Early Weight-Bearing After the Lapiplasty Mini-Incision Procedure (Mini3D) (Mini3D)
Primary Purpose
Hallux Valgus, Bunion
Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Treatment of Hallux Valgus
Sponsored by
About this trial
This is an interventional treatment trial for Hallux Valgus
Eligibility Criteria
Inclusion Criteria:
Patients satisfying the following criteria will be considered the screening population and will be eligible for participation:
- Male and females between the ages 14 and 58 years at the time of consent;
- Closed physeal plates at the time of consent;
- Intermetatarsal angle is between 10.0˚ - 22.0˚;
- Hallux valgus angle is between 16.0˚ - 40.0˚;
- Willing and able to adhere to early weight-bearing instructions post-operatively;
- Capable of completing self-administered questionnaires;
- Acceptable surgical candidate, including use of general anesthesia;
- Female patients must be of non-child bearing potential or have a negative pregnancy test within 7 days prior to 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.
Exclusion Criteria:
Patients satisfying the following criteria will not be eligible for participation:
- 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);
- Additional concomitant procedures outside of the 1st ray;
- Moderate or Severe osteoarthritis of the MTP joint based on radiographic imaging (including lack of evident crista) or positive grind test;
- Symptomatic flatfoot or asymptomatic flatfoot (defined as calcaneal inclination <5˚and talonavicular subluxation/uncovering >50%);
- BMI >40 kg/m²;
- Current nicotine user, including current use of nicotine patch;
- Current clinical diagnosis of diabetes with fasting plasma glucose > 126 mg/dL and/or HbA1c ≥7.0;
- Current clinical diagnosis of peripheral neuropathy or by assessment on 4-point monofilament test;
- Current clinical diagnosis of fibromyalgia;
- Current clinical diagnosis of Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy (CRPS/RSD);
- Current uncontrolled hypothyroidism;
- 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 retard 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;
- Current diagnosis of metatarsus adductus (defined as MAA ≥ 23˚);
- Known keloid and hypertrophic scar forming;
- Scheduled to undergo a same-day bilateral procedure. Patient agrees to refrain from the Lapiplasty® Procedure (or other hallux valgus procedures) on contralateral foot for minimum of 6 months post index 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 early weight-bear post-procedure;
- Patient requires an incision >4.0 cm to complete the procedure (determined pre-operatively or intra-operatively);
- Patient is actively involved with a workman's compensation case or is currently involved in litigation;
- Patient is currently 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 the Treace ALIGN3D™ study without ongoing protocol defined AE; these are not exclusionary;
- 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
- DOC - Decatur Orthopaedic Clinic
- DOC - Decatur Orthopaedic Clinic
- Phoenix Foot and Ankle Institute
- Orlando Foot and Ankle Clinic - Waterford Lakes Office
- JCMG - Podiatry
- Desert Orthopaedic Center
- University of Pennsylvania / Penn Medicine
- Stonebriar Foot and Ankle
- Foot & Ankle Associates of North Texas - Keller
- Sports Medicine Associates of San Antonio
Outcomes
Primary Outcome Measures
Radiographic Recurrence
To determine radiographic recurrence of hallux valgus and the timing of failure following hallux valgus correction with the Lapiplasty® Procedure
Secondary Outcome Measures
Radiographic Angular/Positional Alignment
Change in radiographic angular/positional alignment before/after the Lapiplasty® Procedure
Radiographic Healing
Union vs non-union -- Non-union defined as lucency at TMT joint, hardware failure and/or loss of correction, plus clinical pain at first TMT joint
Clinical complications due to Lapiplasty® System Implants, the procedure, the post-op weight-bearing protocol or health conditions that could affect other outcome measures - measured by Adverse Events and Product Complaint data
Clinical complications due to Lapiplasty® System Implants, the procedure, the post-op weight-bearing protocol or health conditions that could affect other outcome measures - measured by Adverse Events and Product Complaint data
Time to start weight-bearing in a boot
Time to start weight-bearing in a boot
Time to start weight-bearing in a shoe
Time to start weight-bearing in a shoe
Time to return to full unrestricted activity
Time to return to full unrestricted activity
Change in Pain
Change in pain assess via Visual Analog Scale (VAS)
Change in Quality of Life
Change in quality of life via PROMIS-29, PROMIS-25, MOxFQ
Change in Range of Motion
1st MTP dorsiflexion and plantarflexion
Change in Radiographic Foot Length
Change in radiographic foot length compared to baseline visit
Change in Radiographic Foot Width
Change in radiographic foot width compared to baseline visit
Change in Swelling at Foot, Ankle & Mid-Calf (Circumference)
Change in swelling as compared to 0-2 week visit
Change in Scar Quality as Measured by Patient and Observer Scar Assessment Scale (POSAS)
Change in scar quality in comparison to baseline visit
Full Information
NCT ID
NCT05082012
First Posted
September 14, 2021
Last Updated
October 3, 2023
Sponsor
Treace Medical Concepts, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT05082012
Brief Title
Early Weight-Bearing After the Lapiplasty Mini-Incision Procedure (Mini3D)
Acronym
Mini3D
Official Title
Prospective Clinical StuDy of Tri-planar Tarsometatarsal (TMT) ArthroDesis With Early Weight-Bearing After Lapiplasty® ProceDure Through a Mini-Incision™ Approach (Mini3D)
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
September 17, 2021 (Actual)
Primary Completion Date
September 17, 2024 (Anticipated)
Study Completion Date
July 31, 2025 (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 Lapiplasty® Procedure using the Lapiplasty® Mini-Incision™ System for patients in need of hallux valgus surgery.
