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Carbon Fiber Implants

Intramedullary Nailing of Tibia Shaft Fractures With Carbon Fiber Implants Versus Titanium Nails: A Randomized Cohort Study

Status
Terminated
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03382041
Enrollment
20
Registered
2017-12-22
Start date
2017-05-23
Completion date
2021-03-31
Last updated
2023-07-25

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Tibial Shaft Fractures

Brief summary

The investigators will compare intramedullary nailing of open and closed tibia shaft fractures with carbon fiber implant versus titanium implant in a Level I trauma setting.

Detailed description

The tibia (long bone in the leg) bears most of the body weight and is the most commonly fractured long bone in the body. According to the National Center for Health Statistics; tibia, fibula and ankle fractures account for an annual sum of 581,000 fractures. Of all long bone fractures, the tibia is the most common site for non -union(failure to heal). For many years, the standard practice in the treatment of fractures of the tibia shaft and other long bones has been intramedullary nailing (placing rod in the bone)using titanium or stainless steel implants( tibial nails). More recently however, orthopaedic surgeons have found an alternative to the standard carbon fiber implants (tibial nails), especially in the prophylactic reinforcement of bones susceptible to pathological fractures following metastatic tumors. The new carbon fiber has also been used in the treatment of tibial non-union (non- healing bone); which has shown satisfactory outcomes. A clear advantage over titanium implants (tibial nails) is the carbon fiber's radiolucent (ability to see through the implant on x-ray) property. This allows for improved visualization of early healing and the reduction of fracture segments (i.e. fracture alignment) without the typical radiopaque (inability to see through the implant on x-ray) density and artifact found with metals on x-ray, MRI or CT Scans. The early visualization of callus formation8(healing) may therefore serve as a good prognostic predictor of successful union. Thus orthopaedic trauma patients, especially in cases of polytrauma may heal faster; attain earlier weight bearing status, and independence, decrease rehabilitation center stays and advance recovery with possible quicker return to work. These benefits have economic significance in reducing direct costs to patients and their families as well as to the healthcare system. Use of carbon fiber implants (tibial nails) seems to hold the promise of a shorter recovery time with better functional outcome than with more rigid titanium implants (tibial nails). This is due to the carbon fiber implants(tibial nails) elasticity (flexibility) which is close to that of bone, preventing excessive rigidity and possible non- union (non -healing bone). Intramedullary nails have continued to evolve, beginning with stainless steel implants and progressing to titanium. The titanium nail has been used over several years and the carbon fiber is a newer material and is now used by several institutions for treatment of tibial shaft fractures. There are no studies that directly compare the two nails in a prospective manner. The standard of care for treatment of tibial shaft fractures is the use of an intramedullary (rod inside the bone) implant. Both implants perform the same function but are made of different materials. Current treatment of tibia fractures at The University of Alabama at Birmingham (UAB) utilizes both titanium and carbon fiber implants.

Interventions

DEVICECarbon Fiber Implant

A cannulated rod, made of long carbon fiber reinforced polymer, with interlocking holes at its proximal and distal ends. The Nail provides for a slight bend. A Tantalum radiopaque marker along the Nail longitudinal axis provides for its visualization under fluoroscopy. The Nail proximal end is marked by a tantalum marker.

An intramedullary rod, also known as an intramedullary nail (IM nail) or inter-locking nail or Küntscher nail (without proximal or distal fixation), is a metal rod forced into the medullary cavity of a bone. IM nails have long been used to treat fractures of long bones of the body

Sponsors

CarboFix Orthopedics
CollaboratorINDUSTRY
University of Alabama at Birmingham
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Intervention model description

The investigators will compare intramedullary nailing( placing a rod in the tibia) of open and closed tibia shaft fractures with carbon fiber implant (tibial nail) versus titanium implant (tibial nail) in a Level I trauma setting.

