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Trident® Tritanium™ Acetabular Shell Revision Study

Not Applicable
Completed
Conditions
Arthroplasty, Replacement, Hip
Interventions
Device: Trident® Tritanium™ Acetabular Shell
Registration Number
NCT00535626
Lead Sponsor
Stryker Orthopaedics
Brief Summary

The purpose of this study is to evaluate a hip implant system used when a previous hip replacement surgery has failed.

Detailed Description

Total hip replacement is considered to be a very successful surgical procedure for the treatment of degenerative joint disease. Clinical results for cementless acetabular components have demonstrated excellent long-term fixation of these devices. However, so called 'first generation' cementless acetabular components have not had similar success rates. In these cases the acetabular component is often revised due to loosening, wear or infection.

Revision hip arthroplasty also becomes a challenge as patients often present with severe bone loss and poor bone quality. This can lead to compromised initial stability, which in turn leads to lack of long-term fixation and failure. Acetabular revision with a cementless component has shown improved results over cemented fixation.

Radiographic evaluation of the Trident® Tritanium™ Acetabular Shell will provide valuable early to intermediate information that may help predict the long-term success of this new system.

It is the intention of this study to closely follow subjects that have undergone revision hip replacement with regard to implant survivorship, signs of radiographic loosening, subjects' function evaluated through Harris Hip Score and Lower Extremity Activity Scale, subject quality of life through SF-36 and adverse events.

The primary efficacy hypothesis is that the rate of revision or pending revision (as defined by radiographic parameters) due to instability or lack of fixation for the Trident® Tritanium™ Acetabular Shell will be less than 10% at 5 years.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
241
Inclusion Criteria
  1. Males and non-pregnant females, 21-85 years of age at the time of surgery.
  2. Patient is a candidate for a revision of a failed acetabular component with a cementless acetabular component.
  3. Patient has signed an IRB approved study consent form.
  4. Patient is willing and able to comply with postoperative requirements including postoperative weight bearing restrictions and self-evaluations.
Exclusion Criteria
  1. Patient is morbidly obese, BMI > 40.
  2. Patient has a systemic or metabolic bone disorder leading to progressive bone deterioration.
  3. Patient is immunologically compromised or receiving steroids in excess of normal physiological requirements (> 30 days).
  4. Patient's bone stock is compromised by disease or infection which cannot provide adequate support and/or fixation to the prosthesis.
  5. Patient has an active or suspected latent infection on or about the hip joint.
  6. Patient is a prisoner.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Trident® Tritanium™ Acetabular ShellTrident® Tritanium™ Acetabular ShellTrident® Tritanium™ Acetabular Shell used in revision total hip replacement
Primary Outcome Measures
NameTimeMethod
Number of Hips Requiring Revision or Pending Revision of the Acetabular Shell (as Defined by Radiographic Parameters) Due to Instability or Lack of Fixation5 years post-operative
Secondary Outcome Measures
NameTimeMethod
Change in SF-36 From Pre-operative to Post-operative Visitspre-op, 3 month, 1, 2, 3, 4, 5 years

The change in SF-36 is reported by comparing the mean preoperative, 3 month, 1, 2, 3, 4, and 5 year scores. The SF-36 Health Survey is a 36 item patient-completed questionnaire to measure general health and well-being. It includes a physical and mental status component score; each ranging from 0-100. Low values represent a poor health state and high values represent a good health state.

Radiographic Outcomes: Migration of the Acetabular Shell Greater Than 5 mm in Any Direction3 month, 1, 2, 3, 4, 5 years

Defined as the measurable change in the acetabular shell position relative to reproducible bony landmarks.

Change in Lower Extremity Activity Scale (LEAS) From Pre-operative to Post-operativepre-op, 3 month, 1, 2, 3, 4, 5 years

The change in LEAS is reported by comparing the mean pre-operative, 3 month, 1, 2, 3, 4, and 5 year scores. The LEAS is completed by the participant to assess activity level. Activity levels were ordered in terms of intensity from 1 to 18, with 18 indicating the highest activity level.

Change in Harris Hip Score (HHS) From Pre-operative to Post-operative Visitspre-op, 3 month, 1, 2, 3, 4, 5 years

The change in HHS is reported by comparing the mean pre-operative, 3-month, 1, 2, 3, 4, and 5 year post-operative scores. Scores can range from 0 to 100, with 0 being the worst and 100 being the best score. 90-100 = excellent, 80-89 = good, 70-79 = fair, 0-69 = poor.

Radiographic Outcomes: Radiolucency (RLL) Around the Acetabular Shell is Greater Than 2 mm in All Zones3 month, 1, 2, 3, 4, 5 years

Defined as a lucent area seen parallel and in close proximity to the device at the prosthesis/bone interface encompassing at least 50% of the zone, and at least 1 mm or greater in width. May be accompanied by a radiopaque (reactive) line. Assessed for each of the three modified DeLee Charnley zones.

Trial Locations

Locations (15)

University of Louisville, 201 Abraham Flexner Way, Suite 100

🇺🇸

Louisville, Kentucky, United States

NYU Hospital for Joint Diseases

🇺🇸

New York, New York, United States

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

Crystal Clinic

🇺🇸

Akron, Ohio, United States

Rockwood Clinic

🇺🇸

Spokane, Washington, United States

Heekin Institute for Orthopedic Research, Inc.

🇺🇸

Jacksonville, Florida, United States

St Joseph Mercy Hospital

🇺🇸

Ypsilanti, Michigan, United States

Dartmouth-Hitchcock Medical Center

🇺🇸

Lebanon, New Hampshire, United States

New England Baptist Hospital

🇺🇸

Boston, Massachusetts, United States

Orthopedic Specialty Institute

🇺🇸

Orange, California, United States

Illinois Bone & Joint Institute

🇺🇸

Glenview, Illinois, United States

Hospital for Special Surgery

🇺🇸

New York, New York, United States

Scott & White Memorial Hospital

🇺🇸

Temple, Texas, United States

The Methodist Hospital

🇺🇸

Houston, Texas, United States

Cedars Medical Center

🇺🇸

Miami, Florida, United States

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