OsteoarthritisTARVANCT02128555
Total Ankle Replacement Versus Arthrodesis Trial
A study testing Total Ankle Replacement and Arthrodesis in people with Osteoarthritis, run by University College, London at 17 sites in United Kingdom.
Trial summary
The purpose of TARVA is to determine whether Total Ankle Replacement (TAR) provides better clinical outcomes than ankle arthrodesis in patients aged 50-85 years with end-stage ankle osteoarthritis, and compare cost-effectiveness of the two treatments Read more about this study
- Who is it for?
- Ages 50 to 85 yearsHealthy volunteers can take part
- Conditions the study is for
- Osteoarthritis
- What is being tested?
- Total Ankle Replacement and Arthrodesis
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 303 participants
- Where
- 17 sitesUnited Kingdom
- Study dates
- Jan 2015to 28 Feb 2029
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 85 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Diagnosis of end-stage ankle osteoarthritis
- Aged 50-85 years inclusive
- The surgeon believes the patient is suitable for both TAR and arthrodesis (having considered deformity, stability, bone quality, soft tissue envelope, and neurovascular status)
- The patient is able to read and understand the Patient Information Sheet (PIS) and trial procedures
- The patient is willing and able to provide written informed consent
Who cannot join
- Previous ipsilateral talonavicular, subtalar or calcaneocuboid fusion or surgery planned within 1 year of index procedure
- More than 4 lower limb joints fused (including contralateral limb, but excluding proximal interphalangeal joint fusions)
- • Unable to have MRI/CT scan (e.g. severe claustrophobia or contraindication for either scan)
- History of local bone or joint infection
- Any co-morbidity, which, in the opinion of the investigator, is severe enough to; interfere with the patient's ability to complete the study assessments or; presents an unacceptable risk to the patient's safety
- Participant in another clinical trial that would materially impact on their participation in this study
Trial locations and contacts
17 sites in 1 country.
17 sites in 1 country
United Kingdom17 sites
Brighton & Sussex University Hospitals NHS Trust
Brighton
North Bristol NHS Trust
Bristol
Cardiff and Vale Orthopaedic Centre
Cardiff
Royal Derby Hospital
Derby, DE22 3NE
Royal Surrey County Hospital
Guildford, GU2 7XX
Hull and East Yorkshire Hospitals NHS Trust
Hull
Aintree University Hospital
Liverpool, L9 7AL
Freeman Hospital
Newcastle, NE7 7DN
Northumbria Healthcare NHS Foundation Trust
Newcastle
Norfolk and Norwich University Hospitals NHS Foundation Trust
Norwich
Nottingham University Hospitals NHS Trust
Nottingham
Robert Jones & Agnes Hunt Orthopaedic Hospital
Oswestry, SY10 7AG
Oxford University Hospitals NHS Foundation Trust
Oxford, OX3 7LD
Northern General Hospital
Sheffield, S5 7AU
Royal National Orthopaedic Hospital NHS Trust
Stanmore, HA7 4LP
Royal Cornwall Hospitals NHS Trust
Truro, Cornwall, TR1 3LQ
Wrightington Hospital
Wigan, WN6 9EP
About this study
Official title: A Randomised, Multi-centre, Non-blinded, Prospective, Parallel Group Trial of Total Ankle Replacement (TAR) Versus Ankle Arthrodesis in Patients With End Stage Ankle Osteoarthritis, Comparing Clinical Outcomes and Cost-effectiveness.
The purpose of TARVA is to determine whether Total Ankle Replacement (TAR) provides better clinical outcomes than ankle arthrodesis in patients aged 50-85 years with end-stage ankle osteoarthritis, and compare cost-effectiveness of the two treatments
Read the detailed description
This is a randomised, multi-centre, non-blinded, prospective, parallel-group trial of TAR versus ankle arthrodesis in patients with end-stage ankle osteoarthritis (OA) aged between 50 and 85 years, comparing clinical outcomes (pain-free function, quality of life (QoL), range of motion (ROM), and rate of post-procedural complications) and cost-effectiveness. TARVA is a clinician-led, pragmatic, superiority trial designed to compare the improvement in pain-free function, as assessed by the Manchester-Oxford Foot Questionnaire (MOXFQ) walking/standing domain score from pre-op to 52 weeks post-op for each surgical treatment group. A total of 328 patients will be randomly allocated on an equal basis to one of two surgical treatments: i) Total Ankle Replacement; and ii) Ankle Arthrodesis. Randomisation will be stratified by surgeon and presence of OA in two adjacent joints as determined by a pre-operative MRI scan.
