Avascular Necrosis of the Talus, Talar Dysfunction, Talar Osteochondral Defect of Ankle
Conditions
Keywords
Avascular necrosis, Talus, Ankle joint
Brief summary
This is a Humanitarian Device Exemption (HDE) approved device. The purpose of this study is to evaluate the continued safety and probable benefit of the restor3d Total Talus Replacement device in commercial use.
Interventions
The restor3d patient-specific TTR Implant and Instrumentation System is designed to replace a native talus bone that has been affected by a disease state or injury. The implant is an additively manufactured Cobalt Chromium alloy (ASTM F3213) construct produced by laser powder bed fusion. The data-driven design of the implant enables the patient to salvage their joint while maintaining ankle range of motion, reducing pain and improving physical function.
Sponsors
OrthoCarolina Research Institute, Inc.
Restor3D
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
22 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* ≥22 Years of Age * Scheduled to receive TTR implant for one of the following indications: * Avascular necrosis of the talus * Avascular necrosis of the talus in addition to talar collapse, cysts or non-union * Large, uncontained, unstable, or cystic talar osteochondral defects with risk of collapse or talar osteochondral defects not responsive to traditional treatments * Nonunion following talar fracture or talar extrusion, unresponsive to more conservative treatments * Have not had a prior Total Talus Replacement device implanted * Not planning to receive bilateral Total Talus Replacement devices * Subject signs a written informed consent form (ICF) prior to the surgical procedure
Exclusion criteria
* Surgical procedures other than those listed in the indications for use. * Use of implant greater than 6 months from date of patient's preoperative CT scan. * Degenerative changes in the tibiotalar, subtalar or talonavicular joints. * Gross deformity in sagittal or coronal planes. More than 15 degrees of varus or valgus deformity in the coronal plane, or more than 50% subluxation anteriorly or posteriorly of the talus in the sagittal plane * Patients with an active local or systemic infection. * Osteonecrosis of the calcaneus, distal tibia or navicular. * Known history of existing malignancy, or any systemic infection, local infection, or skin compromise at the surgical site. * Blood supply limitations and previous infections that may prevent healing. * Physical conditions that would eliminate adequate implant support or prevent healing, including inadequate soft tissue coverage. * Conditions which may limit the patient's ability or willingness to restrict activities or follow directions postoperatively during the healing period. * Presence of neurological deficit which would prevent patient postoperative compliance. * Patients with foreign body sensitivity, suspected or documented material allergy or intolerance. Where material sensitivity is suspected, appropriate tests should be conducted, and sensitivity ruled out prior to implantation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of participants who pass a composite of safety and probable benefit outcomes | At 5 years compared to baseline | The primary endpoint for this post approval study is a composite of safety and probable benefit. The safety endpoint is defined by the absence of device-related SAE and subsequent secondary surgical intervention (SSSI) on the affected joints. The probable benefit endpoint is defined as joint salvage with the restor3d device still in place. This composite endpoint will be evaluated by determining the proportion of patients who do not have a device-related SAE or SSSI, AND have the restor3d implant in place at 5 years. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Foot and Ankle Outcome Score (FAOS) Composite score from baseline | At 5 years compared to baseline | Foot and Ankle Outcome Score (FAOS) is a 42-item questionnaire with 5 subscales: pain (9 items), other symptoms (7 items), activities of daily living (ADL) (17 items), sports/recreation (5 items), and quality of life (4 items). Each question is graded from 0 to 4 on a 5-point Likert scale (none, mild, moderate, severe, and extreme problems). Composite FAOS scores include all 42-items across the 5 subscales, scored together to provide one comprehensive value. The FAOS composite score ranges from 0 to 100 where a score of 0 indicates the worst possible symptoms, and a score of 100 indicates no symptoms. |
| Change in Foot and Ankle Outcome Score (FAOS) pain subscale score from baseline | At 5 years compared to baseline | — |
| Change in Foot and Ankle Outcome Score (FAOS) other symptoms subscale score from baseline | At 5 years compared to baseline | — |
| Change in Foot and Ankle Outcome Score (FAOS) activities of daily living (ADL) subscale score from baseline | At 5 years compared to baseline | — |
| Change in perceived pain from baseline | At 5 years compared to baseline | Scores on the 11-point Pain Numeric Rating Scale (NRS) rated from 0-10 where higher scores indicate worse pain |
| Change in Foot and Ankle Outcome Score (FAOS) quality of life (QOL) subscale score from baseline | At 5 years compared to baseline | — |
| Change in ankle range of motion (ROM) from baseline | At 5 years compared to baseline | Ankle ROM will be evaluated using a goniometer to determine the change in degrees of plantarflexion and dorsiflexion |
| Proportion of procedure-related Serious Adverse Events | At 5 years compared to baseline | Procedure-related Serious Adverse Event will be defined as the number of patients who have a procedure-related event including: death, life-threatening condition, hospital admission (initial or prolonged), disability or permanent damage, or required intervention to prevent permanent impairment or damage. |
| Proportion of Adverse Events | At 5 years compared to baseline | Adverse Event will be defined as the number of patients who have a non-serious, unexpected procedure- or device-related event before 5 years post-implantation. |
| Change in Foot and Ankle Outcome Score (FAOS) sports/recreation subscale score from baseline | At 5 years compared to baseline | — |
Countries
United States
Outcome results
None listed