Trial Outcomes & Findings for Prospective Randomized Evaluation of a Two and Three Piece Total Ankle Replacement (NCT NCT01504438)

NCT ID: NCT01504438

Last Updated: 2021-05-05

Results Overview

To assess changes in pain across time following total ankle replacement. The visual analog scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a mark on a 100mm line that represents a continuum between "no pain" and "worst pain." A score of 0 represents less pain intensity while a score of 100 represents high pain intensity

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

100 participants

Primary outcome timeframe

Baseline, 6 months, 1 year, 2 years, 3 years

Results posted on

2021-05-05

Participant Flow

Two subjects were not randomized.

Participant milestones

Participant milestones
Measure
Salto-Talaris Total Ankle Replacement
Salto-Talaris Total Ankle Replacement surgery
STAR Total Ankle Replacement
STAR Total Ankle Replacement: STAR Total Ankle Replacement
Overall Study
STARTED
48
50
Overall Study
COMPLETED
22
25
Overall Study
NOT COMPLETED
26
25

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Data not collected on 2 participants in the STAR Total Ankle Replacement group.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Salto-Talaris Total Ankle Replacement
n=37 Participants
Salto-Talaris Total Ankle Replacement surgery
STAR Total Ankle Replacement
n=37 Participants
STAR Total Ankle Replacement: STAR Total Ankle Replacement
Total
n=74 Participants
Total of all reporting groups
Age, Continuous
65.83 years
STANDARD_DEVIATION 11.20 • n=37 Participants
65.64 years
STANDARD_DEVIATION 8.17 • n=37 Participants
65.73 years
STANDARD_DEVIATION 9.68 • n=74 Participants
Sex: Female, Male
Female
22 Participants
n=37 Participants
32 Participants
n=37 Participants
54 Participants
n=74 Participants
Sex: Female, Male
Male
15 Participants
n=37 Participants
5 Participants
n=37 Participants
20 Participants
n=74 Participants
Race/Ethnicity, Customized
White
33 Participants
n=37 Participants
34 Participants
n=37 Participants
67 Participants
n=74 Participants
Race/Ethnicity, Customized
Other
4 Participants
n=37 Participants
3 Participants
n=37 Participants
7 Participants
n=74 Participants
Region of Enrollment
United States
37 Participants
n=37 Participants
37 Participants
n=37 Participants
74 Participants
n=74 Participants
Smoking status
Current
2 Participants
n=37 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
0 Participants
n=35 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
2 Participants
n=72 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
Smoking status
Former
18 Participants
n=37 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
15 Participants
n=35 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
33 Participants
n=72 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
Smoking status
Never
17 Participants
n=37 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
20 Participants
n=35 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
37 Participants
n=72 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
Diabetes
Yes
3 Participants
n=37 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
6 Participants
n=35 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
9 Participants
n=72 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
Diabetes
No
34 Participants
n=37 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
29 Participants
n=35 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.
63 Participants
n=72 Participants • Data not collected on 2 participants in the STAR Total Ankle Replacement group.

PRIMARY outcome

Timeframe: Baseline, 6 months, 1 year, 2 years, 3 years

Population: Data not collected at 3 years.

To assess changes in pain across time following total ankle replacement. The visual analog scale (VAS) is a validated, subjective measure for acute and chronic pain. Scores are recorded by making a mark on a 100mm line that represents a continuum between "no pain" and "worst pain." A score of 0 represents less pain intensity while a score of 100 represents high pain intensity

Outcome measures

Outcome measures
Measure
Salto-Talaris Total Ankle Replacement
n=37 Participants
Salto-Talaris Total Ankle Replacement surgery
STAR
n=37 Participants
STAR Total Ankle Replacement
Pain Following a Total Ankle Replacement as Measured by the Visual Analog Scale (VAS) for Pain
Baseline
67.0 mm
Standard Deviation 25.9
71.3 mm
Standard Deviation 21.4
Pain Following a Total Ankle Replacement as Measured by the Visual Analog Scale (VAS) for Pain
6 months
16.7 mm
Standard Deviation 22.9
18.6 mm
Standard Deviation 20.0
Pain Following a Total Ankle Replacement as Measured by the Visual Analog Scale (VAS) for Pain
1 year
12.0 mm
Standard Deviation 19.1
16.9 mm
Standard Deviation 20.8
Pain Following a Total Ankle Replacement as Measured by the Visual Analog Scale (VAS) for Pain
2 years
12.4 mm
Standard Deviation 19.4
23.5 mm
Standard Deviation 28.7

PRIMARY outcome

Timeframe: Baseline, 6 months, 1 year, 2 years, 3 years

Population: Data not collected at 3 years.

