Wound; KneeNCT03285529
The Use of STRATAFIX Suture Device Compared to Standard-of-care for Deep Tissue Closure in Total Knee Arthroplasty
A study testing STRATIFIX and VICRYL in people with Wound; Knee, run by The Cleveland Clinic at 1 site in United States.
Trial summary
The STRATAFIX (Ethicon, Johnson and Johnson, Somerville, New Jersey) Knotless Tissue Control suture device is a barbed suture that uses anchor technology to securely engage with the soft tissues while also eliminating the need for knots. Read more about this study
- Who is it for?
- Ages 18 to 80 years
- Conditions the study is for
- Wound; Knee
- What is being tested?
- STRATIFIX and VICRYL
- Type of treatment
- Pill or oral medicine, Injection or infusion, Medical device
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 60 participants
- Where
- 1 siteUnited States
- Study dates
- 26 Sep 2017to 31 May 2019
- Phase
- Interventional
- 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 18 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Males and females, between the ages of 18 to 80 years at the time of signing the informed consent document.
- Understand and voluntarily sign an informed consent document prior to any study-related assessments/procedures are conducted.
- Able to adhere to the study visit schedule and other protocol requirements.
- Able to fluently speak and understand the local language
- If female, is non-pregnant (negative pregnancy test results at the baseline/randomization visit) and non-lactating.
- End-stage osteoarthritis patients planning to undergo primary total knee arthroplasty
- BMI less than 40 kg/m2
Who cannot join
- BMI greater than or equal to 40 kg/m2.
- History of known bleeding disorder.
- History of medical co-morbidity that may result in poor wound healing (i.e. diabetes mellitus, peripheral vascular disease).
- Patients <18 or >80 years of age.
- Patients who are prisoners.
- Mentally unable to sign informed consent.
- Has an uncontrolled illness that, in the opinion of the investigator, is likely to cause the patient to be withdrawn from the trial or would otherwise interfere with interpreting the results of the study.
Trial locations and contacts
1 site in 1 country.
About this study
The STRATAFIX (Ethicon, Johnson and Johnson, Somerville, New Jersey) Knotless Tissue Control suture device is a barbed suture that uses anchor technology to securely engage with the soft tissues while also eliminating the need for knots. The anchors, or barbs, are pressed out of the device core or formed within the core in a geometric pattern and arranged in a tapered manner to allow the device to pass through tissue in the direction toward the needle during closure. These knotless tissue control devices are deployed using a continuous technique, which is anticipated to be faster and more cost-effective than interrupted suturing.
Read the detailed description
Preclinical and biomechanical studies have demonstrated efficacy in cosmetic skin and deep tissue closures.[1], [2] In addition, barbed sutures have been shown to provide water-tight closure and wound strength comparable to or superior to closure with conventional sutures. Many comparative studies have been published contrasting barbed sutures to conventional closure techniques in multiple surgical fields. [3], [4] Various studies have evaluated the outcomes of different barbed suture devices, however there are no reports assessing the length of closure times using STRATAFIX (Ethicon, Johnson and Johnson, Somerville, New Jersey) Knotless Tissue Control Devices during deep closure in total hip arthroplasty. Stephens et al. [5] performed a prospective randomized study of 500 total knee arthroplasty patients who received either barbed suture (250) or conventional sutures (250) for deep closure of the surgical wound. The mean operating time was significantly shorter in the barbed group as compared to conventional group (64.3 vs 68.1 minutes, p=<0.001). In a study of 80 TKA (61 barbed, 19 conventional deep sutures) and 54 THA patients (37 barbed, 17 conventional deep sutures), Smith et al. [6] found significantly shorter closure time in the barbed suture group (16.78 vs. 26.5 minutes, p<0.001). One study reports one the use of Stratfix suture for intracorporeal suturing in myomectomy. Giampaolino et al. [7] performed a prospective randomized study on 47 patients and evaluated the mean operative time for laparoscopic posterior myomectomy using Stratafix or conventional suture for intracorporeal suturing. There was a significant decrease in mean operative time associated with use of Stratafix suture as compared to conventional suture (66.3 vs 73 minutes, p=0.005).
This prospective randomized single-center study will examine the outcomes, mainly closure time, of deep closure during total knee arthroplasty using the STRATAFIX Symmetric PDS Plus (Ethicon, Johnson and Johnson, Somerville, New Jersey) barbed suture compared to interrupted VICRYL suture (Ethicon, Johnson and Johnson, Somerville, New Jersey).
