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AzTrials

Distal Humerus FractureSPRINTNCT04748016

3D-printed Bone Models in Addition to CT Imaging for Intra-articular Fracture Repair

A study testing 3D printed (3DP) bone models + CT imaging and CT imaging in people with Distal Humerus Fracture and Distal Femur Fracture, run by The University of Hong Kong at 1 site in Hong Kong.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The purpose of this study is to compare the effectiveness of 3D-printed bone models in addition to CT imaging versus CT imaging alone on surgical quality and operation time for patients undergoing surgical repair of intra-articular fractures. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
3D printed (3DP) bone models + CT imaging and CT imaging
Could I receive a placebo?
No, everyone receives an active treatment
How many people
80 participants
Where
1 siteHong Kong
Study dates
13 Mar 2020to 31 Dec 2023
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 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • age 18 years or older
  • with intra-articular fracture of the proximal or distal humerus, proximal ulna, proximal radius, distal femur, or proximal or distal tibia (pilon fracture)
  • requiring anticipated surgical repair of fracture
  • with pre-operative CT scan already available as part of routine assessment

Who cannot join

  • pathological fracture
  • multiple fractures requiring simultaneous or staged operations
  • fractures around the hip, pelvis and acetabulum, and any other fracture types not specified in the inclusion criteria
  • requiring surgery within 24 hours of admission
  • unable or unwilling to give consent to participate

Trial locations and contacts

1 site in 1 country.

Christian Fang contact

22554581

cfang@hku.hk

Hong Kong1 site, 1 recruiting
  • Queen Mary Hospital, The University of Hong Kong

    Hong Kong

    Christian Xinshuo Fang, 22554581

    Christian Xinshuo Fang

    Recruiting

Other trials in Hong Kong

About this study

Official title: Sterilised 3D-PRINTed Bone Models in Addition to Conventional CT Imaging for Operative Visualisation in Complex Intra-articular Fracture Repair - A Multi-centre, Double-blind Randomised Controlled Trial

The purpose of this study is to compare the effectiveness of 3D-printed bone models in addition to CT imaging versus CT imaging alone on surgical quality and operation time for patients undergoing surgical repair of intra-articular fractures.

Read the detailed description

Surgical fixation of intra-articular fractures is a technically demanding task that poses significant challenges to orthopaedic surgeons. Articular fragments may be comminuted, depressed, or impacted, and neighbouring soft tissue is often heavily compromised. Furthermore, aggressive surgical dissection is typically necessary to achieve adequate visualisation, and anatomical reduction often devitalises bone fragments and invites deep infection. The management of intra-articular fractures requires a well-designed preoperative plan and a skilfully executed surgical tactic to guarantee the best possible outcome. Multiplanar reformation (CT-MPR) and three-dimensional reconstruction (CT-3DR) are imaging techniques that have enhanced intraoperative visualisation, however, accurate analysis of complex fractures remains challenging.

3D printing is a rapidly developing, low-cost technology that is already being applied across numerous contexts in orthopaedics and traumatology. 3D printed bone models can be produced from digitised CT data in a matter of hours, providing a dimensionally accurate representation of the patient's skeleton which approximates real-life visual and tactile experiences. When used in preoperative planning, these models have shown to improve surgeon communication and shorten surgical duration. Despite positive early results, few clinical studies have studied the effect of 3D bone model use on surgical outcome. The purpose of this randomised controlled trial is to compare the effectiveness of intraoperatively utilised 3D bone models in addition to conventional CT imaging on reduction quality and surgical duration versus CT imaging alone for patients undergoing surgical fixation of complex intraarticular fractures.

Patients providing informed consent will be screened for eligibility. All eligible patients will be randomly assigned in a double-blind manner (participant and outcome assessor) to receive surgical fracture fixation with or without the addition of sterilised 3D-printed bone models to standard CT imaging for intraoperative visualisation.

Being tested
3D printed (3DP) bone models + CT imaging, CT imaging
Keywords
3D Printing, Intra-articular Fracture, Patient-specific instrumentation
Medical subject headings
Humeral Fractures, Distal, Femoral Fractures, Distal, Shoulder Fractures, Intra-Articular Fractures

What participants receive

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

  • 3D printed (3DP) bone models + CT imagingOther

    In addition to CT-MPR and CT-3DR, 3DP models will be used for surgical planning and intraoperative visualization.

  • CT imagingOther

    CT-MPR and CT-3DR used for surgical planning and intraoperative visualization.