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes

Inclusion criteria

* i. Skeletal maturity (patients included will be 18 - 64 years, i.e. whose epiphyseal/growth plates are closed) ii. Arbeitsgemeinschaft ur Osteosynthesefragen/Orthpaedica Trauma Association (AO/OTA) Fracture class 42; open and closed tibia shaft fracture (Gustilo-Anderson Types I II, and III; Tscherne closed types 0, I, 2 and 3), Tscherne open types I and II. iii. Fractures amenable to intramedullary nailing (placing a rod within the bone) iv. Fracture gaps less than 2 cm due to bone loss v. In cases of bilateral tibial fractures the investigators would include both if they meet inclusion criteria.. vi. Patient's informed consent or that of a legally acceptable representative

Exclusion criteria

i. Subjects currently enrolled in one or more clinical studies ii. Skeletal immaturity (i.e. 17 years and younger) iii. Fractures planned for non-operative management iv. Complex intra-articular involvement of tibia plateau or distal tibia v. Pathologic fractures (fractures secondary to disease) vi. Concomitant ipsilateral tibia shaft fractures with complex pilon and/or plateau fractures requiring fixation vii. Patients already treated or in re-treatment viii. Tibia already infected as diagnosed by the attending physician ix. Patients likely to be lost before completing adequate follow-up, such as prisoners or planned out-of-state (and other likely problems in the investigator's judgment, with maintaining follow-up visit schedule) x. Patient is intellectually challenged or has a severe psychiatric condition xi. Patient is incompetent in the English Language xii. Patient is non-ambulatory before injury or as a consequence of polytrauma xiii. Inability to obtain patient's informed consent and/or that of a legally acceptable representative \-

Design outcomes

Primary

MeasureTime frameDescription
The Number of Participants Identified With Fracture HealingFrom baseline through 6 weeks.Will assess radiographically the fracture healing for patients treated with Carbon Fiber and Titanium Implants.

Secondary

MeasureTime frameDescription
Short Musculoskeletal Function Assessment Questionnaire (SMFA) Score.6 monthsPatient reported levels of function and satisfaction with the fixation method and overall treatment. The SMFA will be administered to patients at 6 months following injury. The scores of bother are calculated by summing up the responses to the items and then transforming the scores according to the formula. This transformation formula gives the final scores which ranged from 0-100. The higher scores indicate poorer function.
Veterans Rand Health Survey (VR-12)6 weeks.The Veterans Rand 12 Item Health Survey is a multipurpose, self-administered generic measure health status. It was developed to measure health-related quality of life, estimate disease burden and compare disease-specific benchmarks across populations. The VR-12 items measure eight health domains: general health perceptions, physical functioning and role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning and mental health. The instrument produces a physical health and mental health. Assesses how much physical health has changed over a period of time. The VR instruments use a nine-point ordinal response choices for four items in the VR-12. These answers then contribute to the scales for role limitations due to physical and emotional problems and the physical and mental summary scores.
Short Musculoskeletal Function Assessment Questionnaire (SMFA).6 monthsThe SMFA will be administered to patients at 6 months following injury. The scores of dysfunction are calculated by summing up the responses to the items and then transforming the scores according to the formula. This transformation formula gives the final scores which ranged from 0-100. The higher scores indicate poorer function.
Veterans Rand Health Survey (VR-12) (Optional)18 months.The Veterans Rand 12 Item Health Survey is a multipurpose, self-administered generic measure health status. It was developed to measure health-related quality of life, estimate disease burden and compare disease-specific benchmarks across populations. The VR-12 items measure eight health domains: general health perceptions, physical functioning and role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning and mental health. The instrument produces a physical health and mental health. Assesses how much physical health has changed over a period of time. The VR instruments use a nine-point ordinal response choices for four items in the VR-12. These answers then contribute to the scales for role limitations due to physical and emotional problems and the physical and mental summary scores.
Treatment CostBaseline to 18 months.Compare 2 year treatment cost per patient, associated with fixation of tibial shaft fractures using novel carbon fiber implants in comparison with titanium implants. A Carbon Fiber Implant had a cost of $2,848.35 per device, as the number value below in the Outcome Measure Data Table. We were unable to obtain the cost of the Titanium Nail.
Brief Pain Inventory (BPI)6 months.The BPI is a widely used, 15-item measure of pain intensity and interference with daily life. The questionnaire assesses three key pain domains: pain intensity, pain interference, and efficacy of pain treatments or medications. The BPI rapidly assesses the functional severity of pain and its impact on function. The scale range is 0 to 10. A lower score means pain does not interfere with normal activities of daily living.

