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OsteoarthritisPhase 4NCT01418378

Sigma CR150 Versus Sigma CR Knee RCT

A Phase 4 study testing Sigma CR150 and Sigma CR in people with Osteoarthritis, run by DePuy International at 4 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study will compare two very similar designs of knee replacement device. One device (Sigma CR150) is a slightly modified version of the original (Sigma CR) and has been modified to enhance/accommodate higher flexion. Read more about this study

Who is it for?
Ages 50 to 75 years
Conditions the study is for
Osteoarthritis
What is being tested?
Sigma CR150 and Sigma CR
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
191 participants
Where
4 sitesin 3 countries
Study dates
3 Aug 2011to 17 Feb 2016
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 50 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • i)Male or female subjects, aged between 50 and 75 years inclusive.
  • ii)Subjects who are able to give voluntary, written informed consent to participate in this clinical investigation and from whom consent has been obtained.
  • Subjects who, in the opinion of the Clinical Investigator, are able to understand this clinical investigation, co-operate with the investigational procedures and are willing to return to the hospital for all the required post-operative follow-ups.
  • Subjects defined by the Investigator as ASA Grade I or II.
  • Subjects with a primary diagnosis of osteoarthritis.
  • Subjects who require a primary total knee arthroplasty.
  • Subjects who can achieve active flexion of 90 degrees.

Who cannot join

  • Subjects who, in the opinion of the Clinical Investigator, have an existing condition that would compromise their participation and follow-up in this clinical investigation.
  • Subjects who are known drug or alcohol abusers or with psychological disorders that could affect follow-up care or treatment outcomes.
  • Subjects who have participated in a clinical investigation with an investigational product in the last month.
  • Subjects who are currently involved in any injury litigation claims.
  • Subjects with an anatomical limb alignment of above 20 degrees varus or valgus.
  • Subjects with a fixed flexion deformity of over 20 degrees.
Show all 19Show fewer
  • Subjects with recurvatum (definition: hyperextension ≥ 5 degrees).
  • Subjects who cannot flex their hip to 90 degrees.
  • Subjects with a BMI of 35 or above.
  • Subjects defined by the Investigator as ASA Grade III-V.
  • Subjects who are identified pre-operatively as having bone defects which require augmentation.
  • Subjects who have previously undergone total or unicondylar knee arthroplasty, high tibial osteotomy, ligament reconstruction, ORIF or with previous fracture in the knee joint.
  • Subjects with primary or secondary diagnosis of inflammatory or traumatic arthritis.
  • Subjects who have undergone contralateral total knee arthroplasty during the previous 6 months.
  • Subjects who in the opinion of the Investigator require patellar resurfacing.
  • Intra-operative exclusion criteria:
  • Subjects who have uncontained bone defects or defects bigger than 8 mm3 and/or require augmentation.
  • Subjects who are not suitable to receive both the study and comparator devices.
  • Subjects who require patellar resurfacing

Trial locations and contacts

4 sites in 3 countries.

4 sites in 3 countries

United Kingdom2 sites
  • Calderdale Royal Hospital

    Halifax, West Yorkshire, HX3 0PW

  • Victoria Hospital

    Kirkcaldy, Fife, KY2 5AH

Other trials in United Kingdom

India1 site
  • Sunshine Hospitals

    Secunderabad, Andhra Pradesh, 500003

Other trials in India

Singapore1 site
  • Singapore General Hospital

    Singapore, 169608

Other trials in Singapore

About this study

Official title: A Double-blinded Randomised Controlled Trial Comparing the Performance of the Sigma® CR150 and Sigma® CR Knee Systems, When Used in Fixed Bearing Primary Cruciate Retaining Total Knee Arthroplasty for the Treatment of Osteoarthritis

This study will compare two very similar designs of knee replacement device. One device (Sigma CR150) is a slightly modified version of the original (Sigma CR) and has been modified to enhance/accommodate higher flexion. The original device has been in widespread clinical use with excellent results since 1996 and this study will determine whether the design modifications of the newer device add further value. The newer device has been in clinical use with good short-term(unpublished) outcomes since becoming commercially available in January 2009.

