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Rupture of Anterior Cruciate LigamentNCT04431063

Comparison of the Functional Outcome of Site Peroneus Longus Graft Donors With and Without Distal Stump Suturing of Peroneus Tendon Brevis on ACL Reconstruction Case in Cipto Mangunkusumo Hospital in Jakarta With 24 Patient as Subject Who Will Divide Into 2 Group.

A study testing Distal Stump Suturing in people with Rupture of Anterior Cruciate Ligament, run by Universitas Indonesia at 1 site in Indonesia.

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

Injury of the Anterior Cruciate Ligament (ACL) is one of the most common sports injuries. The incidence rate reaches 68.6 cases per 100,000 people per year. Management of ACL injuries for individuals who want to return to the level of exercise activity as before, mostly in the form of reconstructive surgery. Read more about this study

Who is it for?
Any age
Conditions the study is for
Rupture of Anterior Cruciate Ligament
What is being tested?
Distal Stump Suturing
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
24 participants
Where
1 siteIndonesia
Study dates
1 Dec 2018to 30 Jun 2022
Phase
Interventional
Are there results?
None posted in the registry

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 Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Patients with total ACL rupture using peroneus longus graft
  • The suturing procedure for the distal stump peroneus longus against the peroneus brevis tendon is performed by orthopedic specialists or resident chiefs who have been given training in advance.

Who cannot join

  • Osteoarthtis Knee Kellgren-Lawrence III and IV
  • Osteoarthtis Knee Kellgren-Lawrence III and IV
  • Flatfoot as evidenced by physical examination and footprinting

Trial locations and contacts

1 site in 1 country.

Indonesia1 site
  • Cipto Mangunkusumo Hospital

    Jakarta, DKI Jakarta, 14250

Other trials in Indonesia

About this study

Official title: Comparison of the Functional Outcome of Site Peroneus Longus Graft Donors With and Without Distal Stump Suturing of Peroneus Tendon Brevis on ACL Reconstruction Case .

Injury of the Anterior Cruciate Ligament (ACL) is one of the most common sports injuries. The incidence rate reaches 68.6 cases per 100,000 people per year. Management of ACL injuries for individuals who want to return to the level of exercise activity as before, mostly in the form of reconstructive surgery. As many as 60,000 to 175,000 cases of ACL reconstruction per year are carried out in the United States At present, many reconstructive surgeries are performed by taking tendon grafts on the patient's own body (autograft) to then be used instead of the ACL. The most widely used graft sources are Hamstring and Bone-Patellar Tendon-Bone (BPTB) grafts. Other alternative grafts are Quadriceps tendon, Fascia Lata, Iliotibial Band, and Peroneus Longus Tendon. Each graft retrieval technique has advantages and disadvantages. BPTB graft has the best tensile strength and bone union with bone, but the complications of anterior knee pain are also quite common (5-55%). Hamstring grafts and Quadriceps grafts minimize the complications of anterior knee pain, with fairly good tensile strength, but the union of grafts with bone takes longer. The loss of Hamstring tendons also causes a decrease in muscle strength in Hamstring, where Hamstring has an important role in preventing the anterior translation of the tibia Peroneus Longus Tendon graft is an alternative graft developed to minimize complications associated with graft use from the area around the knee. Peroneus Longus tendons also have tensile strength similar to Hamstring tendons.

As with other graft extracts, Peroneus Longus tendon graft is also accompanied by complications in the donor site. Possible complications arising from the loss of the Peroneus Longus tendon include ankle instability and decreased flexion strength of the 1st ray and ankle eversion. Research carried out by Bancha et al showed a reduction in flexion strength of 1st ray and ankle eversion significantly, without any instability in the ankle. Peroneus longus provides 5.5% strength for moderate dorsiflexion for ankle eversion movements, peroneus longus is the main muscle. But in other studies it is said that the use of peroneus longus graft does not interfere with the stability of the ankle and ROM. Does not even affect the functional outcome of the ankle However, in a study conducted by Bancha et al and Kerimoglu et al., The technique used for taking Peroneus Longus graft tendons did not include suturing in the distal stump of Peroneous Longus. So with this study, researchers wanted to find out whether different results would be found related to donor site complications if the technique used included suturing the distal stump of the Peroneus Longus tendon against the peroneus brevis tendon