Countries

United States

Participant flow

Participants by arm

ArmCount
Carbon Fiber Implant
There is an alternative to the standard treatment, which is carbon fiber implants (tibial nails), especially in the prophylactic reinforcement of bones susceptible to pathological fractures following metastatic tumors. The new carbon fiber has also been used in the treatment of tibial non-union (non- healing bone); which has shown satisfactory outcomes. Carbon Fiber Implant: A cannulated rod, made of long carbon fiber reinforced polymer, with interlocking holes at its proximal and distal ends. The Nail provides for a slight bend. A Tantalum radiopaque marker along the Nail longitudinal axis provides for its visualization under fluoroscopy. The Nail proximal end is marked by a tantalum marker.
7
Titanium Implant
The standard of practice in the treatment of fractures of the tibial shaft and other long bones has been the intramedullary nailing using titanium or stainless steel implants. Titanium Implant: An intramedullary rod, also known as an intramedullary nail (IM nail) or inter-locking nail or Küntscher nail (without proximal or distal fixation), is a metal rod forced into the medullary cavity of a bone. IM nails have long been used to treat fractures of long bones of the body
13
Total20

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyConsent Form Lost21
Overall StudyLost to Follow-up14
Overall StudyWithdrawal by Subject14

Baseline characteristics

CharacteristicCarbon Fiber ImplantTitanium ImplantTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
0 Participants0 Participants0 Participants
Age, Categorical
Between 18 and 65 years
7 Participants13 Participants20 Participants
Race/Ethnicity, Customized
Black
2 Participants4 Participants6 Participants
Race/Ethnicity, Customized
Hispanic
1 Participants0 Participants1 Participants
Race/Ethnicity, Customized
White
4 Participants9 Participants13 Participants
Region of Enrollment
United States
7 participants13 participants20 participants
Sex: Female, Male
Female
2 Participants3 Participants5 Participants
Sex: Female, Male
Male
5 Participants10 Participants15 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 30 / 4
other
Total, other adverse events
0 / 30 / 4
serious
Total, serious adverse events
1 / 30 / 4

Outcome results

Primary

The Number of Participants Identified With Fracture Healing

Will assess radiographically the fracture healing for patients treated with Carbon Fiber and Titanium Implants.

Time frame: From baseline through 6 weeks.

Population: 7 subjects were withdrawn due to the discretion of the PI, 2 subjects withdrew consent, 6 subjects were lost to follow-up.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Carbon Fiber ImplantThe Number of Participants Identified With Fracture Healing1 Participants
Titanium ImplantThe Number of Participants Identified With Fracture Healing1 Participants
Primary

The Number of Participants Identified With Fracture Healing

Will assess radiographically the fracture healing for patients treated with Carbon Fiber and Titanium Implants.

Time frame: From baseline through 3 months.

Population: 7 subjects were withdrawn due to the discretion of the PI, 2 subjects withdrew consent, 6 subjects were lost to follow-up, 1 subject did not have x-rays done.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Carbon Fiber ImplantThe Number of Participants Identified With Fracture Healing1 Participants
Titanium ImplantThe Number of Participants Identified With Fracture Healing2 Participants
Secondary

Brief Pain Inventory (BPI)

The BPI is a widely used, 15-item measure of pain intensity and interference with daily life. The questionnaire assesses three key pain domains: pain intensity, pain interference, and efficacy of pain treatments or medications. The BPI rapidly assesses the functional severity of pain and its impact on function. The scale range is 0 to 10. A lower score means pain does not interfere with normal activities of daily living.

Time frame: 6 months.