Achieving higher knee flexion may be required for cultural reasons or by the increasingly younger, more active patient population undergoing knee replacement today. In addition to promoting flexion, it is also possible that this design change may help the knee replacement to last longer than traditional implants in patients who achieve higher flexion. Therefore, the study will compare the two devices in terms of survivorship, flexion and other measures of the success of a total knee replacement (range of motion, knee-related quality of life, activity and generic quality of life) over the short-term.

Read more

A minimum of one hundred and forty subjects (minimum 70 per group) with osteoarthritis and aged 50-75 years will be included at UK/international hospitals.

Study duration is 2 years and patients will complete standard knee outcome scores plus radiological evaluation.

Subjects would receive one of the study devices regardless of their involvement in the study, and apart from (possible)additional visits, x-rays and/or questionnaires, treatment and follow-up care will be as per the care they would receive outside of the study.

Conditions
Osteoarthritis
Being tested
Sigma CR150, Sigma CR
Keywords
Sigma, cruciate, retaining, fixed, primary, total, knee, arthroplasty, cemented, osteoarthritis
Medical subject headings
Osteoarthritis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Sigma CR150Device

    Also called PFC Sigma CR150

    Sigma CR150 femoral component used in combination with the Highly Polished Cobalt Chrome fixed bearing tibial tray and the Curved (XLK) polyethylene bearing (cemented, no patellar resurfacing).

  • Sigma CRDevice

    Also called PFC Sigma CR

    Sigma CR femoral component used in combination with the Highly Polished Cobalt Chrome fixed bearing tibial tray and the Curved (XLK) polyethylene bearing (cemented, no patellar resurfacing).

Study groups in NCT01418378
Study groupRoleWhat they receive
Sigma CR150Active comparatorSigma CR150 femoral component used in combination with the Highly Polished Cobalt Chrome fixed bearing tibial tray and the Curved (XLK) polyethylene bearing (cemented, no patellar resurfacing).
Receives: Device: Sigma CR150
Sigma CRActive comparatorSigma CR femoral component used in combination with the Highly Polished Cobalt Chrome fixed bearing tibial tray and the Curved (XLK) polyethylene bearing (cemented, no patellar resurfacing).
Receives: Device: Sigma CR

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Knees Who Survived at 2 Years Post-operative

    The Kaplan-Meier success rate at 24-months post-operatively was calculated with Kaplan-Meier time-to-event methodology, where the time variable for patients who were successful (no components revised for any reason) was censored at the time of last follow-up.

    Measured: 2 Years

Secondary outcomes (33)
  1. Change From Baseline in Goniometer Measured Maximum Passive Flexion at 2 Years

    Comparative evaluation of the change from baseline values in 2 year goniometer-measured passive flexion. A goniometer is an instrument used to measure angles in degrees and captures the change in angle between the upper and lower leg

    Measured: Pre-operative baseline to 2 years

  2. Knee Injury and Osteoarthritis Outcome Pain Subscore - 1 Year

    Comparative evaluation of the change from baseline values at 1 years in Knee Injury and Osteoarthritis Outcome Pain Subscore

    The subscore ranges from 0 (no pain) to 36 (extreme pain). The subscore is then transformed into a 0 (extreme pain) to 100 (no pain) scale.

    100 - (score x 100) / 36 = transformed score

    Measured: Pre-operative baseline to 1 year

  3. Knee Injury and Osteoarthritis Outcome Pain Subscore - 2 Years

    Comparative evaluation of the change from baseline values at 2 years in Knee Injury and Osteoarthritis Outcome Pain Subscore

    The subscore ranges from 0 (no pain) to 36 (extreme pain). The subscore is then transformed into a 0 (extreme pain) to 100 (no pain) scale.

