A Prospective, Double Blinded, Multicenter, Randomized, Controlled Trial to Evaluate Mechanical Debridement vs. Radiofrequency-Based Debridement in the Treatment of Articular Cartilage Lesions
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Chondral Lesion Plus Partial Medial Meniscectomy
- Sponsor
- Smith & Nephew, Inc.
- Enrollment
- 148
- Locations
- 7
- Primary Endpoint
- Change From Baseline in Knee and Osteoarthritis Outcomes Scores (KOOS) at Week 52 Post-operative
- Status
- Terminated
- Last Updated
- 7 years ago
Overview
Brief Summary
The purpose of this study is to evaluate changes in clinical and imaging outcomes following arthroscopic treatment of a single medial femoral chondral lesion plus partial medial meniscectomy by Radiofrequency-Based debridement or Mechanical Debridement in subjects ≥ eighteen (18) years of age.
Detailed Description
This is a non-inferiority, prospective, double blinded, multi-center, randomized, controlled, adaptive study design with enrollment of 82 randomized subjects at up to 13 study sites. Study duration will be until the last subject enrolled reaches 104 weeks post-operative. The study will be comprised of two parts: Part I: Part I will require all Investigators perform 1 to 3 procedures using the Quantum 2 Controller plus Paragon T2 ICW Wand or the WEREWOLF Controller plus FLOW 50 Wand. Investigators must be qualified by training to perform procedures prior to use of either study device. This purpose of Part I will be to minimize variability with the recommended directions for use established in the instructions for use (IFU). Part I subjects will be followed per protocol follow-up requirements, and will be included in the safety population only. These subjects will be additive (to the safety population) to the 82 randomized subjects planned as part of the primary evaluation in Part II. Part II: Part II will consist of 82 randomized subjects. Each Investigator may initiate enrollment of subjects in this part of the study following completion of Part I requirements. The Part II study implements a randomized adaptive study design, whereby an interim analysis will be conducted for sample size re-assessment. There is no intention of reducing the sample size as a result of this interim analysis; however, the sample size may be increased to either establish the non-inferiority and/or may be increased sufficiently to establish superiority depending on the results of the interim analysis.
Investigators
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Change From Baseline in Knee and Osteoarthritis Outcomes Scores (KOOS) at Week 52 Post-operative
Time Frame: Postop Week 52
The scores of 5 subscales of KOOS (i.e., Pain, other Symptoms, Function in daily living \[ADL\], Function in Sport and Recreation \[Sport/Rec\] and knee related Quality of Life \[QoL\]) at Baseline, Week 52 and change from Baseline were summarized descriptively by treatment group. The average of KOOS subscale scores was considered as the primary endpoint. For any subject if the value of effectiveness parameter was missing at Week 52 then it was imputed by last observed post-Baseline value (LOCF method). Each subscale response is based on a 5-point Likert system with each response score ranging from 0 (no problems) to 4 (extreme problems). Each subscale score is calculated independently. A score of 100 indicated no problems and a score of 0 indicated extreme problems. KOOS subscale score = 100 - (mean of the observed items within the subscale x100 / 4)
Secondary Outcomes
- Change in Visual Analog Scale (VAS) Scores From Baseline(Baseline, Postop Day 10, Weeks 6, 12, 24, 36, 52, and 104/ET)
- Change in EQ-5D-5L Scores From Baseline (EQ-VAS Summary Total Score)(Baseline, Postop Day 10, Weeks 6, 12, 24, 36, 52, and 104/ET)
- Magnetic Resonance Imaging (MRI) and International Cartilage Repair Society (ICRS) Chondral Lesion Assessments(Postop Day 10, Day 10 to Week 52, Week 52 to Week 104/ET)
- Number of Participants Stratified by Generalized Laxity Level on IKDC Knee Evaluation(Baseline, Postop Weeks 6, 12, 24, 36, 52, and 104/ET)
- Number of Participants Stratified by Alignment Level on IKDC Knee Evaluation(Baseline, Postop Weeks 6, 12, 24, 36, 52, and 104/ET)
- Number of Participants Stratified by Patellar Position Level on IKDC Knee Evaluation(Baseline, Postop Weeks 6, 12, 24, 36, 52, and 104/ET)
- Change in International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form Scores From Baseline.(Baseline, Postop Weeks 6, 12, 24, 36, 52, and 104/Early Termination (ET))
- Number of Participants Stratified by Patella Subluxation/Dislocation Level on IKDC Knee Evaluation(Baseline, Postop Weeks 6, 12, 24, 36, 52, and 104/ET)
- Change in KOOS Scores From Baseline(Baseline, Postop Weeks 6, 12, 24, 36, 52, and 104/ET)
- Change in 12-Item Short Form Survey (SF-12) Scores From Baseline - Physical Component Summary (PCS) Score(Baseline, Postop Weeks 6, 12, 24, 36, 52, and 104/ET)
- Change in SF-12 Scores From Baseline - Mental Component Summary (MCS) Score(Baseline, Postop Weeks 6, 12, 24, 36, 52, and 104/ET)
- Change in EuroQoL 5 Dimensions, 5 Level Scale (EQ-5D-5L) Scores From Baseline (EQ-5D-5L Summary Total Score)(Baseline, Postop Day 10, Weeks 6, 12, 24, 36, 52, and 104/ET)
- Subject Satisfaction Postoperatively at Weeks 52 and 104(Postop Weeks 52 and 104/ET)