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantBrief Pain Inventory (BPI)1.38 units on a scaleStandard Deviation 1.49
Titanium ImplantBrief Pain Inventory (BPI)2.75 units on a scaleStandard Deviation 3.54
Secondary

Brief Pain Inventory (BPI)

The BPI is a widely used, 15-item measure of pain intensity and interference with daily life. The questionnaire assesses three key pain domains: pain intensity, pain interference, and efficacy of pain treatments or medications. The BPI rapidly assesses the functional severity of pain and its impact on function. The BPI rapidly assesses the functional severity of pain and its impact on function. The scale range is 0 to 10. A lower score means pain does not interfere with normal activities of daily living.

Time frame: 12 months.

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantBrief Pain Inventory (BPI)1.17 units on a scaleStandard Deviation 1.26
Titanium ImplantBrief Pain Inventory (BPI)0.58 units on a scaleStandard Deviation 0.8
Secondary

Brief Pain Inventory (BPI)

The BPI is a widely used, 15-item measure of pain intensity and interference with daily life. The questionnaire assesses three key pain domains: pain intensity, pain interference, and efficacy of pain treatments or medications. The BPI rapidly assesses the functional severity of pain and its impact on function. The BPI rapidly assesses the interference of pain and its impact on function. The scale range is 0 to 10. A lower score means pain does not interfere with normal activities of daily living.

Time frame: 12 months.

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantBrief Pain Inventory (BPI)3.10 units on a scaleStandard Deviation 2.4
Titanium ImplantBrief Pain Inventory (BPI)2.33 units on a scaleStandard Deviation 4.04
Secondary

Brief Pain Inventory (BPI)

The BPI is a widely used, 15-item measure of pain intensity and interference with daily life. The questionnaire assesses three key pain domains: pain intensity, pain interference, and efficacy of pain treatments or medications. The BPI rapidly assesses the functional severity of pain and its impact on function. The BPI rapidly assesses the interference of pain and its impact on function. The scale range is 0 to 10. A lower score means pain does not interfere with normal activities of daily living.

Time frame: 6 months.

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantBrief Pain Inventory (BPI)2.21 units on a scaleStandard Deviation 0.69
Titanium ImplantBrief Pain Inventory (BPI)3.10 units on a scaleStandard Deviation 5.36
Secondary

Brief Pain Inventory (BPI)

The BPI is a widely used, 15-item measure of pain intensity and interference with daily life. The questionnaire assesses three key pain domains: pain intensity, pain interference, and efficacy of pain treatments or medications. The BPI rapidly assesses the functional severity of pain and its impact on function.The BPI rapidly assesses the functional severity of pain and its impact on function. The scale range is 0 to 10. A lower score means pain does not interfere with normal activities of daily living.

Time frame: 6 months.

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantBrief Pain Inventory (BPI)1.38 units on a scaleStandard Deviation 1.49
Titanium ImplantBrief Pain Inventory (BPI)2.75 units on a scaleStandard Deviation 3.54
Secondary

Short Musculoskeletal Function Assessment Questionnaire (SMFA).

The SMFA will be administered to patients at 6 months following injury. The scores of dysfunction are calculated by summing up the responses to the items and then transforming the scores according to the formula. This transformation formula gives the final scores which ranged from 0-100. The higher scores indicate poorer function.

Time frame: 6 months

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantShort Musculoskeletal Function Assessment Questionnaire (SMFA).31.53 units on a scaleStandard Deviation 20.55
Titanium ImplantShort Musculoskeletal Function Assessment Questionnaire (SMFA).38.56 units on a scaleStandard Deviation 32.46
Secondary

Short Musculoskeletal Function Assessment Questionnaire (SMFA).

Patient reported levels of function and satisfaction with the fixation method and overall treatment. The Short Form Musculoskeletal Assessment (SMFA) will be administered to patients at 12 months following injury. The scores of dysfunction are calculated by summing up the responses to the items and then transforming the scores according to the formula. This transformation formula gives the final scores which ranged from 0-100. The higher scores indicate poorer function.

Time frame: 12 months.

