Pelvic Girdle Pain Clinical Trial
Official title:
A Pre-Market Multicenter National Open Label Single Arm Study to Evaluate the Safety and Performance of a Class III Medical Device (Greenbone Implant) for Iliac Crest Reconstruction Following Bone Graft Harvesting for Pelvic Fusion.
This is a multi-centre, prospective, open-label, single-arm, first-in-man clinical
investigation. The patients enrolled in this clinical trial will undergo elective surgery for
pelvic fusion. Following harvesting of autologous bone graft form the iliac crest, the donor
site will be reconstructed with a new scaffold known as GreenBone.
GreenBone is a ceramic reabsorbable scaffold which is obtained by the transformation of wood.
It has a very similar structure to bone.
The aim of the study is to evaluate the safety of using the GreenBone in humans and also to
evaluate its capacity to promote new bone formation at the donor site.
Bone defects can result from high-energy traumatic events, bone resection due to different
pathologies such as tumors or infection, or from the treatment of complex non-unions, all
very challenging conditions in orthopaedic practice. Defects of pelvic iliac crest most
frequently result from harvesting of iliac bone graft for bone grafting and fusion procedures
and can be associated with significant morbidity.
Current reconstruction options of the bone defects usually imply the use of bone grafts
and/or biocompatible materials, to create a scaffold that bridges the defect, favouring the
migration of cells from the neighbouring tissues to fill the gap. Autografts and allografts
are the most commonly used bone grafts currently used for large bone defects. However, the
use of both types of grafts has significant disadvantages. For iliac crest reconstruction in
particular, different types of synthetic materials and xenografts have been used. However, at
the moment, there is not any ideal bone substitute with the necessary osteoinductive,
osteoconductive and mechanical properties. GreenBone is a synthetic, acellular, reabsorbable,
new generation bone graft, being suitable for surgical reconstruction of bone defects.
When autologous bone graft is needed for the treatment of non-unions or bone defects, it is
harvested from the pelvic iliac crest in the form of either tricortical graft material or
cancellous bone. Harvested tricortical graft blocks are used to facilitate fusion of joints
(i.e. pubis symphysis, sacroiliac joint), to structurally support metaphyseal areas of
articular impaction injuries (i.e. tibial plateau) and to fill in metaphyseal bone voids. The
GreenBone device, with its inherent physical and biomimetic properties, possesses similar
structural properties to bone, and thus, it can be considered the ideal bone graft.
Reconstruction of the donor site restores the pelvic anatomy and minimises the risk of
chronic pain, haematoma formation and herniation of the abdominal contents.
The purpose of this study is to assess the safety of the use of GreenBone in patients
undergoing iliac crest reconstruction to restore bone defects. In particular, this study will
evaluate the progression of bone healing and regeneration of the donor site throughout a
6-month observation period, it will evaluate the postoperative pain related to iliac crest
graft harvesting, and it will evaluate the health related quality of life of patients at 6
months.
Patient who will be enrolled in the study will receive exactly the same operation that they
would receive normally for pelvic fusion with the only difference that instead of having
xenograft (bone obtained from cows) applied to the donor site (the site in your pelvis from
where the surgeon will harvest the bone graft), you will receive the GreenBone material.
Following surgery patients will be followed-up for 6 months. At each follow-up visit, the
safety of the use of the GreenBone implant will be assessed and patients will complete a
pain-scale and quality of life questionnaires. Moreover, incorporation of the Bone graft into
the iliac crest will be assessed radiologically.
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