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Trial registered on ANZCTR
Registration number
ACTRN12607000505404
Ethics application status
Approved
Date submitted
27/08/2007
Date registered
4/10/2007
Date last updated
4/10/2007
Type of registration
Retrospectively registered
Titles & IDs
Public title
A study assessing Periarticular Knee Osteotomy Surgery Outcomes with or without Autologous Chrondrocyte Implantation (MACI technique).
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Scientific title
A prospective Controlled Trial assessing Periarticular Knee Osteotomy Surgery Outcomes with or without Autologous Chrondrocyte Implantation (MACI technique).
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Osteoarthritis of the knee
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Condition category
Condition code
Musculoskeletal
2396
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Osteoarthritis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
High Tibial Osteotomy (HTO) is a well established operation for osteoarthritis. The principle of this surgery is as follows: in patients with arthritis localised to one side of their joint (usually the medial side) and a corresponding alignment that places the majority of their weight in this area, correcting the alignment to place the body weight towards the other side of the joint will usually relieve symptoms as well as slow the progression of the arthritis. The damaged articular cartilage is thought to then have some potential also to repair or regenerate. Another option is to combine this procedure with another well established technique of articular cartilage transplantation (MACI) to restore the joint surface in the arthritic side of the knee joint. The purpose of this study is to compare the clinical and Magnetic Resonance Imaging (MRI) results of patients who simply have an HTO alone, with those who have an HTO combined with MACI, to determine whether or not addition of this new technique enhances the regeneration and repair of damaged cartilage in knee joints with arthritis. This will have significant implications for our ability to treat arthritis and return arthritic joints back to normal function.
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Intervention code [1]
2016
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Treatment: Surgery
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Comparator / control treatment
The historical group will be previous study patients who have had the high tibial osteotomy without MACI procedure (NSH Protocol No. 0501-004M)
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Control group
Historical
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Outcomes
Primary outcome [1]
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Articular Cartilage Glycosaminoglycan (GAG) content assessment (dGEMRIC MRI): This procedure includes the administration of gadolinium. This injection will be done by a qualified doctor in case of allergic reaction to the radiological contrast being administered. MRI is performed precontrast and at 1.5 hr after an intravenous injection of Gd-DTPA(2-) at 0.2 mmol/kg body weight. This procedure is regularly used in MRI diagnostic imaging and not different from normal routine radiological practice.
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Assessment method [1]
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Timepoint [1]
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All patients to have MRI preoperatively. MRI involving volumetric analysis and dGEMRIC analysis will be performed at 1 year and 2 years postoperatively.
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Primary outcome [2]
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Articular Cartilage morphology and volumetric assessment: For the tibial and femoral cartilage, MRI's are acquired in the frontal plane with a spoiled 3D gradient echo sequence with selective water excitation. An in-plane resolution of 0.312x0.312 mm and a slice thickness of 1.4 mm will be used. Post-processing: Previous validated post-processing software will be used to determine the mean thickness of medial and lateral tibia and femur.
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Assessment method [2]
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Timepoint [2]
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All patients to have MRI preoperatively. MRI involving volumetric analysis and dGEMRIC analysis will be performed at 1 year and 2 years postoperatively.
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Secondary outcome [1]
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Pain, stiffness, and physical functional disability: Disease specific problem will be evaluated with the Knee Injury and Osteoarthritis Outcome Score, and International Knee Documentation Committee (IKDC) subjective outcome scores.
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Assessment method [1]
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Timepoint [1]
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6 and 12 months
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Eligibility
Key inclusion criteria
Inclusion will involve those patients who have been placed on waiting list for high tibial osteotomy. The patients will be offered the opportunity to take part in the trial, with no consequences for early withdrawal.
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Minimum age
18
Years
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Maximum age
N/A
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients will be excluded, or removed from the study due to severe claustrophobia in MRI scanner, Gadolinium sensitivity or patients’ withdrawal.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
Historical controls that have a high tibial osteotomy without MACI procedure will be compared to patients that have a high tibial osteotomy with MACI.
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Phase
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
30/09/2007
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
20
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Sydney Orthopaedic Research Institute
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Address [1]
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Level 1, The Gallery,
445 Victoria Avenue,
Chatswood NSW 2067
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Country [1]
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Australia
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Primary sponsor type
Other
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Name
Sydney Orthopaedic Research Institute
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Address
Level 1, The Gallery,
445 Victoria Avenue,
Chatswood NSW 2067
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
2405
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern Sydney Central Coast NSW Health
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Ethics committee address [1]
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The Research Office Level 4 Vindin House Royal North Shore Hospital St Leonards NSW 2065
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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19/09/2007
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Ethics approval number [1]
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0609-170M
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Summary
Brief summary
The study is a prospective investigation analyzing the outcomes of patients with unicompartmental osteoarthritis undergoing osteotomy (HTO). We will compare the outcomes of patients undergoing HTO alone, to those undergoing the combined procedure of HTO and MACI resurfacing of the arthritic femoral and tibial surfaces of the involved compartment. It has been shown previously that some articular surface regeneration can occur with HTO alone, although the amount and quality of this regenerate is not well defined. The next stage in evolution of regeneration would seem to be to directly promote this by chondrocyte transplantation. Techniques such as MACI have successfully improved patient outcomes in the treatment of isolated chondral defects. The next step would be to show these improvements are possible in patients with more advanced osteoarthritis. Before advocating this however, it is important to show objective advantages of this technique over HTO alone. The outcomes will be assessed radiologically and clinically, and if the combined procedure is shown to have superior results, this would provide greater evidence for increased application of this technology. In addition, this would demonstrate a clear advantage of the MACI technique over periosteal patch techniques due to the difficulty of application of periosteal patches to diffuse arthritic defects.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Karen Beatty
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Address
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Level 1, The Gallery, 445 Victoria Avenue, Chatswood NSW 2067
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Country
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Australia
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Phone
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02 9904-7182
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Karen Beatty
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Address
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Level 1, The Gallery, 445 Victoria Avenue, Chatswood NSW 2067
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Country
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Australia
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Phone
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02 9904-7182
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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