Being tested
Distal Stump Suturing
Keywords
ACL, Rupture of ACL, Donor site, Peroneus Longus Graft, Distal Stump, Peroneus Brevis
Medical subject headings
Anterior Cruciate Ligament Injuries

What participants receive

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

  • Distal Stump SuturingProcedure or surgery

    in ACL Reconstruction case , Group A consist of subject with operation procedure suturing the distal stump peroneus longus against the peroneus brevis in ACL reconstruction using the peroneus longus autograft.

Study groups in NCT04431063
Study groupRoleWhat they receive
Sutured StumpExperimentalThe group consist of subject with distal stump suturing of perobeus longus agains peroneus brevis in ACL Reconstruction Case
Receives: Procedure: Distal Stump Suturing
Unsutured StumpNo interventionThe group consist of subject without distal stump suturing of peroneus longus agains peroneus brevis in ACL Reconstruction Case

What is being measured

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

  1. Preoperative hand dynamometer value

    Value of objective measurement of the strength of the medial part of the plantarflexion in the one metatarsal head with the hand of the Dynamometer when the patient is supine. The measurement is done 3 times and the value used is the average of the 3 times the measurement. Healthy ankles were also examined as a comparison with the same measurement method. There is no minimum and maximum value, and the higher value the better the outcome

    Measured: This measurement was carried out at the preoperative setting

  2. Three-months postoperative hand dynamometer value

    Value of objective measurement of the strength of the medial part of the plantarflexion in the one metatarsal head with the hand of the Dynamometer when the patient is supine. The measurement is done 3 times and the value used is the average of the 3 times the measurement. Healthy ankles were also examined as a comparison with the same measurement method. There is no minimum and maximum value, and the higher value the better the outcome

    Measured: This measurement was carried out at 3 months postoperatively

  3. Six-months postoperative hand dynamometer value

    Value of objective measurement of the strength of the medial part of the plantarflexion in the one metatarsal head with the hand of the Dynamometer when the patient is supine. The measurement is done 3 times and the value used is the average of the 3 times the measurement. Healthy ankles were also examined as a comparison with the same measurement method. There is no minimum and maximum value, and the higher value the better the outcome

    Measured: This measurement was carried out at 6 months postoperatively

  4. Preoperative Clark's Angle Value

    the value of the objective angle measurement on the footprint by drawing a line from the medial side of the one metatarsal head and the heel against the second line which is connecting the one metatrsal head and the peak of the medial longitudinal arch. Clarke Angle of < 31° means there is tendency to flatness and/or pronation. angle of 31° to < 45° is the normal range. Clarke Angle of > 45° means there is tendency to cavus foot

    Measured: This measurement was carried out at the preoperative setting

  5. Three-months Clark's Angle Value

    the value of the objective angle measurement on the footprint by drawing a line from the medial side of the one metatarsal head and the heel against the second line which is connecting the one metatrsal head and the peak of the medial longitudinal arch. Clarke Angle of < 31° means there is tendency to flatness and/or pronation. angle of 31° to < 45° is the normal range. Clarke Angle of > 45° means there is tendency to cavus foot

    Measured: This measurement was carried out at the 3 months postoperatively

  6. Six-months Clark's Angle Value

    the value of the objective angle measurement on the footprint by drawing a line from the medial side of the one metatarsal head and the heel against the second line which is connecting the one metatrsal head and the peak of the medial longitudinal arch. Clarke Angle of < 31° means there is tendency to flatness and/or pronation. angle of 31° to < 45° is the normal range. Clarke Angle of > 45° means there is tendency to cavus foot

