Trial Outcomes & Findings for BBOT: Bacterial Burden in Ortho Trauma Procedures (NCT NCT03126448)

NCT ID: NCT03126448

Last Updated: 2020-04-28

Results Overview

The objective of this research is to see if highly sensitive bacterial assays are useful for determining whether fracture nonunions are infected

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

142 participants

Primary outcome timeframe

Study surgery to 6-month clinical follow-up

Results posted on

2020-04-28

Participant Flow

Participant milestones

Participant milestones
Measure
Group 1: Closed Index Fractures
Group 1 is clean, closed fractures undergoing index open reduction internal fixation (ORIF), intramedullary nailing (IMN) where the fracture site is accessible, or staged treatment of a pilon or plateau that was initially treated by joint spanning external fixation. Tissue obtained at the time of surgery will be sent to the research laboratory for culture and performance of the two highly sensitive assays. Highly Sensitive Assays: Tissue will be collected at the time of surgery from patients in each arm of the study. In addition to tissue stored in RNAlater and sent to a research laboratory, cultures will also be sent to Quest Diagnostics for independent culture results.
Group 2: Hardware Removal From Healed Fractures
Group 2 will include patients having a plate removed from a healed fracture without clinical evidence of infection and excluding history of open fracture. Tissue obtained at the time of surgery will be sent to the research laboratory for culture and performance of the two highly sensitive assays. Highly Sensitive Assays: Tissue will be collected at the time of surgery from patients in each arm of the study. In addition to tissue stored in RNAlater and sent to a research laboratory, cultures will also be sent to Quest Diagnostics for independent culture results.
Group 3: Index Treatment of Fracture Nonunions
Group 3 will be patients that are undergoing an index procedure for fracture nonunion at a site where prior surgery has been undertaken for the fracture. Exclusions include bone grafting of 'critical' defects, active clinical infection, or \< 3 months from index fracture fixation. Tissue obtained at the time of surgery will be sent to the research laboratory for culture and performance of the two highly sensitive assays. Highly Sensitive Assays: Tissue will be collected at the time of surgery from patients in each arm of the study. In addition to tissue stored in RNAlater and sent to a research laboratory, cultures will also be sent to Quest Diagnostics for independent culture results.
Overall Study
STARTED
56
49
37
Overall Study
COMPLETED
43
41
27
Overall Study
NOT COMPLETED
13
8
10

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

BBOT: Bacterial Burden in Ortho Trauma Procedures

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Group 1: Closed Index Fractures
n=43 Participants
Group 1 is clean, closed fractures undergoing index open reduction internal fixation (ORIF), intramedullary nailing (IMN) where the fracture site is accessible, or staged treatment of a pilon or plateau that was initially treated by joint spanning external fixation. Tissue obtained at the time of surgery will be sent to the research laboratory for culture and performance of the two highly sensitive assays. Highly Sensitive Assays: Tissue will be collected at the time of surgery from patients in each arm of the study. In addition to tissue stored in RNAlater and sent to a research laboratory, cultures will also be sent to Quest Diagnostics for independent culture results.
Group 2: Hardware Removal From Healed Fractures
n=41 Participants
Group 2 will include patients having a plate removed from a healed fracture without clinical evidence of infection and excluding history of open fracture. Tissue obtained at the time of surgery will be sent to the research laboratory for culture and performance of the two highly sensitive assays. Highly Sensitive Assays: Tissue will be collected at the time of surgery from patients in each arm of the study. In addition to tissue stored in RNAlater and sent to a research laboratory, cultures will also be sent to Quest Diagnostics for independent culture results.
Group 3: Index Treatment of Fracture Nonunions
n=27 Participants
Group 3 will be patients that are undergoing an index procedure for fracture nonunion at a site where prior surgery has been undertaken for the fracture. Exclusions include bone grafting of 'critical' defects, active clinical infection, or \< 3 months from index fracture fixation. Tissue obtained at the time of surgery will be sent to the research laboratory for culture and performance of the two highly sensitive assays. Highly Sensitive Assays: Tissue will be collected at the time of surgery from patients in each arm of the study. In addition to tissue stored in RNAlater and sent to a research laboratory, cultures will also be sent to Quest Diagnostics for independent culture results.
Total
n=111 Participants
Total of all reporting groups
Age, Continuous
43 years
STANDARD_DEVIATION 19 • n=99 Participants
46 years
STANDARD_DEVIATION 15 • n=107 Participants
47 years
STANDARD_DEVIATION 14 • n=206 Participants
45 years
STANDARD_DEVIATION 21 • n=7 Participants
Sex: Female, Male
Female
19 Participants
n=99 Participants
21 Participants
n=107 Participants
10 Participants
n=206 Participants
50 Participants
n=7 Participants
Sex: Female, Male
Male
24 Participants
n=99 Participants
20 Participants
n=107 Participants
17 Participants
n=206 Participants
61 Participants
n=7 Participants
Race/Ethnicity, Customized
Caucasian
29 participants
n=99 Participants
31 participants
n=107 Participants
21 participants
n=206 Participants
81 participants
n=7 Participants
ASA Physical Status Classification System
2.1 units on a scale
STANDARD_DEVIATION 0.7 • n=99 Participants
2.0 units on a scale
STANDARD_DEVIATION 0.8 • n=107 Participants
2.2 units on a scale
STANDARD_DEVIATION 0.5 • n=206 Participants
2.1 units on a scale
STANDARD_DEVIATION 0.8 • n=7 Participants
High Energy Injury
32 Participants
n=99 Participants
32 Participants
n=107 Participants
17 Participants
n=206 Participants
81 Participants
n=7 Participants
Compartment Syndrome
0 Participants
n=99 Participants
1 Participants
n=107 Participants
2 Participants
n=206 Participants
3 Participants
n=7 Participants
Pre-operative Antibiotics Administered
43 Participants
n=99 Participants
40 Participants
n=107 Participants
26 Participants
n=206 Participants
109 Participants
n=7 Participants
Open Fracture
NA Participants
n=99 Participants
4 Participants
n=107 Participants
18 Participants
n=206 Participants
NA Participants
n=7 Participants