Up to 200 subjects will be treated in this study at up to 20 clinical sites. Patients 14 years through 58 years with symptomatic hallux valgus will be eligible to participate based on the inclusion and exclusion criteria defined in the study protocol.
Detailed Description
Prospective, multicenter, unblinded study to evaluate outcomes of the Lapiplasty® Procedure using the Lapiplasty® Mini-Incision™ System for patients in need of hallux valgus surgery:
To determine radiographic recurrence of hallux valgus and the timing of failure following hallux valgus correction with the Lapiplasty® Procedure.
To determine whether the Lapiplasty® Procedure effectively corrects anatomical alignment of the 1st metatarsal and sesamoids in all three planes.
To assess whether early weight-bearing after the Lapiplasty® Procedure affects the union rates or causes loss of 3-plane correction.
To evaluate the quality of life and pain scores following the Lapiplasty® Procedure.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hallux Valgus, Bunion
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
200 (Anticipated)
8. Arms, Groups, and Interventions
Intervention Type
Device
Intervention Name(s)
Treatment of Hallux Valgus
Other Intervention Name(s)
Lapiplasty® Mini-Incision™ Procedure
Intervention Description
Patients 14 years through 58 years with symptomatic hallux valgus will be eligible to participate based on the inclusion/exclusion criteria established in the study protocol. Anticipated subject duration will be 2 years post index procedure.
Primary Outcome Measure Information:
Title
Radiographic Recurrence
Description
To determine radiographic recurrence of hallux valgus and the timing of failure following hallux valgus correction with the Lapiplasty® Procedure
Time Frame
24 months
Secondary Outcome Measure Information:
Title
Radiographic Angular/Positional Alignment
Description
Change in radiographic angular/positional alignment before/after the Lapiplasty® Procedure
Time Frame
pre-op, 6 weeks, 4 months, 6 months, 12 months, 24 months post Lapiplasty® Procedure
Title
Radiographic Healing
Description
Union vs non-union -- Non-union defined as lucency at TMT joint, hardware failure and/or loss of correction, plus clinical pain at first TMT joint
Time Frame
12 months post Lapiplasty® Procedure
Title
Clinical complications due to Lapiplasty® System Implants, the procedure, the post-op weight-bearing protocol or health conditions that could affect other outcome measures - measured by Adverse Events and Product Complaint data
Description
Clinical complications due to Lapiplasty® System Implants, the procedure, the post-op weight-bearing protocol or health conditions that could affect other outcome measures - measured by Adverse Events and Product Complaint data
Time Frame
24 months post Lapiplasty® Procedure
Title
Time to start weight-bearing in a boot
Description
Time to start weight-bearing in a boot
Time Frame
0-3 weeks, post Lapiplasty® Procedure
Title
Time to start weight-bearing in a shoe
Description
Time to start weight-bearing in a shoe
Time Frame
6 weeks, post Lapiplasty® Procedure
Title
Time to return to full unrestricted activity
Description
Time to return to full unrestricted activity
Time Frame
6 weeks - 6 months, post Lapiplasty® Procedure
Title
Change in Pain
Description
Change in pain assess via Visual Analog Scale (VAS)
Time Frame
0-2 weeks, 2-3 weeks, 6 weeks, 4 months, 6 months, 12 months, 24 months post Lapiplasty® Procedure
Title
Change in Quality of Life
Description
Change in quality of life via PROMIS-29, PROMIS-25, MOxFQ
Time Frame
6 months, 12 months, 24 months post Lapiplasty® Procedure
Title
Change in Range of Motion
Description
1st MTP dorsiflexion and plantarflexion
Time Frame
12 months, 24 months post Lapiplasty® Procedure
Title
Change in Radiographic Foot Length
Description
Change in radiographic foot length compared to baseline visit
Time Frame
12 months post Lapiplasty® Procedure
Title
Change in Radiographic Foot Width
Description
Change in radiographic foot width compared to baseline visit
Time Frame
12 months post Lapiplasty® Procedure
Title
Change in Swelling at Foot, Ankle & Mid-Calf (Circumference)
Description
Change in swelling as compared to 0-2 week visit
Time Frame
6 weeks and 4 months post Lapiplasty® Procedure
Title
Change in Scar Quality as Measured by Patient and Observer Scar Assessment Scale (POSAS)
Description
Change in scar quality in comparison to baseline visit