    Measured: This measurement was carried out at the 6 months postoperatively

  7. Preoperative the American Orthopedic Foot and Ankle Score (AOFAS)

    the questionnaire for assessing the function of both injured feet and ankles and the knee that is in the process of healing. AOFAS score has the range of value of 0 to 100. 0 is the worst value and 100 is the best value possible

    Measured: Examination carried out 4 times for each patient in preoperative setting

  8. Three months postoperative the American Orthopedic Foot and Ankle Score (AOFAS)

    the questionnaire for assessing the function of both injured feet and ankles and the knee that is in the process of healing. AOFAS score has the range of value of 0 to 100. 0 is the worst value and 100 is the best value possible

    Measured: Examination carried out 4 times for each patient in 3 months postoperatively

  9. Six months postoperative the American Orthopedic Foot and Ankle Score (AOFAS)

    the questionnaire for assessing the function of both injured feet and ankles and the knee that is in the process of healing. AOFAS score has the range of value of 0 to 100. 0 is the worst value and 100 is the best value possible

    Measured: Examination carried out 4 times for each patient in 6 months postoperatively

  10. Preoperative visual analogue scale foot and ankle (VAS-FA)

    the questionnaire for assessing the function of both injured feet and ankles and the knee that is in the process of healing. VAS-FA score has the range of value of 0 to 100. 0 is the worst value and 100 is the best value possible

    Measured: Examination carried out 4 times for each patient at preoperative setting

  11. Three-months postoperative visual analogue scale foot and ankle (VAS-FA)

    the questionnaire for assessing the function of both injured feet and ankles and the knee that is in the process of healing. AS-FA score has the range of value of 0 to 100. 0 is the worst value and 100 is the best value possible

    Measured: Examination carried out 4 times for each patient at 3 months postoperatively

  12. Six-months postoperative visual analogue scale foot and ankle (VAS-FA)

    the questionnaire for assessing the function of both injured feet and ankles and the knee that is in the process of healing. AS-FA score has the range of value of 0 to 100. 0 is the worst value and 100 is the best value possible

    Measured: Examination carried out 4 times for each patient at 6 months postoperatively

Timeline

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

  1. First posted16 Jun 2020
  2. Study start1 Dec 2018
  3. Primary completion1 Dec 2021
  4. Study completion30 Jun 2022

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
24 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04431063
Sponsor's protocol ID
18-10-1173
Status last verified
May 2023
First submitted
3 Jun 2020
Last updated
23 May 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Lyman S, Koulouvaris P, Sherman S, Do H, Mandl LA, Marx RG. Epidemiology of anterior cruciate ligament reconstruction: trends, readmissions, and subsequent knee surgery. J Bone Joint Surg Am. 2009 Oct;91(10):2321-8. doi: 10.2106/JBJS.H.00539.

    PubMed 19797565
  • Angthong C, Chernchujit B, Apivatgaroon A, Chaijenkit K, Nualon P, Suchao-in K. The Anterior Cruciate Ligament Reconstruction with the Peroneus Longus Tendon: A Biomechanical and Clinical Evaluation of the Donor Ankle Morbidity. J Med Assoc Thai. 2015 Jun;98(6):555-60.

    PubMed 26219159
  • Cerulli G, Placella G, Sebastiani E, Tei MM, Speziali A, Manfreda F. ACL Reconstruction: Choosing the Graft. Joints. 2013 Jun 12;1(1):18-24. eCollection 2013 Mar.

    PubMed 25606507
  • Kerimoglu S, Aynaci O, Saracoglu M, Aydin H, Turhan AU. [Anterior cruciate ligament reconstruction with the peroneus longus tendon]. Acta Orthop Traumatol Turc. 2008 Jan-Feb;42(1):38-43. doi: 10.3944/aott.2008.038. Turkish.

    PubMed 18354276
  • Silver RL, de la Garza J, Rang M. The myth of muscle balance. A study of relative strengths and excursions of normal muscles about the foot and ankle. J Bone Joint Surg Br. 1985 May;67(3):432-7. doi: 10.1302/0301-620X.67B3.3997956.