    100 - (score x 100) / 36 = transformed score

    Measured: 2 years

  4. Knee Injury and Osteoarthritis Outcome Symptoms Subscore - 1 Years

    Comparative evaluation of the change from baseline values at 1 year in Knee Injury and Osteoarthritis Outcome Symptom Subscore

    The subscore ranges from 0 (no symptoms) to 36 (always have symptoms). The subscore is then transformed into a 0 (always have symptoms) to 100 (never have symptoms) scale.

    100 - (score x 100) / 36 = transformed score

    Measured: 1 years

  5. Knee Injury and Osteoarthritis Outcome Symptom Subscore - 2 Years

    Comparative evaluation of the change from baseline values at 2 years in Knee Injury and Osteoarthritis Outcome Symptom Subscore

    The subscore ranges from 0 (never have symptoms) to 28 (always have symptoms). The subscore is then transformed into a 0 (always have symptoms) to 100 (never have symptoms) scale.

    100 - (score x 100) / 28 = transformed score

    Measured: 2 years

  6. Knee Injury and Osteoarthritis Outcome - Activities of Daily Living Subscore - 1 Years

    Comparative evaluation of the change from baseline values at 1 years in Knee Injury and Osteoarthritis Outcome Symptom Subscore

    The subscore ranges from 0 (no difficulty) to 68 (extreme difficulty). The subscore is then transformed into a 0 (extreme difficulty) to 100 (no difficulty) scale.

    100 - (score x 100) / 68 = transformed score

    Measured: 1 year

  7. Knee Injury and Osteoarthritis Outcome - Activities of Daily Living Subscore - 2 Years

    Comparative evaluation of the change from baseline values at 2 years in Knee Injury and Osteoarthritis Outcome Activities of Daily Living Subscore

    The subscore ranges from 0 (no difficulty) to 68 (extreme difficulty). The subscore is then transformed into a 0 (extreme difficulty) to 100 (no difficulty) scale.

    100 - (score x 100) / 68 = transformed score

    Measured: 2 year

  8. Knee Injury and Osteoarthritis Outcome - Sport and Recreation Subscore - 1 Years

    Comparative evaluation of the change from baseline values at 1 years in Knee Injury and Osteoarthritis Outcome Activities of Daily Living Subscore

    The subscore ranges from 0 (no difficulty) to 20 (extreme difficulty). The subscore is then transformed into a 0 (extreme difficulty) to 100 (no difficulty) scale.

    100 - (score x 100) / 20 = transformed score

    Measured: 1 year

  9. Knee Injury and Osteoarthritis Outcome Sport and Recreation Subscore - 2 Years

    Comparative evaluation of the change from baseline values at 2 years in Knee Injury and Osteoarthritis Outcome Activities of Daily Living Subscore

    The subscore ranges from 0 (no difficulty) to 20 (extreme difficulty). The subscore is then transformed into a 0 (extreme difficulty) to 100 (no difficulty) scale.

    100 - (score x 100) / 20 = transformed score

    Measured: 2 year

  10. Knee Injury and Osteoarthritis Outcome - Quality of Life Subscore - 1 Years

    Comparative evaluation of the change from baseline values at 1 years in Knee Injury and Osteoarthritis Outcome Activities of Quality of life Subscore

    The subscore ranges from 0 (no difficulty) to 16 (extreme difficulty). The subscore is then transformed into a 0 (extreme difficulty) to 100 (no difficulty) scale.

    100 - (score x 100) / 16 = transformed score

    Measured: 1 year

  11. Knee Injury and Osteoarthritis Outcome - Quality of Life Subscore - 2 Years

    Comparative evaluation of the change from baseline values at 2 years in Knee Injury and Osteoarthritis Outcome Quality of Life Subscore

    The subscore ranges from 0 (no difficulty) to 16 (extreme difficulty). The subscore is then transformed into a 0 (extreme difficulty) to 100 (no difficulty) scale.