- Conditions
- Wound; Knee
- Being tested
- STRATIFIX, VICRYL
- Keywords
- barbed suture, knoteless suture, total knee arthroplasty, wound, closure, time
- Medical subject headings
- Wounds and Injuries
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
STRATIFIXDevice
STRATIFIX symmetric PDS Plus; Stratifix knotless suture
VICRYLDevice
Vicryl #1
| Study group | Role | What they receive |
|---|---|---|
| STRATAFIX GROUP | Active comparator | STRATIFIX symmetric PDS Plus #1 will be used to close the capsule following total knee arthroplasty. The subcutaneous layer will be then closed with simple interrupted knots using number 2-0 braided absorbable sutures (Vicryl), followed by closure of the subcutaneous layer using a number 2-0 monofilament absorbable suture with inverted interrupted knots (Monocryl) followed by the use of steri-strips and adhesive Receives: Device: STRATIFIX |
| CONTROL GROUP | Placebo comparator | The arthrotomy (deep layer) is repaired using Vicryl #1 followed by closure of the intermediate layer with a 2-0 Vicryl and a subcutaneous layer with a 2-0 Monocryl followed by steri-strips and adhesive, following total knee arthroplasty. Receives: Device: VICRYL |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time to Close, Minutes
Time from first needle insertion to complete skin closure per protocol
Measured: Day of surgery
Secondary outcomes (1)
Number of Participants With Wound Complications
superficial wound infection, deep wound infection, periprosthetic joint infection, wound hematoma, and wound dehiscence.
Measured: 90 days postoperative
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Sep 2017
- Study start26 Sep 2017
- Primary completion28 Feb 2019
- Study completion31 May 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Wound; KneeStudies of the same condition, open and under way.
- More trials run by The Cleveland ClinicThe 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
- Single blind
- Who is masked
- Participant
- Enrolment
- 60 participants (actual)
Sponsor and investigators
- Lead sponsor
- The Cleveland Clinic
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Viktor Krebs, M.D., The Cleveland Clinic
- Investigators
- Viktor Krebs, MD, Principal investigator, The Cleveland Clinic
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03285529
- Sponsor's protocol ID
- 17-841
- Status last verified
- Oct 2020
- First submitted
- 14 Sep 2017
- Last updated
- 19 Nov 2020
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- No: No data will be shared with other researchers.
Publications
Sundaram K, Warren JA, Klika A, Piuzzi NS, Mont MA, Krebs V. Barbed sutures reduce arthrotomy closure duration compared to interrupted conventional sutures for total knee arthroplasty: a randomized controlled trial. Musculoskelet Surg. 2021 Dec;105(3):275-281. doi: 10.1007/s12306-020-00654-y. Epub 2020 Mar 7.
PubMed 32146687
Study at a glance
From the registry record, last updated by the sponsor on 19 Nov 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Use of STRATAFIX Suture Device Compared to Standard-of-care for Deep Tissue Closure in Total Knee Arthroplasty
- ClinicalTrials.gov ID
- NCT03285529
- Acronym / sponsor ID
- 17-841
- Conditions
- Wound; Knee
- Keywords
- barbed suture, knoteless suture, total knee arthroplasty, wound, closure, time
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 60 participants (actual)
- Lead sponsor
- The Cleveland ClinicUniversity, hospital or other
- Study start
- 26 Sep 2017 (actual)
- Primary completion
- 28 Feb 2019 (actual)
- Study completion
- 31 May 2019 (actual)
- First posted
- 18 Sep 2017 (actual)
- Results
- Posted 19 Nov 2020
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The STRATAFIX (Ethicon, Johnson and Johnson, Somerville, New Jersey) Knotless Tissue Control suture device is a barbed suture that uses anchor technology to securely engage with the soft tissues while also eliminating the need for knots. The anchors, or barbs, are pressed out of the device core or formed within the core in a geometric pattern and arranged in a tapered manner to allow the device to pass through tissue in the direction toward the needle during closure. These knotless tissue control devices are deployed using a continuous technique, which is anticipated to be faster and more cost-effective than interrupted suturing.
