Bone Resorption, Cavus Deformity, Complication, Flatfoot, Osteolysis
Conditions
Keywords
Bone Healing, Osteotomy, Calcaneus, Bio-integrative, Metallic, Screws
Brief summary
The use of bio-integrative implants in orthopedic surgery is growing exponentially. As many biomechanical and histological studies were able to sustain its structural and biological properties, few clinical studies are available to support its advantages, such as good osteosynthesis, lower rates of removal, and diminished implant-related artifact in imaging studies. This information is vital to providers when choosing the proper material and planning postoperative treatment. This trial intends to test the capacity of the bioabsorbable screws in reaching the same clinical and radiographical outcomes of the current metallic screws.
Detailed description
A minimum of 44 patients undergoing Medial or Lateral Displacement Calcaneal Osteotomy (MDCO) will be randomized in two parallel groups for surgery, considering applied the implant. One group will be operated using two 4.0mm cannulated bio-integrative (absorbable) screws, and the other group using two 4.0mm cannulated metallic screws. Patients will be blinded evaluated for a mean follow-up of twelve weeks in terms of bone healing, complications, and implant-related artifact using weight-bearing computed tomography (WBCT).
Interventions
PROCEDURECalcaneus Osteotomy (Metallic)
Calcaneus Displacement Osteotomy using two metallic screws
PROCEDURECalcaneus Osteotomy (Bio-integrative)
Calcaneus Displacement Osteotomy using two bio-integrative screws
Sponsors
University of Iowa
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Masking description
The evaluator doctor will not have access to the protocol test applied to each patient and the surgeries will be conducted by different physicians.
Intervention model description
Randomized, investigator-blinded, in parallel groups, two-arms, single-center, non-inferiority, clinical trial.
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Individuals must be older than 18 and younger than 75 years of age, both genders; * Participants must be experiencing symptoms related to their baseline condition for at least six months before the surgery; * Clinical diagnosis of hindfoot malignment, defined as the presence of a clinical hindfoot angle above 10 degrees of valgus or any degree of varus; * Surgical planning, including a calcaneus displacement osteotomy through a traditional oblique cut.
Exclusion criteria
* Previous surgery involving the affected calcaneus; * History or documented evidence of autoimmune or peripheral vascular diseases; * History or documented evidence of peripheral neuropathy (nervous compression syndrome, tarsal tunnel syndrome) or systemic inflammatory disease a (rheumatoid arthritis, spondylitis, Reiter Syndrome, etc.); * Any condition that represents a contraindication of the proposed therapies; * Impossibility or incapacity to sign the informed Consent Form; * Presence of infectious process (superficial on the skin and cellular tissue, or deep in the bone) in the region to be treated. * Osteotomies requiring resection of wedges (Dweyer, triple Dweyer, etc.); * Osteotomies planned to occur in a non-traditional cut (Malerba, Scarf, etc.).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Bone healing | 6 weeks | \- Amount of bone bridging crossing the osteotomy site: Determined by the percentage of bone trabeculae crossing the osteotomy site on every tomography cut (amount of the cut in millimeters that shows bone spanning the two fragments divided by the total amount of osteotomy's surface on the cut). \- Weight-bearing computed tomography (WBCT) acquisitions will be used to determine this percentage. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Implant-related artifact | 6 weeks | \- Quantity of Hounsfield units around the implants Measured on WBCT acquisitions. |
| Complications | 6 weeks | \- Percentage of minor and major complications: Dehiscence: inability to heal the soft tissue coverage until the end of the 4th post-operative week. Peripherical nerve damage: hypoesthesia or paresthesia not solved until the 6th week after the surgery. Infection: clinical signs of site infection or pus drainage at the wound that required antibiotics. |
Countries
United States
Contacts
Primary ContactNacime Salomao Barbachan Mansur, MD, PhD
Outcome results
None listed