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantShort Musculoskeletal Function Assessment Questionnaire (SMFA).29.85 units on a scaleStandard Deviation 28.35
Titanium ImplantShort Musculoskeletal Function Assessment Questionnaire (SMFA).31.09 units on a scaleStandard Deviation 27.85
Secondary

Short Musculoskeletal Function Assessment Questionnaire (SMFA) Score.

Patient reported levels of function and satisfaction with the fixation method and overall treatment. The SMFA will be administered to patients at 6 months following injury. The scores of bother are calculated by summing up the responses to the items and then transforming the scores according to the formula. This transformation formula gives the final scores which ranged from 0-100. The higher scores indicate poorer function.

Time frame: 6 months

Population: One patient wasn't available to evaluate from the Titanium group.

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantShort Musculoskeletal Function Assessment Questionnaire (SMFA) Score.32.39 units on a scaleStandard Deviation 22.6
Titanium ImplantShort Musculoskeletal Function Assessment Questionnaire (SMFA) Score.49.24 units on a scaleStandard Deviation 46.71
Secondary

Short Musculoskeletal Function Assessment Questionnaire (SMFA) Score.

Patient reported levels of function and satisfaction with the fixation method and overall treatment. The Short Form Musculoskeletal Assessment (SMFA) will be administered to patients at 12 months following injury. The scores of bother are calculated by summing up the responses to the items and then transforming the scores according to the formula. This transformation formula gives the final scores which ranged from 0-100. The higher scores indicate poorer function.

Time frame: 12 months.

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantShort Musculoskeletal Function Assessment Questionnaire (SMFA) Score.34.09 units on a scaleStandard Deviation 32.06
Titanium ImplantShort Musculoskeletal Function Assessment Questionnaire (SMFA) Score.37.88 units on a scaleStandard Deviation 36.46
Secondary

Short Musculoskeletal Function Assessment Questionnaire (SMFA) Score.

Patient reported levels of function and satisfaction with the fixation method and overall treatment. The Short Form Musculoskeletal Assessment (SMFA) will be administered to patients at 18 months following injury. The scores of the dysfunction and bother indices are calculated by summing up the responses to the items and then transforming the scores according to the formula. This transformation formula gives the final scores which ranged from 0-100. The higher scores indicate poorer function.

Time frame: 18 months.

Population: Data was not collected.

Secondary

Treatment Cost

Compare 2 year treatment cost per patient, associated with fixation of tibial shaft fractures using novel carbon fiber implants in comparison with titanium implants. A Carbon Fiber Implant had a cost of $2,848.35 per device, as the number value below in the Outcome Measure Data Table. We were unable to obtain the cost of the Titanium Nail.

Time frame: Baseline to 18 months.

Population: Costs were determined for 1 carbon fiber implant. Costs were not available for 2 carbon fiber implant participants and 4 Titanium implant participants.

ArmMeasureValue (NUMBER)
Carbon Fiber ImplantTreatment Cost2,848.35 Dollars
Secondary

Veterans Rand Health Survey (VR-12)

The Veterans Rand 12 Item Health Survey is a multipurpose, self-administered generic measure health status. It was developed to measure health-related quality of life, estimate disease burden and compare disease-specific benchmarks across populations. The VR-12 items measure eight health domains: general health perceptions, physical functioning and role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning and mental health. The instrument produces a physical health and mental health. Assesses how much physical health has changed over a period of time. The VR instruments use a nine-point ordinal response choices for four items in the VR-12. These answers then contribute to the scales for role limitations due to physical and emotional problems and the physical and mental summary scores.

Time frame: 6 weeks.

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantVeterans Rand Health Survey (VR-12)31.63 units on a scaleStandard Deviation 3.72
Titanium ImplantVeterans Rand Health Survey (VR-12)25.53 units on a scaleStandard Deviation 8.42
Secondary

Veterans Rand Health Survey (VR-12)

The Veterans Rand 12 Item Health Survey is a multipurpose, self-administered generic measure health status. It was developed to measure health-related quality of life, estimate disease burden and compare disease-specific benchmarks across populations. The VR-12 items measure eight health domains: general health perceptions, physical functioning and role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning and mental health. Assesses how much physical health has changed over a period of time. The VR instruments use a nine-point ordinal response choices for four items in the VR-12. These answers then contribute to the scales for role limitations due to physical and emotional problems and the physical and mental summary scores. The score is based on the US average, which is 50. The score is a T-score which has a mean and standard deviation (mean of 50 has standard deviation of 10). The higher the score the healthier the individual.