    100 - (score x 100) / 16 = transformed score

    Measured: 2 years

  12. Change From Baseline in Goniometer Measured Maximum Passive Flexion at 1 Year.

    Comparative evaluation of the change from baseline values in 1 year goniometer-measured passive Flexion. A goniometer is an instrument used to measure angles in degrees and captures the change in angle between the upper and lower leg. Passive flexion involves moving the leg through range of motion without active muscle contraction

    Measured: 1 year

  13. Change From Baseline in Goniometer Measured Maximum Passive Extension at 1 Year

    Comparative evaluation of the change from baseline values in 1 year goniometer-measured passive extension. A goniometer is an instrument used to measure angles in degrees and captures the change in angle between the upper and lower leg. Passive extension involves the leg being moved without active muscle contraction

    Measured: 1 year

  14. Change From Baseline in Goniometer Measured Maximum Passive Extension at 2 Years

    Comparative evaluation of the change from baseline values in 2 year goniometer-measured passive extension. A goniometer is an instrument used to measure angles in degrees and captures the change in angle between the upper and lower leg. Passive extension involves moving the leg without active muscle contraction

    Measured: 2 year

  15. Change From Baseline in Goniometer Measured Maximum Total Range of Motion at 1 Year

    Comparative evaluation of the change from baseline values in 1 year goniometer-measured total range of motion. A goniometer is an instrument used to measure angles in degrees and captures the change in angle between the upper and lower leg. Total range of motion is the full distance the lower leg travels in relation to the upper leg.

    Measured: 1 year

  16. Change From Baseline in Goniometer Measured Maximum Total Range of Motion at 2 Years.

    Comparative evaluation of the change from baseline values in 2 year goniometer-measured total range of motion. A goniometer is an instrument used to measure angles in degrees and captures the change in angle between the upper and lower leg. Total range of motion is the full distance the lower leg travels in relation to the upper leg.

    Measured: 2 years

  17. Number of Participants With Flexion Contracture at 1 Year

    Summary of flexion contracture at 1 year time point. Flexion contracture is a shortening of the muscles that prevents the leg from fully extending

    Measured: 1 years

  18. Number of Participants With Flexion Contracture at 2 Years

    Summary of flexion contracture at 2 year time point.Flexion contracture is a shortening of the muscles that prevents the leg from fully extending

    Measured: 2 years

  19. Total Knee Society Score at 1 Year

    Total Knee Society Knee Score change from baseline at 1 year

    The Total Knee Society Score is comprised of two scores: the Knee Score and the Function Score. Both have a 0-100 range. Sub-scales are combined to compute a total score of 100

    The Total Knee Society Score is made up of pain, range of motion, alignment and stability subscores. An Excellent score is 80-100, a good score is 70-79, a fair score is 60-69 and a poor score is anything below 60.

    Measured: 1 year

  20. Total Knee Society Knee Score at 2 Years

    Total Knee Society Knee Score change from baseline at 2 years

    The Total Knee Society Score is comprised of two scores: the Knee Score and the Function Score. Both have a 0-100 range. Sub-scales are combined to compute a total score of 100

    The Total Knee Society Score is made up of pain, range of motion, alignment and stability subscores. An Excellent score is 80-100, a good score is 70-79, a fair score is 60-69 and a poor score is anything below 60.

    Measured: 2 years

  21. Anatomic Alignment Angle

    Anatomic angle measured at 1 year time point.

    If one draws a line from the center of the hip joint to the center of the ankle joint this is considered to be the mechanical axis of the femur.

    A line drawn through the center of the femoral shaft is the anatomic axis.

    The angle created at the intersection of these lines is referred to as the anatomic alignment angle.

    A normal angle is approximately 7-9 degrees "valgus" or slightly "knock-kneed". "Varus" angles are less common and are also referred to as "bow-legged".