- Conditions
- Osteoarthritis
- Being tested
- Total Ankle Replacement, Arthrodesis
- Keywords
- ankle arthritis, osteoarthritis, total ankle replacement, arthrodesis, quality of life, musculoskeletal
- Medical subject headings
- Osteoarthritis, Ankylosis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Total Ankle ReplacementProcedure or surgery
The joints are resurfaced with metal implants and a mobile plastic liner is placed between them as the gliding surface.
ArthrodesisProcedure or surgery
Also called Fusion
The remaining damaged cartilage is removed from the ends of the bone and the two bones are then held together in compression using screws, or plates until they join to become one (bone fusion), so that there is no longer any movement at that joint.
| Study group | Role | What they receive |
|---|---|---|
| Arthrodesis | Active comparator | Ankle arthrodesis (fusion) Receives: Procedure: Arthrodesis |
| Total Ankle Replacement | Experimental | Total Ankle Replacement Receives: Procedure: Total Ankle Replacement |
What is being measured
The primary outcome is the main question the study is designed to answer.
Self-reported pain-free function domain score
To compare the improvement in self-reported pain-free function domain score from pre-op to 52 weeks post-op for TAR versus arthrodesis, assessed by MOXFQ walking/standing domain scores.
Measured: Pre-operation (baseline) to 52 weeks
Secondary outcomes (7)
Self-reported pain-free function domain score
To compare the improvement in self-reported pain-free function domain score from pre-op to 26 weeks post-op for TAR versus arthrodesis, assessed by MOXFQ walking/standing domain scores.
Measured: Pre-operation (baseline) to 26 weeks
Self-reported pain and social interaction domain score
To compare the improvement in self-reported pain and social interaction domain scores from pre-op to 26 and 52 weeks post-op for TAR versus arthrodesis, assessed by MOXFQ.
Measured: Pre-operation (baseline) to 26 and 52 weeks
Self-reported physical function
To compare the improvement in self-reported physical function from pre-op to 26 and 52 weeks post-op of TAR versus arthrodesis, assessed by the Foot and Ankle Ability Measure (FAAM) questionnaire.
Measured: Pre-operation (baseline) to 26 and 52 weeks
Self-reported quality of life
To compare the improvement in QoL from pre-op to 26 and 52 weeks post-op of TAR versus arthrodesis, assessed by EQ-5D.
Measured: Pre-operation (baseline) to 26 and 52 weeks
Range of Motion
To compare the change in total ROM (plantarflexion and dorsiflexion) from pre-op to 52 weeks post-op of TAR versus arthrodesis, assessed by goniometer.
Measured: Pre-operation (baseline) to 52 weeks
Adverse events
To compare the safety of TAR versus arthrodesis in terms of complications and adverse events.
Measured: 52 weeks
Incremental cost and cost-effectiveness
To compare the incremental cost and cost-effectiveness of TAR versus arthrodesis by recording cost of all components and procedure-related costs for each surgical treatment, and using self-reported data from the Health and Social Care Services Use questionnaire.
Measured: 52 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 May 2014 (estimated)
- Study startJan 2015
- Primary completion23 Dec 2019
- Study completion28 Feb 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for OsteoarthritisStudies of the same condition, open and under way.
- More trials run by University College, LondonThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 303 participants (actual)
Sponsor and investigators
- Lead sponsor
- University College, London
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute for Health Research, United Kingdom
- Responsible party
- Sponsor
- Investigators
- Andrew Goldberg, Principal investigator, Royal National Orthopaedic Hospital NHS Trust
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02128555
- Sponsor's protocol ID
- 12/0518
- Other IDs
- 12/35/27, ISRCTN60672307, U1111-1157-4155
- Acronym
- TARVA
- Status last verified
- Mar 2021
- First submitted
- 11 Apr 2014
- Last updated
- 15 Mar 2021
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Goldberg AJ, Bordea E, Chowdhury K, Hauptmannova I, Blackstone J, Brooking D, Deane EL, Bendall S, Bing A, Blundell C, Dhar S, Molloy A, Milner S, Karski M, Hepple S, Siddique M, Loveday DT, Mishra V, Cooke P, Halliwell P, Townshend D, Skene SS, Dore CJ; TARVA Study Group. Cost-Utility Analysis of Total Ankle Replacement Compared with Ankle Arthrodesis for Patients Aged 50-85 Years with End-Stage Ankle Osteoarthritis: The TARVA Study. Pharmacoecon Open. 2024 Mar;8(2):235-249. doi: 10.1007/s41669-023-00449-4. Epub 2024 Jan 8.