Study groups in NCT04748016
Study groupRoleWhat they receive
3D-printed models plus CT imagingExperimentalFracture repair surgery using sterilized 3DP models, CT-MPR and CT-3DR for planning and intraoperative visualization
Receives: Other: 3D printed (3DP) bone models + CT imaging
CT imaging aloneActive comparatorFracture repair surgery using CT-MPR and CT-3DR for planning and intraoperative visualization
Receives: Other: CT imaging

What is being measured

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

  1. Quality of articular surface reduction grading assessed by three-point scale

    The quality of articular surface reduction will be rated by two surgeons blinded to intervention allotment assessing post-operative and intraoperative fluoroscopic images. The Kappa value will be recorded for inter-observer agreement between two observers (1. Perfect reduction, 2. Observable imperfections 1-2mm, 3. Significant imperfections >2mm)

    Measured: Immediately post-operation

  2. Skin to skin duration of surgery (minutes)

    The skin to skin duration of the surgery will be recorded.

    Measured: Immediately post-operation

Secondary outcomes (7)
  1. Total fluoroscopy time (seconds)

    The total intraoperative fluoroscopy time will be recorded in seconds.

    Measured: Immediately post-operation

  2. Intraoperative blood loss (mL)

    The patient's blood loss during the surgery will be recorded.

    Measured: Immediately post-operation

  3. Total length of skin incision (mm)

    The total length on the incision will be measured post operation.

    Measured: Immediately post-operation

  4. Total tourniquet time (minutes)

    Total time the tourniquet was applied will be recorded.

    Measured: Immediately post-operation

  5. Incidence of surgical complications

    Incidence of infection, neurological deficit, wound breakdown, loss of fixation, revision surgery will be recorded at follow up.

    Measured: 3 months post-operation

  6. Quality of articular surface reduction grading assessed by three-point scale

    The quality of articular surface reduction will be rated by two surgeons blinded to intervention allotment assessing post-operative and intraoperative fluoroscopic images. The Kappa value will be recorded for inter-observer agreement between two observers (1. Perfect reduction, 2. Observable imperfections 1-2mm, 3. Significant imperfections >2mm)

    Measured: 3 months post operation

  7. Health-related quality of life measured by SF-12 Chinese (HK) version

    12-item Short Form Health Survey (SF-12), a patient-reported outcome measure of HRQOL comprised of a mental component (MCS) and physical component (PCS), each with a final score ranging from 0 (worst outcome) to 100 (best outcome).

    Measured: 3 months post-operation

Timeline

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

  1. First posted10 Feb 2021
  2. Study start13 Mar 2020
  3. Primary completion31 Dec 2023 (estimated)
  4. Study completion31 Dec 2023 (estimated)

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
Model description
Double-blind randomised control trial with 40 patients in two interventional arm
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04748016
Sponsor's protocol ID
UW 18-480
Acronym
SPRINT
Status last verified
Jul 2022
First submitted
5 Feb 2021
Last updated
20 Jul 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Anonymized dataset to be included as supplementary data in final publication

Publications

  • Jupiter JB, Fernandez DL, Toh CL, Fellman T, Ring D. Operative treatment of volar intra-articular fractures of the distal end of the radius. J Bone Joint Surg Am. 1996 Dec;78(12):1817-28. doi: 10.2106/00004623-199612000-00004.

    PubMed 8986658
  • Kang HW, Lee SJ, Ko IK, Kengla C, Yoo JJ, Atala A. A 3D bioprinting system to produce human-scale tissue constructs with structural integrity. Nat Biotechnol. 2016 Mar;34(3):312-9. doi: 10.1038/nbt.3413. Epub 2016 Feb 15.

    PubMed 26878319
  • You W, Liu LJ, Chen HX, Xiong JY, Wang DM, Huang JH, Ding JL, Wang DP. Application of 3D printing technology on the treatment of complex proximal humeral fractures (Neer3-part and 4-part) in old people. Orthop Traumatol Surg Res. 2016 Nov;102(7):897-903. doi: 10.1016/j.otsr.2016.06.009. Epub 2016 Aug 9.

    PubMed 27521179
  • Yang L, Shang XW, Fan JN, He ZX, Wang JJ, Liu M, Zhuang Y, Ye C. Application of 3D Printing in the Surgical Planning of Trimalleolar Fracture and Doctor-Patient Communication. Biomed Res Int. 2016;2016:2482086. doi: 10.1155/2016/2482086. Epub 2016 Jul 3.