The SF-36 comprises 36 questions which cover eight domains of health: Limitations in physical activities because of health problems, Limitations in social activities because of physical or emotional problems, Limitations in usual role activities because of physical health problems, Bodily pain, General mental health (psychological distress and well-being), Limitations in usual role activities because of emotional problems, Vitality (energy and fatigue), and General health perceptions. Scores for the different domains are converted and pooled using a scoring key, for a total score indicating a range of low to high Quality of Life (QOL). Each scale is directly transformed into a 0-100 scale on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability i.e., a score of zero is equivalent to maximum disability

Outcome measures

Outcome measures
Measure
Salto-Talaris Total Ankle Replacement
n=37 Participants
Salto-Talaris Total Ankle Replacement surgery
STAR
n=37 Participants
STAR Total Ankle Replacement
Functional Health Following a Total Ankle Replacement Using the 36-Item Short Form Health Survey (SF-36).
Baseline
69.1 score on a scale
Standard Deviation 19.3
67.4 score on a scale
Standard Deviation 22.1
Functional Health Following a Total Ankle Replacement Using the 36-Item Short Form Health Survey (SF-36).
6 months
47.7 score on a scale
Standard Deviation 17.4
51.4 score on a scale
Standard Deviation 19.1
Functional Health Following a Total Ankle Replacement Using the 36-Item Short Form Health Survey (SF-36).
1 year
71.4 score on a scale
Standard Deviation 18.7
70.7 score on a scale
Standard Deviation 21.2
Functional Health Following a Total Ankle Replacement Using the 36-Item Short Form Health Survey (SF-36).
2 years
77.1 score on a scale
Standard Deviation 17.3
69.5 score on a scale
Standard Deviation 21.6

PRIMARY outcome

Timeframe: Baseline, 6 months, 1 year, 2 years, 3 years

Population: Data not collected at 3 years.

The SMFA consists of two sections: 34 questions covering the assessment of the patient's function and 12 questions covering how bothered patients are by their symptoms. Items are scored in six categories: daily activities, emotional status, arm and hand function, mobility category, and bother index. On a scale of 1 to 5, patients rate their ability on each item and higher total scores represent greater degree of dysfunction or bother. SMFA higher total score represent greater degree of dysfunction or bother. The lowest score is 0 representing the best possible function and the highest score is 100 representing an overall higher degree of dysfunction or bother.

Outcome measures

Outcome measures
Measure
Salto-Talaris Total Ankle Replacement
n=37 Participants
Salto-Talaris Total Ankle Replacement surgery
STAR
n=37 Participants
STAR Total Ankle Replacement
Physical Limitations Following a Total Ankle Replacement as Measured by the Short Musculoskeletal Function Assessment (SMFA) Questionnaire.
Baseline
83.0 score on a scale
Standard Deviation 19.2
80.3 score on a scale
Standard Deviation 19.5
Physical Limitations Following a Total Ankle Replacement as Measured by the Short Musculoskeletal Function Assessment (SMFA) Questionnaire.
6 months
54.9 score on a scale
Standard Deviation 14.7
60.4 score on a scale
Standard Deviation 18.7
Physical Limitations Following a Total Ankle Replacement as Measured by the Short Musculoskeletal Function Assessment (SMFA) Questionnaire.
1 year
51.5 score on a scale
Standard Deviation 12.6
57.1 score on a scale
Standard Deviation 15.6
Physical Limitations Following a Total Ankle Replacement as Measured by the Short Musculoskeletal Function Assessment (SMFA) Questionnaire.
2 years
48.5 score on a scale
Standard Deviation 12.9
56.1 score on a scale
Standard Deviation 18.9

PRIMARY outcome

Timeframe: Baseline, 6 months, 1 year, 2 years, 3 years

Population: Data not collected at 3 years.