PubMed 38189868Goldberg AJ, Chowdhury K, Bordea E, Blackstone J, Brooking D, Deane EL, Hauptmannova I, Cooke P, Cumbers M, Skene SS, Dore CJ. Total ankle replacement versus ankle arthrodesis for patients aged 50-85 years with end-stage ankle osteoarthritis: the TARVA RCT. Health Technol Assess. 2023 Mar;27(5):1-80. doi: 10.3310/PTYJ1146.
PubMed 37022932Muller P, Skene SS, Chowdhury K, Cro S, Goldberg AJ, Dore CJ; TARVA Study Group. A randomised, multi-centre trial of total ankle replacement versus ankle arthrodesis in the treatment of patients with end stage ankle osteoarthritis (TARVA): statistical analysis plan. Trials. 2020 Feb 18;21(1):197. doi: 10.1186/s13063-019-3973-4.
PubMed 32070409Goldberg AJ, Zaidi R, Thomson C, Dore CJ, Skene SS, Cro S, Round J, Molloy A, Davies M, Karski M, Kim L, Cooke P; TARVA study group. Total ankle replacement versus arthrodesis (TARVA): protocol for a multicentre randomised controlled trial. BMJ Open. 2016 Sep 6;6(9):e012716. doi: 10.1136/bmjopen-2016-012716.
PubMed 27601503
Study at a glance
From the registry record, last updated by the sponsor on 15 Mar 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomised, Multi-centre, Non-blinded, Prospective, Parallel Group Trial of Total Ankle Replacement (TAR) Versus Ankle Arthrodesis in Patients With End Stage Ankle Osteoarthritis, Comparing Clinical Outcomes and Cost-effectiveness.
- ClinicalTrials.gov ID
- NCT02128555
- Acronym / sponsor ID
- TARVA / 12/0518
- Conditions
- Osteoarthritis
- Keywords
- ankle arthritis, osteoarthritis, total ankle replacement, arthrodesis, quality of life, musculoskeletal
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 303 participants (actual)
- Lead sponsor
- University College, LondonUniversity, hospital or other
- Collaborators
- National Institute for Health Research, United Kingdom
- Study start
- Jan 2015 (actual)
- Primary completion
- 23 Dec 2019 (actual)
- Study completion
- 28 Feb 2029 (estimated)
- First posted
- 1 May 2014 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of TARVA is to determine whether Total Ankle Replacement (TAR) provides better clinical outcomes than ankle arthrodesis in patients aged 50-85 years with end-stage ankle osteoarthritis, and compare cost-effectiveness of the two treatments
Detailed description
This is a randomised, multi-centre, non-blinded, prospective, parallel-group trial of TAR versus ankle arthrodesis in patients with end-stage ankle osteoarthritis (OA) aged between 50 and 85 years, comparing clinical outcomes (pain-free function, quality of life (QoL), range of motion (ROM), and rate of post-procedural complications) and cost-effectiveness. TARVA is a clinician-led, pragmatic, superiority trial designed to compare the improvement in pain-free function, as assessed by the Manchester-Oxford Foot Questionnaire (MOXFQ) walking/standing domain score from pre-op to 52 weeks post-op for each surgical treatment group. A total of 328 patients will be randomly allocated on an equal basis to one of two surgical treatments: i) Total Ankle Replacement; and ii) Ankle Arthrodesis. Randomisation will be stratified by surgeon and presence of OA in two adjacent joints as determined by a pre-operative MRI scan.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Arthrodesis | Active comparator | Procedure: ArthrodesisAnkle arthrodesis (fusion) |
| Total Ankle Replacement | Experimental | Procedure: Total Ankle ReplacementTotal Ankle Replacement |
Who may qualify
- Ages
- 50 to 85 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Diagnosis of end-stage ankle osteoarthritis
- Aged 50-85 years inclusive
- The surgeon believes the patient is suitable for both TAR and arthrodesis (having considered deformity, stability, bone quality, soft tissue envelope, and neurovascular status)
- The patient is able to read and understand the Patient Information Sheet (PIS) and trial procedures
- The patient is willing and able to provide written informed consent
Key exclusion criteria (6 listed)
- Previous ipsilateral talonavicular, subtalar or calcaneocuboid fusion or surgery planned within 1 year of index procedure
- More than 4 lower limb joints fused (including contralateral limb, but excluding proximal interphalangeal joint fusions)
- • Unable to have MRI/CT scan (e.g. severe claustrophobia or contraindication for either scan)
- History of local bone or joint infection
- Any co-morbidity, which, in the opinion of the investigator, is severe enough to; interfere with the patient's ability to complete the study assessments or; presents an unacceptable risk to the patient's safety
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Total Ankle ReplacementThe joints are resurfaced with metal implants and a mobile plastic liner is placed between them as the gliding surface. | Procedure or surgery | Total Ankle Replacement |
| ArthrodesisAlso: FusionThe remaining damaged cartilage is removed from the ends of the bone and the two bones are then held together in compression using screws, or plates until they join to become one (bone fusion), so that there is no longer any movement at that joint. | Procedure or surgery | Arthrodesis |
Primary outcome
Self-reported pain-free function domain score
Time frame: Pre-operation (baseline) to 52 weeks
To compare the improvement in self-reported pain-free function domain score from pre-op to 52 weeks post-op for TAR versus arthrodesis, assessed by MOXFQ walking/standing domain scores.