PRIMARY outcome

Timeframe: Study surgery to 6-month clinical follow-up

The objective of this research is to see if highly sensitive bacterial assays are useful for determining whether fracture nonunions are infected

Outcome measures

Outcome measures
Measure
Group 1: Closed Index Fractures
n=43 Participants
Group 1 is clean, closed fractures undergoing index open reduction internal fixation (ORIF), intramedullary nailing (IMN) where the fracture site is accessible, or staged treatment of a pilon or plateau that was initially treated by joint spanning external fixation. Tissue obtained at the time of surgery will be sent to the research laboratory for culture and performance of the two highly sensitive assays. Highly Sensitive Assays: Tissue will be collected at the time of surgery from patients in each arm of the study. In addition to tissue stored in RNAlater and sent to a research laboratory, cultures will also be sent to Quest Diagnostics for independent culture results.
Group 2: Hardware Removal From Healed Fractures
n=41 Participants
Group 2 will include patients having a plate removed from a healed fracture without clinical evidence of infection and excluding history of open fracture. Tissue obtained at the time of surgery will be sent to the research laboratory for culture and performance of the two highly sensitive assays. Highly Sensitive Assays: Tissue will be collected at the time of surgery from patients in each arm of the study. In addition to tissue stored in RNAlater and sent to a research laboratory, cultures will also be sent to Quest Diagnostics for independent culture results.
Group 3: Index Treatment of Fracture Nonunions
n=27 Participants
Group 3 will be patients that are undergoing an index procedure for fracture nonunion at a site where prior surgery has been undertaken for the fracture. Exclusions include bone grafting of 'critical' defects, active clinical infection, or \< 3 months from index fracture fixation. Tissue obtained at the time of surgery will be sent to the research laboratory for culture and performance of the two highly sensitive assays. Highly Sensitive Assays: Tissue will be collected at the time of surgery from patients in each arm of the study. In addition to tissue stored in RNAlater and sent to a research laboratory, cultures will also be sent to Quest Diagnostics for independent culture results.
Number of Participants With Tissue Samples Identified With Bacterial DNA According to Highly Sensitive Bacterial Assays
10 Participants
24 Participants
20 Participants

Adverse Events

Group 1: Closed Index Fractures

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

Group 2: Hardware Removal From Healed Fractures

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

Group 3: Index Treatment of Fracture Nonunions

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

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Roman Natoli

Indiana University Health

Phone: 713-516-8973

Results disclosure agreements

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