    Measured: 1 year time point

  22. Anatomic Alignment Angle

    Anatomic angle measured at 2 year time point.

    If one draws a line from the center of the hip joint to the center of the ankle joint this is considered to be the mechanical axis of the femur.

    A line drawn through the center of the femoral shaft is the anatomic axis.

    The angle created at the intersection of these lines is referred to as the anatomic alignment angle.

    A normal angle is approximately 7-9 degrees "valgus" or slightly "knock-kneed". "Varus" angles are less common and are also referred to as "bow-legged".

    Measured: 2 year time point

  23. Alignment - Femoral Component to Anatomic Angle.

    Femoral component angle measured at 1 year time point. This angle is measured between a line drawn from the center of the femoral head and a line across the bottom of the femoral implant (condyles).

    Measured: 1 year time point

  24. Alignment - Femoral Component to Anatomic Angle

    Femoral component angle measured at 2 year time point. This angle is measured between a line drawn from the center of the femoral head and a line across the bottom of the femoral implant (condyles).

    Measured: 2 year time point

  25. Alignment - Tibial Component to Anatomic Angle

    Tibial component angle measured at 1 year time point. This angle is measured between a line drawn from the center of the femoral head tibial implant.

    Measured: 1 year time point

  26. Alignment - Tibial Component to Anatomic Angle

    Tibial component angle measured at 2 year time point. This angle is measured between a line drawn from the center of the femoral head tibial implant.

    Measured: 2 year time point

  27. Alignment - Femoral Component Flexion

    Femoral Component Flexion measured at 1 year time point. This measures the angle between a line drawn though the center of the side of the femur and a line drawn across the top of the flat inner surface of the femoral component.

    Measured: 1 year time point

  28. Alignment - Femoral Component Flexion

    Alignment - Femoral Component Flexion measured at 2 year time point. This measures the angle between a line drawn though the center of the side of the femur and a line drawn across the top of the flat inner surface of the femoral component.

    Measured: 2 year time point

  29. Alignment - Tibial Posterior Slope

    Tibial Posterior Slope measured at 1 year time point. This angle is measured between a line through the center of the side of the tibia and the top flat surface of the tibial implant

    Measured: 1 year time point

  30. Alignment - Tibial Posterior Slope

    Alignment - Tibial Posterior Slope measured at 2 year time point. This angle is measured between a line through the center of the side of the tibia and the top flat surface of the tibial implant

    Measured: 2 year time point

  31. Number of Subjects With Radiolucencies - Femoral Component

    The bone-implant interface at the femoral components were examined radiographically and radiolucencies were measured in millimeters.

    Radiolucent lines (RLLs) greater than 2mm are considered to be clinically significant.

    Measured: 6 to 12 week and 24 month intervals

  32. Number of Subjects With Radiolucencies - Tibial Component

    The bone-implant interface at the tibial components were examined radiographically and radiolucencies were measured in millimeters.

    Radiolucent lines (RLLs) greater than 2mm are considered to be clinically significant.

    Radiolucent lines greater than 2mm are considered to be clinically significant.

    Measured: 6 weeks to 24 months

  33. Radiographic Evaluation of Maximum Flexion

    Maximum knee flexion measured radiographically at 1 year time point

    Measured: 1 year time point

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Aug 2011 (estimated)
  2. Study start3 Aug 2011
  3. Primary completion17 Feb 2016
  4. Study completion17 Feb 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
191 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01418378
Sponsor's protocol ID
CT07/04
Status last verified
Jul 2019
First submitted
9 Aug 2011
Last updated
28 Aug 2019
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Sigma CR150 and Sigma CR in people with Osteoarthritis, run by DePuy International at 4 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Aug 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United Kingdom, India, Singapore. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 31 May 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Knees Who Survived at 2 Years Post-operative (time frame: 2 Years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Aug 2019.

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