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Trial registered on ANZCTR
Registration number
ACTRN12610000858099
Ethics application status
Not yet submitted
Date submitted
7/10/2010
Date registered
14/10/2010
Date last updated
14/10/2010
Type of registration
Prospectively registered
Titles & IDs
Public title
Femoral tunnel placement in Anterior cruciate ligament (ACL)reconstruction
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Scientific title
Anterior Cruciate Ligament Reconstruction: Clinical and Radiological outcomes for three techniques for femoral tunnel placement
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Secondary ID [1]
252863
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none
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Universal Trial Number (UTN)
U1111-1117-4175
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Anterior Cruciate ligamanet rupture
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Condition category
Condition code
Musculoskeletal
258529
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The correct position of the tibial and femoral tunnels for Anterior Cruciate Ligamanet (ACL) reconstruction are generally agreed. However it can be very difficult to acurately reproduce these ideal positions intraoperatively. The correct position of the tibial tunnel is commonly achieved by an outside in aiming device allowing a guide wire to be passed from the proximal tibial cortex into the ACL tibial footprint at the correct trajectory and then the Tibial tunnel drilled with a cannulated drill. The correct placement of the femoral tunnel is more difficult and has been shown to have a larger variability. The current method of femoral tunnel placement is achieved by passing a guide wire either through the tibial tunnel (transtibial technique) already created or through an anteromedial porthole in an inside out manner. Alternatives to these methods are being developed to improve the reproducibility of correct femoral tunnel placement.
A new technique where by an outside in method for placement of the femoral tunnel has been developed to circumvent some of the problems seen with the inside out method. This involves using a tibial aiming device and then passing a specially engineered guide wire called a Flip Cutter (trademark) which when in the correct position can deploy a cutting edge to drill the femoral tunnel in a retrograde fashion. It is thought that this technique will allow more consistent, accurate placement of the femoral tunnel which will correspond in a better functioning graft and more stable knee. The exposure will occour only once during the operation.
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Intervention code [1]
257358
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Treatment: Surgery
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Comparator / control treatment
The trans tibial group will be the controll group
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Control group
Active
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Outcomes
Primary outcome [1]
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Position of the femoral tunnel as measured by Computer Assisted Tomography (CAT) scanning
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Assessment method [1]
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Timepoint [1]
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post operatively
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Primary outcome [2]
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KT1000 'knee ligament arthrometer'
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Assessment method [2]
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Timepoint [2]
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pre operatively, postoperatively at 12, 24 and 36 months
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Primary outcome [3]
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Knee injury and osteoarthritis outcome score
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Assessment method [3]
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Timepoint [3]
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pre operatively, postoperatively at 12, 24 and 36 months
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Secondary outcome [1]
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Torniquet time
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Assessment method [1]
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Timepoint [1]
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intraoperatively
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Secondary outcome [2]
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pivot shift test
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Assessment method [2]
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Timepoint [2]
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post operatively, 12, 24 and 36 months
clinical diagnosis
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Secondary outcome [3]
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anterior draw test
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Assessment method [3]
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Timepoint [3]
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post operatively, 12, 24 and 36 months
clinical diagnosis
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Secondary outcome [4]
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infection
clinical diagnosis
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Assessment method [4]
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Timepoint [4]
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any stage
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Secondary outcome [5]
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implant faiulure
clinical diagnosis
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Assessment method [5]
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Timepoint [5]
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At any stage
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Secondary outcome [6]
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ligament rupture
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Assessment method [6]
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Timepoint [6]
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post operatively, 12, 24 and 36 months
clinical diagnosis
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Eligibility
Key inclusion criteria
Anterior Cruciate Ligamantdeficient knees,
Normal Contralateral knee
Skeletally Mature
Ability to provide informed consent
Four stranded hamstring autograft with retrobutton and interference screw fixation
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Minimum age
16
Years
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Maximum age
100
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Associated ligament injury
Previous Anterior Cruciate Ligamant reconstruction
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Consecutive patients receiving a primary ACL reconstruction by the senior author at Ascott private hospital, Auckland, New Zealand. The Senior author will determine if the patient is suitable for inclusion for the trial. The senior auther will not know what intervention the patient will recieve untill opening a sealed opaque envelope
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomization is via computer-generated random number list, blocked into groups to ensure equal numbers.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/02/2011
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
90
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
2957
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Mark Clatworthy
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Address [1]
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Auckland Bone and Joint Surgery,
Private Bag 28912,
Remuera,
Auckland, 1541.
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Country [1]
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New Zealand
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Primary sponsor type
Individual
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Name
Mark Clatworthy
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Address
Auckland Bone and Joint Surgery,
Private Bag 28912,
Remuera,
Auckland, 1541.
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
257013
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
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Northern X Regional Ethics Committee
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Ethics committee address [1]
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Ministry of Health, 3rd Floor, Unisys Building, Great South Road, Penrose, Private Bag 92 522 Wellesly Street, Auckland 1141
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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17/08/2010
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Approval date [1]
259831
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Ethics approval number [1]
259831
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Summary
Brief summary
The anterior cruciate ligament (ACL) is a major ligament in the knee which is commonly ruptured in active individuals. Following an ACL rupture the knee can feel unstable, predisposing to further injuries and eventually premature arthritis. ACL reconstruction is an operation where the ACL ligament is recreated with a tendon graft taken from another area of the body and fixed between the femur and the tibia with the aim of stabilising the knee. It is clear that accurate placements of both the femoral and tibial tunnel are crucial to the long term success of the operation. The correct placement of the graft in the femur can be difficult using the current methods. A new technique for placement of the femoral tunnel has been developed to allow consistent, accurate placement of the femoral tunnel which could correspond in a better functioning graft and more stable knee This is a study to compare the accuracy of the currently used femoral tunnel techniques with the new technique and determine if this correlates with the patient’s clinical outcome. It is a prospective, randomized, single centre study of three standardized surgical techniques.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Mark Clatworthy
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Address
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Auckland Bone and Joint Surgery,
Private Bag 28912,
Remuera,
Auckland,
1541.
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Country
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New Zealand
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Phone
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+64 9 520 9632
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Fax
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+64 9 520 9636
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Email
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[email protected]
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Contact person for scientific queries
Name
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Mark Clatworthy
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Address
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Auckland Bone and Joint Surgery,
Private Bag 28912,
Remuera,
Auckland,
1541.
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Country
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New Zealand
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Phone
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+64 9 520 9632
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Fax
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+64 9 520 9636
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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