poly travma and open fractures
Patients using oral or parenteral corticosteroids, methotrexate, cyclosporine or other immunosuppressive drugs
Exclusion Criteria:
Patients who have not accepted the method.
Patients outside the working age range
Pregnant women
Patients with heart, lung, renal, hepatic failure, epilepsy, cerebrovascular attack or ischemia
Patients with allergy to antibiotics
Patients with another silvery implant in the body like a silver-coated implant
Patients with a history of known allergies or hypersensitivity to silver
Facility Information:
Facility Name
Eskisehir Osmangazi University Hospital
City
Eskişehir
ZIP/Postal Code
26480
Country
Turkey
12. IPD Sharing Statement
Plan to Share IPD
No
IPD Sharing Plan Description
After the publication of the study nidividual participant data (IPD) will be available to other researchers.
Learn more about this trial
Antimicrobial Synthetic Bone Grafts
We'll reach out to this number within 24 hrs