    PubMed 3997956
  • Frobell RB, Roos EM, Roos HP, Ranstam J, Lohmander LS. A randomized trial of treatment for acute anterior cruciate ligament tears. N Engl J Med. 2010 Jul 22;363(4):331-42. doi: 10.1056/NEJMoa0907797.

    PubMed 20660401
  • Mentiplay BF, Perraton LG, Bower KJ, Adair B, Pua YH, Williams GP, McGaw R, Clark RA. Assessment of Lower Limb Muscle Strength and Power Using Hand-Held and Fixed Dynamometry: A Reliability and Validity Study. PLoS One. 2015 Oct 28;10(10):e0140822. doi: 10.1371/journal.pone.0140822. eCollection 2015.

    PubMed 26509265
  • Click Fenter P, Bellew JW, Pitts T, Kay R. A comparison of 3 hand-held dynamometers used to measure hip abduction strength. J Strength Cond Res. 2003 Aug;17(3):531-5. doi: 10.1519/1533-4287(2003)0172.0.co;2.

    PubMed 12930182
  • Surburg PR, Suomi R, Poppy WK. Validity and reliability of a hand-held dynamometer with two populations. J Orthop Sports Phys Ther. 1992;16(5):229-34. doi: 10.2519/jospt.1992.16.5.229.

    PubMed 18796754
  • Murley GS, Tan JM, Edwards RM, De Luca J, Munteanu SE, Cook JL. Foot posture is associated with morphometry of the peroneus longus muscle, tibialis anterior tendon, and Achilles tendon. Scand J Med Sci Sports. 2014 Jun;24(3):535-41. doi: 10.1111/sms.12025. Epub 2013 Jan 10.

    PubMed 23301865
  • Pita-Fernandez S, Gonzalez-Martin C, Seoane-Pillado T, Lopez-Calvino B, Pertega-Diaz S, Gil-Guillen V. Validity of footprint analysis to determine flatfoot using clinical diagnosis as the gold standard in a random sample aged 40 years and older. J Epidemiol. 2015;25(2):148-54. doi: 10.2188/jea.JE20140082. Epub 2014 Nov 8.

    PubMed 25382154
  • Gonzalez-Martin C, Pita-Fernandez S, Seoane-Pillado T, Lopez-Calvino B, Pertega-Diaz S, Gil-Guillen V. Variability between Clarke's angle and Chippaux-Smirak index for the diagnosis of flat feet. Colomb Med (Cali). 2017 Mar 30;48(1):25-31.

    PubMed 28559643
  • Quatman CE, Hewett TE. The anterior cruciate ligament injury controversy: is "valgus collapse" a sex-specific mechanism? Br J Sports Med. 2009 May;43(5):328-35. doi: 10.1136/bjsm.2009.059139. Epub 2009 Apr 15.

    PubMed 19372087
  • McGuine TA, Winterstein AP, Carr K, Hetzel S. Changes in Health-Related Quality of Life and Knee Function After Knee Injury in Young Female Athletes. Orthop J Sports Med. 2014 Apr 22;2(4):2325967114530988. doi: 10.1177/2325967114530988. eCollection 2014 Apr.

    PubMed 26535324
  • Beynnon BD, Johnson RJ, Abate JA, Fleming BC, Nichols CE. Treatment of anterior cruciate ligament injuries, part I. Am J Sports Med. 2005 Oct;33(10):1579-602. doi: 10.1177/0363546505279913.

    PubMed 16199611

Questions about this trial

What is this clinical trial studying?

A study testing Distal Stump Suturing in people with Rupture of Anterior Cruciate Ligament, run by Universitas Indonesia at 1 site in Indonesia.

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 2 inclusion and 3 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 23 May 2023. 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 Indonesia. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Preoperative hand dynamometer value (time frame: This measurement was carried out at the preoperative setting). The study lists 12 primary outcomes in all. 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 NCT04431063, which also lists 31 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 23 May 2023.

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