The AOFAS Ankle-Hindfoot Rating System is a standardized evaluation of the clinical status of the ankle-hindfoot. Patients report their pain and physicians assess alignment; the patient and physician work together to complete the functional portion. Scores range from 0 to 100, with healthy ankles receiving 100 points.

Outcome measures

Outcome measures
Measure
Salto-Talaris Total Ankle Replacement
n=37 Participants
Salto-Talaris Total Ankle Replacement surgery
STAR
n=37 Participants
STAR Total Ankle Replacement
Pain and Function Following a Total Ankle Replacement as Measured by the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Rating System
2 years
84.5 score on a scale
Standard Deviation 9.3
64.7 score on a scale
Standard Deviation 23.7
Pain and Function Following a Total Ankle Replacement as Measured by the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Rating System
Baseline
44.6 score on a scale
Standard Deviation 14.9
46.4 score on a scale
Standard Deviation 17.9
Pain and Function Following a Total Ankle Replacement as Measured by the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Rating System
6 months
80.2 score on a scale
Standard Deviation 13.5
76.1 score on a scale
Standard Deviation 17.3
Pain and Function Following a Total Ankle Replacement as Measured by the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Rating System
1 year
84.5 score on a scale
Standard Deviation 9.9
78.0 score on a scale
Standard Deviation 12.9

PRIMARY outcome

Timeframe: Baseline, 6 months, 1 year, 2 years, 3 years

Population: Data not collected at 3 years.

The FADI has 26 items, each of which is scored from 0 (unable to do) to 4 (no difficulty at all). The four pain items of the FADI are scored 0 (none) to 4 (unbearable). The total score ranges 0 to 104 with higher scores indicating a better outcome.

Outcome measures

Outcome measures
Measure
Salto-Talaris Total Ankle Replacement
n=37 Participants
Salto-Talaris Total Ankle Replacement surgery
STAR
n=37 Participants
STAR Total Ankle Replacement
To Measure a Change in One's Daily Activity Following a Total Ankle Replacement Using the Foot and Ankle Disability Index (FADI) at Multiple Time Points.
Baseline
55.1 score on a scale
Standard Deviation 18.9
51.6 score on a scale
Standard Deviation 13.3
To Measure a Change in One's Daily Activity Following a Total Ankle Replacement Using the Foot and Ankle Disability Index (FADI) at Multiple Time Points.
6 months
8.0 score on a scale
Standard Deviation 11.3
51.5 score on a scale
Standard Deviation 17.7
To Measure a Change in One's Daily Activity Following a Total Ankle Replacement Using the Foot and Ankle Disability Index (FADI) at Multiple Time Points.
1 year
20.1 score on a scale
Standard Deviation 21.5
26.2 score on a scale
Standard Deviation 13.7
To Measure a Change in One's Daily Activity Following a Total Ankle Replacement Using the Foot and Ankle Disability Index (FADI) at Multiple Time Points.
2 years
16.0 score on a scale
Standard Deviation 15.1
18.0 score on a scale
Standard Deviation 18.7

SECONDARY outcome

Timeframe: Baseline, 6 months, 1 year, 2 years, 3 years

Population: Data not collected.

In order to understand the effect of the ankle replacement on lower extremity kinematics and kinetics, each subject will be asked to complete a series of functional tasks and level walking trials at each of the study timepoints.

Outcome measures

Outcome data not reported

Adverse Events

Salto-Talaris Total Ankle Replacement

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

STAR Total Ankle Replacement

Serious events: 1 serious events
Other events: 0 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Salto-Talaris Total Ankle Replacement
n=48 participants at risk
Salto-Talaris Total Ankle Replacement surgery
STAR Total Ankle Replacement
n=50 participants at risk
STAR Total Ankle Replacement: STAR Total Ankle Replacement
General disorders
Death
0.00%
0/48 • Up to 7 years
2.0%
1/50 • Up to 7 years

Other adverse events

Adverse event data not reported

Additional Information

James Nunley II, M.D.

Duke University

Phone: 919-684-4033

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place