Time Frame
4 months, 6 months, and 12 months post Lapiplasty® Procedure
10. Eligibility
Sex
All
Minimum Age & Unit of Time
14 Years
Maximum Age & Unit of Time
58 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Patients satisfying the following criteria will be considered the screening population and will be eligible for participation:
Male and females between the ages 14 and 58 years at the time of consent;
Closed physeal plates at the time of consent;
Intermetatarsal angle is between 10.0˚ - 22.0˚;
Hallux valgus angle is between 16.0˚ - 40.0˚;
Willing and able to adhere to early weight-bearing instructions post-operatively;
Capable of completing self-administered questionnaires;
Acceptable surgical candidate, including use of general anesthesia;
Female patients must be of non-child bearing potential or have a negative pregnancy test within 7 days prior to 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.
Exclusion Criteria:
Patients satisfying the following criteria will not be eligible for participation:
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);
Additional concomitant procedures outside of the 1st ray;
Moderate or Severe osteoarthritis of the MTP joint based on radiographic imaging (including lack of evident crista) or positive grind test;
Symptomatic flatfoot or asymptomatic flatfoot (defined as calcaneal inclination <5˚and talonavicular subluxation/uncovering >50%);
BMI >40 kg/m²;
Current nicotine user, including current use of nicotine patch;
Current clinical diagnosis of diabetes with fasting plasma glucose > 126 mg/dL and/or HbA1c ≥7.0;
Current clinical diagnosis of peripheral neuropathy or by assessment on 4-point monofilament test;
Current clinical diagnosis of fibromyalgia;
Current clinical diagnosis of Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy (CRPS/RSD);
Current uncontrolled hypothyroidism;
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 retard 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;
Current diagnosis of metatarsus adductus (defined as MAA ≥ 23˚);
Known keloid and hypertrophic scar forming;
Scheduled to undergo a same-day bilateral procedure. Patient agrees to refrain from the Lapiplasty® Procedure (or other hallux valgus procedures) on contralateral foot for minimum of 6 months post index 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 early weight-bear post-procedure;
Patient requires an incision >4.0 cm to complete the procedure (determined pre-operatively or intra-operatively);
Patient is actively involved with a workman's compensation case or is currently involved in litigation;
Patient is currently 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 the Treace ALIGN3D™ study without ongoing protocol defined AE; these are not exclusionary;
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.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jody McAleer, DPM, FACFAS
Organizational Affiliation
JCMG - Podiatry
Official's Role
Principal Investigator
Facility Information:
Facility Name
DOC - Decatur Orthopaedic Clinic
City
Decatur
State/Province
Alabama
ZIP/Postal Code
35601
Country
United States
Facility Name
DOC - Decatur Orthopaedic Clinic
City
Hartselle
State/Province
Alabama
ZIP/Postal Code
35640
Country
United States
Facility Name
Phoenix Foot and Ankle Institute
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85251
Country
United States
Facility Name
Orlando Foot and Ankle Clinic - Waterford Lakes Office
City
Orlando
State/Province
Florida
ZIP/Postal Code
32825
Country
United States
Facility Name
JCMG - Podiatry
City
Jefferson City
State/Province
Missouri
ZIP/Postal Code
65109
Country
United States
Facility Name
Desert Orthopaedic Center
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89121
Country
United States
Facility Name
University of Pennsylvania / Penn Medicine
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19106
Country
United States
Facility Name
Stonebriar Foot and Ankle
City
Frisco
State/Province
Texas
ZIP/Postal Code
75034
Country
United States
Facility Name
Foot & Ankle Associates of North Texas - Keller
City
Keller
State/Province
Texas
ZIP/Postal Code
76248
Country
United States
Facility Name
Sports Medicine Associates of San Antonio
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78240
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Early Weight-Bearing After the Lapiplasty Mini-Incision Procedure (Mini3D)
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