Time frame: 6 months

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantVeterans Rand Health Survey (VR-12)39.57 units on a scaleStandard Deviation 8.75
Titanium ImplantVeterans Rand Health Survey (VR-12)38.40 units on a scaleStandard Deviation 10.15
Secondary

Veterans Rand Health Survey (VR-12)

The Veterans Rand 12 Item Health Survey is a multipurpose, self-administered generic measure health status. It was developed to measure health-related quality of life, estimate disease burden and compare disease-specific benchmarks across populations. The VR-12 items measure eight health domains: general health perceptions, physical functioning and role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning and mental health. Assesses how much physical health has changed over a period of time. The VR instruments use a nine-point ordinal response choices for four items in the VR-12. These answers then contribute to the scales for role limitations due to physical and emotional problems and the physical and mental summary scores. The score is based on the US average, which is 50. The score is a T-score which has a mean and standard deviation (mean of 50 has standard deviation of 10). The higher the score the healthier the individual.

Time frame: 12 months.

Population: The participants were not analyzed at the 18 month time point.

Secondary

Veterans Rand Health Survey (VR-12)

The Veterans Rand 12 Item Health Survey is a multipurpose, self-administered generic measure health status. It was developed to measure health-related quality of life, estimate disease burden and compare disease-specific benchmarks across populations. The VR-12 items measure eight health domains: general health perceptions, physical functioning and role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning and mental health. Assesses how much physical health has changed over a period of time. The VR instruments use a nine-point ordinal response choices for four items in the VR-12. These answers then contribute to the scales for role limitations due to physical and emotional problems and the physical and mental summary scores. The score is based on the US average, which is 50. The score is a T-score which has a mean and standard deviation (mean of 50 has standard deviation of 10). The higher the score the healthier the individual.

Time frame: 6 weeks

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantVeterans Rand Health Survey (VR-12)41.08 units on a scaleStandard Deviation 6.61
Titanium ImplantVeterans Rand Health Survey (VR-12)43.07 units on a scaleStandard Deviation 5.12
Secondary

Veterans Rand Health Survey (VR-12)

The Veterans Rand 12 Item Health Survey is a multipurpose, self-administered generic measure health status. It was developed to measure health-related quality of life, estimate disease burden and compare disease-specific benchmarks across populations. The VR-12 items measure eight health domains: general health perceptions, physical functioning and role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning and mental health. Assesses how much physical health has changed over a period of time. The VR instruments use a nine-point ordinal response choices for four items in the VR-12. These answers then contribute to the scales for role limitations due to physical and emotional problems and the physical and mental summary scores. The score is based on the US average, which is 50. The score is a T-score which has a mean and standard deviation (mean of 50 has standard deviation of 10). The higher the score the healthier the individual.

Time frame: 3 months.

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantVeterans Rand Health Survey (VR-12)40.20 units on a scaleStandard Deviation 18.67
Titanium ImplantVeterans Rand Health Survey (VR-12)36.10 units on a scaleStandard Deviation 42.47
Secondary

Veterans Rand Health Survey (VR-12)

The Veterans Rand 12 Item Health Survey is a multipurpose, self-administered generic measure health status. It was developed to measure health-related quality of life, estimate disease burden and compare disease-specific benchmarks across populations. The VR-12 items measure eight health domains: general health perceptions, physical functioning and role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning and mental health. Assesses how much physical health has changed over a period of time. The VR instruments use a nine-point ordinal response choices for four items in the VR-12. These answers then contribute to the scales for role limitations due to physical and emotional problems and the physical and mental summary scores. The score is based on the US average, which is 50. The score is a T-score which has a mean and standard deviation (mean of 50 has standard deviation of 10). The higher the score the healthier the individual.