    PubMed 27446944
  • Kacl GM, Zanetti M, Amgwerd M, Trentz O, Seifert B, Stucki H, Hodler J. Rapid prototyping (stereolithography) in the management of intra-articular calcaneal fractures. Eur Radiol. 1997;7(2):187-91. doi: 10.1007/s003300050132.

    PubMed 9038112
  • Yan CH, Chiu KY, Ng FY, Chan PK, Fang CX. Comparison between patient-specific instruments and conventional instruments and computer navigation in total knee arthroplasty: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc. 2015 Dec;23(12):3637-45. doi: 10.1007/s00167-014-3264-2. Epub 2014 Sep 13.

    PubMed 25217311
  • Yang J, Cai H, Lv J, Zhang K, Leng H, Sun C, Wang Z, Liu Z. In vivo study of a self-stabilizing artificial vertebral body fabricated by electron beam melting. Spine (Phila Pa 1976). 2014 Apr 15;39(8):E486-92. doi: 10.1097/BRS.0000000000000211.

    PubMed 24430723
  • Peltola SM, Melchels FP, Grijpma DW, Kellomaki M. A review of rapid prototyping techniques for tissue engineering purposes. Ann Med. 2008;40(4):268-80. doi: 10.1080/07853890701881788.

    PubMed 18428020
  • Brown GA, Firoozbakhsh K, DeCoster TA, Reyna JR Jr, Moneim M. Rapid prototyping: the future of trauma surgery? J Bone Joint Surg Am. 2003;85-A Suppl 4:49-55. No abstract available.

    PubMed 14652393
  • Hurson C, Tansey A, O'Donnchadha B, Nicholson P, Rice J, McElwain J. Rapid prototyping in the assessment, classification and preoperative planning of acetabular fractures. Injury. 2007 Oct;38(10):1158-62. doi: 10.1016/j.injury.2007.05.020. Epub 2007 Sep 19.

    PubMed 17884058
  • Bizzotto N, Tami I, Tami A, Spiegel A, Romani D, Corain M, Adani R, Magnan B. 3D Printed models of distal radius fractures. Injury. 2016 Apr;47(4):976-8. doi: 10.1016/j.injury.2016.01.013. Epub 2016 Feb 6. No abstract available.

    PubMed 26876530
  • Li Z, Li Z, Xu R, Li M, Li J, Liu Y, Sui D, Zhang W, Chen Z. Three-dimensional printing models improve understanding of spinal fracture--A randomized controlled study in China. Sci Rep. 2015 Jun 23;5:11570. doi: 10.1038/srep11570.

    PubMed 26099838
  • Fang C, Fang B, Wong TM, Lau TW, Pun T, Leung F. Fixing a fractured arthrodesed hip with rapid prototype templating and minimal invasive plate osteosynthesis. Trauma Case Rep. 2015 Nov 14;1(9-12):79-83. doi: 10.1016/j.tcr.2015.10.005. eCollection 2015 Dec.

    PubMed 30101181
  • Wong TM, Jin J, Lau TW, Fang C, Yan CH, Yeung K, To M, Leung F. The use of three-dimensional printing technology in orthopaedic surgery. J Orthop Surg (Hong Kong). 2017 Jan;25(1):2309499016684077. doi: 10.1177/2309499016684077.

    PubMed 28142354
  • Fedorov A, Beichel R, Kalpathy-Cramer J, Finet J, Fillion-Robin JC, Pujol S, Bauer C, Jennings D, Fennessy F, Sonka M, Buatti J, Aylward S, Miller JV, Pieper S, Kikinis R. 3D Slicer as an image computing platform for the Quantitative Imaging Network. Magn Reson Imaging. 2012 Nov;30(9):1323-41. doi: 10.1016/j.mri.2012.05.001. Epub 2012 Jul 6.

    PubMed 22770690

Questions about this trial

What is this clinical trial studying?

A study testing 3D printed (3DP) bone models + CT imaging and CT imaging in people with Distal Humerus Fracture and Distal Femur Fracture, run by The University of Hong Kong at 1 site in Hong Kong.

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 4 inclusion and 5 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: status not confirmed, as of the sponsor's last update on 20 Jul 2022. 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 Hong Kong. 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?

Results are not available in the source record.

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

Contact Christian Fang (22554581, cfang@hku.hk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Quality of articular surface reduction grading assessed by three-point scale (time frame: Immediately post-operation). The study lists 2 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 NCT04748016, which also lists 18 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 20 Jul 2022.

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