7 secondary outcomes
Self-reported pain-free function domain score
Time frame: Pre-operation (baseline) to 26 weeks
Self-reported pain and social interaction domain score
Time frame: Pre-operation (baseline) to 26 and 52 weeks
Self-reported physical function
Time frame: Pre-operation (baseline) to 26 and 52 weeks
Self-reported quality of life
Time frame: Pre-operation (baseline) to 26 and 52 weeks
Range of Motion
Time frame: Pre-operation (baseline) to 52 weeks
Adverse events
Time frame: 52 weeks
Incremental cost and cost-effectiveness
Time frame: 52 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Mar 2021.
- Derived from this study: PubMed 38189868Goldberg AJ, Bordea E, Chowdhury K, Hauptmannova I, Blackstone J, Brooking D, Deane EL, Bendall S, Bing A, Blundell C, Dhar S, Molloy A, Milner S, Karski M, Hepple S, Siddique M, Loveday DT, Mishra V, Cooke P, Halliwell P, Townshend D, Skene SS, Dore CJ; TARVA Study Group. Cost-Utility Analysis of Total Ankle Replacement Compared with Ankle Arthrodesis for Patients Aged 50-85 Years with End-Stage Ankle Osteoarthritis: The TARVA Study. Pharmacoecon Open. 2024 Mar;8(2):235-249. doi: 10.1007/s41669-023-00449-4. Epub 2024 Jan 8.
- Derived from this study: PubMed 37022932Goldberg AJ, Chowdhury K, Bordea E, Blackstone J, Brooking D, Deane EL, Hauptmannova I, Cooke P, Cumbers M, Skene SS, Dore CJ. Total ankle replacement versus ankle arthrodesis for patients aged 50-85 years with end-stage ankle osteoarthritis: the TARVA RCT. Health Technol Assess. 2023 Mar;27(5):1-80. doi: 10.3310/PTYJ1146.
- Derived from this study: PubMed 32070409Muller P, Skene SS, Chowdhury K, Cro S, Goldberg AJ, Dore CJ; TARVA Study Group. A randomised, multi-centre trial of total ankle replacement versus ankle arthrodesis in the treatment of patients with end stage ankle osteoarthritis (TARVA): statistical analysis plan. Trials. 2020 Feb 18;21(1):197. doi: 10.1186/s13063-019-3973-4.
- Derived from this study: PubMed 27601503Goldberg AJ, Zaidi R, Thomson C, Dore CJ, Skene SS, Cro S, Round J, Molloy A, Davies M, Karski M, Kim L, Cooke P; TARVA study group. Total ankle replacement versus arthrodesis (TARVA): protocol for a multicentre randomised controlled trial. BMJ Open. 2016 Sep 6;6(9):e012716. doi: 10.1136/bmjopen-2016-012716.
- TARVA websiteLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Andrew Goldberg principal investigator
Royal National Orthopaedic Hospital NHS Trust
17 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Total Ankle Replacement and Arthrodesis in people with Osteoarthritis, run by University College, London at 17 sites in United Kingdom.
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 5 inclusion and 6 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: under way, not looking for participants, as of the sponsor's last update on 15 Mar 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 17 sites in United Kingdom. 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.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
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?
Self-reported pain-free function domain score (time frame: Pre-operation (baseline) to 52 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02128555, which also lists 4 linked publications.
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 15 Mar 2021.