Time frame: 18 months

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantVeterans Rand Health Survey (VR-12)39.93 units on a scaleStandard Deviation 10.75
Titanium ImplantVeterans Rand Health Survey (VR-12)40.63 units on a scaleStandard Deviation 24.31
Secondary

Veterans Rand Health Survey (VR-12)

The Veterans Rand 12 Item Health Survey is a multipurpose, self-administered generic measure health status. It was developed to measure health-related quality of life, estimate disease burden and compare disease-specific benchmarks across populations. The VR-12 items measure eight health domains: general health perceptions, physical functioning and role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning and mental health. Assesses how much physical health has changed over a period of time. The VR instruments use a nine-point ordinal response choices for four items in the VR-12. These answers then contribute to the scales for role limitations due to physical and emotional problems and the physical and mental summary scores. The score is based on the US average, which is 50. The score is a T-score which has a mean and standard deviation (mean of 50 has standard deviation of 10). The higher the score the healthier the individual.

Time frame: 12 months

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantVeterans Rand Health Survey (VR-12)41.63 units on a scaleStandard Deviation 16.87
Titanium ImplantVeterans Rand Health Survey (VR-12)47.83 units on a scaleStandard Deviation 19.12
Secondary

Veterans Rand Health Survey (VR-12)

The Veterans Rand 12 Item Health Survey is a multipurpose, self-administered generic measure health status. It was developed to measure health-related quality of life, estimate disease burden and compare disease-specific benchmarks across populations. The VR-12 items measure eight health domains: general health perceptions, physical functioning and role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning and mental health. Assesses how much physical health has changed over a period of time. The VR instruments use a nine-point ordinal response choices for four items in the VR-12. These answers then contribute to the scales for role limitations due to physical and emotional problems and the physical and mental summary scores. The score is based on the US average, which is 50. The score is a T-score which has a mean and standard deviation (mean of 50 has standard deviation of 10). The higher the score the healthier the individual.

Time frame: 6 months

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantVeterans Rand Health Survey (VR-12)36.03 units on a scaleStandard Deviation 15.24
Titanium ImplantVeterans Rand Health Survey (VR-12)38.20 units on a scaleStandard Deviation 20.92
Secondary

Veterans Rand Health Survey (VR-12)

The Veterans Rand 12 Item Health Survey is a multipurpose, self-administered generic measure health status. It was developed to measure health-related quality of life, estimate disease burden and compare disease-specific benchmarks across populations. The VR-12 items measure 8 health domains: general health perceptions, physical functioning and role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning and mental health. Assesses how much physical health has changed over a period of time. The VR instruments use a nine-point ordinal response choices for four items in the VR-12. These answers then contribute to the scales for role limitations due to physical and emotional problems and the physical and mental summary scores. The score is based on the US average, which is 50. The score is a T-score which has a mean and standard deviation (mean of 50 has standard deviation of 10). The higher the score the healthier the individual.

Time frame: 3 months

ArmMeasureValue (MEAN)Dispersion
Carbon Fiber ImplantVeterans Rand Health Survey (VR-12)48.03 T-scoreStandard Deviation 15.46
Titanium ImplantVeterans Rand Health Survey (VR-12)44.90 T-scoreStandard Deviation 1.95
Secondary

Veterans Rand Health Survey (VR-12) (Optional)

The Veterans Rand 12 Item Health Survey is a multipurpose, self-administered generic measure health status. It was developed to measure health-related quality of life, estimate disease burden and compare disease-specific benchmarks across populations. The VR-12 items measure eight health domains: general health perceptions, physical functioning and role limitations due to physical and emotional problems, bodily pain, energy-fatigue, social functioning and mental health. The instrument produces a physical health and mental health. Assesses how much physical health has changed over a period of time. The VR instruments use a nine-point ordinal response choices for four items in the VR-12. These answers then contribute to the scales for role limitations due to physical and emotional problems and the physical and mental summary scores.

Time frame: 18 months.

Population: The Carbon Fiber implants (3 participants) and the Titanium implants (4 participants) were healed and did not participate in this evaluation.

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026