Detailed description
Preclinical and biomechanical studies have demonstrated efficacy in cosmetic skin and deep tissue closures.[1], [2] In addition, barbed sutures have been shown to provide water-tight closure and wound strength comparable to or superior to closure with conventional sutures. Many comparative studies have been published contrasting barbed sutures to conventional closure techniques in multiple surgical fields. [3], [4] Various studies have evaluated the outcomes of different barbed suture devices, however there are no reports assessing the length of closure times using STRATAFIX (Ethicon, Johnson and Johnson, Somerville, New Jersey) Knotless Tissue Control Devices during deep closure in total hip arthroplasty. Stephens et al. [5] performed a prospective randomized study of 500 total knee arthroplasty patients who received either barbed suture (250) or conventional sutures (250) for deep closure of the surgical wound. The mean operating time was significantly shorter in the barbed group as compared to conventional group (64.3 vs 68.1 minutes, p=<0.001). In a study of 80 TKA (61 barbed, 19 conventional deep sutures) and 54 THA patients (37 barbed, 17 conventional deep sutures), Smith et al. [6] found significantly shorter closure time in the barbed suture group (16.78 vs. 26.5 minutes, p<0.001). One study reports one the use of Stratfix suture for intracorporeal suturing in myomectomy. Giampaolino et al. [7] performed a prospective randomized study on 47 patients and evaluated the mean operative time for laparoscopic posterior myomectomy using Stratafix or conventional suture for intracorporeal suturing. There was a significant decrease in mean operative time associated with use of Stratafix suture as compared to conventional suture (66.3 vs 73 minutes, p=0.005).
This prospective randomized single-center study will examine the outcomes, mainly closure time, of deep closure during total knee arthroplasty using the STRATAFIX Symmetric PDS Plus (Ethicon, Johnson and Johnson, Somerville, New Jersey) barbed suture compared to interrupted VICRYL suture (Ethicon, Johnson and Johnson, Somerville, New Jersey).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| STRATAFIX GROUP | Active comparator | Device: STRATIFIXSTRATIFIX symmetric PDS Plus #1 will be used to close the capsule following total knee arthroplasty. The subcutaneous layer will be then closed with simple interrupted knots using number 2-0 braided absorbable sutures (Vicryl), followed by closure of the subcutaneous layer using a number 2-0 monofilament absorbable suture with inverted interrupted knots (Monocryl) followed by the use of steri-strips and adhesive |
| CONTROL GROUP | Placebo comparator | Device: VICRYLThe arthrotomy (deep layer) is repaired using Vicryl #1 followed by closure of the intermediate layer with a 2-0 Vicryl and a subcutaneous layer with a 2-0 Monocryl followed by steri-strips and adhesive, following total knee arthroplasty. |
Who may qualify
- Ages
- 18 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Males and females, between the ages of 18 to 80 years at the time of signing the informed consent document.
- Understand and voluntarily sign an informed consent document prior to any study-related assessments/procedures are conducted.
- Able to adhere to the study visit schedule and other protocol requirements.
- Able to fluently speak and understand the local language
- If female, is non-pregnant (negative pregnancy test results at the baseline/randomization visit) and non-lactating.
Key exclusion criteria (7 listed)
- BMI greater than or equal to 40 kg/m2.
- History of known bleeding disorder.
- History of medical co-morbidity that may result in poor wound healing (i.e. diabetes mellitus, peripheral vascular disease).
- Patients <18 or >80 years of age.
- Patients who are prisoners.
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 |
|---|---|---|
| STRATIFIXSTRATIFIX symmetric PDS Plus; Stratifix knotless suture | Device | STRATAFIX GROUP |
| VICRYLVicryl #1 | Device | CONTROL GROUP |
Primary outcome
Time to Close, Minutes
Time frame: Day of surgery
Time from first needle insertion to complete skin closure per protocol
1 secondary outcome
Number of Participants With Wound Complications
Time frame: 90 days postoperative
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Nov 2020.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 32146687Sundaram K, Warren JA, Klika A, Piuzzi NS, Mont MA, Krebs V. Barbed sutures reduce arthrotomy closure duration compared to interrupted conventional sutures for total knee arthroplasty: a randomized controlled trial. Musculoskelet Surg. 2021 Dec;105(3):275-281. doi: 10.1007/s12306-020-00654-y. Epub 2020 Mar 7.
- Individual participant dataSharing planned: No. No data will be shared with other researchers.
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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.
Viktor Krebs, MD principal investigator
The Cleveland Clinic
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing STRATIFIX and VICRYL in people with Wound; Knee, run by The Cleveland Clinic at 1 site in United States.
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 7 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 19 Nov 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. 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. Some participants in this study may receive a placebo. 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?
Yes. Results are posted in the registry (first posted 19 Nov 2020). 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?
Time to Close, Minutes (time frame: Day of surgery). 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 NCT03285529, which also lists 1 linked publication.
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 19 Nov 2020.