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Knee Replacement SurgeryPhase 4NCT01410240

Efficacy and Safety of FLOSEAL for Hemostasis in Total Knee Arthroplasty

A Phase 4 study of Knee Replacement Surgery and Osteoarthritis, run by Baxter Healthcare Corporation at 12 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to compare the efficacy and safety of FLOSEAL to standard of care for hemostasis in subjects undergoing total knee arthroplasty. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Knee Replacement Surgery, Osteoarthritis
Could I receive a placebo?
No, everyone receives an active treatment
How many people
137 participants
Where
12 sitesUnited States
Study dates
Sep 2011to Jan 2013
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participant is 18 to 80 years of age inclusive at the time of screening
  • Participant is planned for primary unilateral total knee arthroplasty
  • Participant has signed the informed consent form
  • Participant is in stable health (i.e., able to undergo surgery and participate in a follow-up program based on physical examination and medical history)
  • Participant has a preoperative Hgb level > 10 g/dL
  • If female of childbearing potential, the participant presents with a negative urine pregnancy test and agrees to employ adequate birth control measures for the duration of the study
  • Participant is willing and able to comply with the requirements of the protocol

Who cannot join

  • Participant has had a previous total or partial knee arthroplasty or any surgery on the knee within the previous 6 months
  • Participant has osteonecrosis or arthrotomy within the last year
  • Participant has prior or current hardware in target knee
  • Participant has had injections in the knee:
  • Steroids within the 3 months prior to scheduled surgery,
  • Synvisc, Hyalin, etc. within the 6 months prior to scheduled surgery
Show all 21Show fewer
  • Participant has had general surgery within 3 months
  • Participant has rheumatoid arthritis or any other inflammatory or traumatic bone injuries to the knee within the 12 months prior to scheduled surgery
  • Participant has allergies to products of bovine origin
  • Participant has a history of bleeding, platelet, or bone marrow disorders
  • Participant has donated more than 1 unit of blood donation in the 3 weeks prior to surgery
  • Participant has a history of a coagulation disorder
  • Participant is currently taking dipyridamole/ASA (Aggrenox) and/or enoxaparin (Lovenox)
  • Participant has been treated with aspirin or Warfarin (Coumadin) or clopidogrel (Plavix) within 7 days prior to surgery
  • Participant is not permitted to remain without his/her anti-coagulant regimen (e.g. Plavix) for 48 hours postoperatively
  • Participant has taken nonsteroidal anti-inflammatory agents or herbal supplements within 7 days of surgery
  • Participant has a history of substance abuse (alcohol, drugs) or is an active smoker
  • Participant has liver cirrhosis
  • Participant has erythropoietin agonist/stimulating agent within 90 days prior to surgery
  • Participant has an active infection or previous history of infection in the affected joint within the previous 6 months
  • Participant has participated in another clinical study involving an investigational product (IP) or device within 30 days prior to study enrollment or is scheduled to participate in another clinical study involving an IP or device during the course of this study

Trial locations and contacts

12 sites in 1 country.

12 sites in 1 country

United States12 sites
  • Hill Country Clinical Research, Inc.

    Austin, Texas, 78759

  • Florida Research Associates, LLC

    DeLand, Florida, 32720

  • Rothman Institute

    Egg Harbor, New Jersey, 08234-5500

  • Colorado Orthopedic Consultants, PC

    Englewood, Colorado, 80110

  • Shrock Orthopedic Research, LLC

    Fort Lauderdale, Florida, 33316

  • Cedars-Sinai Orthopedic Center

    Los Angeles, California, 90042

  • Joint Replacement Surgeons of Indiana Foundations

    Mooresville, Indiana, 46158

  • The Rothman Institute, Philadelphia

    Philadelphia, Pennsylvania, 19107

  • Temple University

    Philadelphia, Pennsylvania, 19140

  • Stanford Orthopedics

    Redwood City, California, 94063

  • Phoenix Clinical Research, LLC

    Tamarac, Florida, 33321

  • George Washington University Medical Faculty Associates

    Washington D.C., District of Columbia, 20037

Other trials in United States

About this study

Official title: A Prospective, Randomized, Controlled, Single-Blinded, Multicenter Study to Evaluate the Efficacy and Safety of FLOSEAL for Hemostasis in Primary Unilateral Total Knee Arthroplasty (TKA)

The purpose of this study is to compare the efficacy and safety of FLOSEAL to standard of care for hemostasis in subjects undergoing total knee arthroplasty.

Being tested
Standard of Care, FLOSEAL Hemostatic Matrix + Standard of care
Medical subject headings
Osteoarthritis

What participants receive

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

  • Standard of CareProcedure or surgery

    Conventional hemostatic techniques, such as cautery and manual compression, will be used.

  • FLOSEAL Hemostatic Matrix + Standard of careDrug

    Also called FLOSEAL

    FLOSEAL will be applied topically to areas of the knee where bleeding is observed (e.g. cut bone surfaces, subcutaneous tissue, posterior joint capsule, synovial tissue, medial and lateral gutters, branches of the genicular vessels, and suprapatellar pouch) and will occur intraoperatively. Sufficient amounts of FLOSEAL will be applied quickly using the provided applicators, followed by immediate approximation with a damp gauze, lap pad or sponge for approximately 2 minutes.

    + Standard of care: conventional hemostatic techniques, such as cautery and manual compression, will be used

Study groups in NCT01410240
Study groupRoleWhat they receive
Standard of Care (SoC)Active comparatorSoC: conventional hemostatic techniques such as cautery and manual compression
Receives: Procedure: Standard of Care
FLOSEAL + Standard of Care (SoC)ExperimentalFLOSEAL: consists of bovine-derived gelatin granules and a human plasma-derived thrombin component. SoC: conventional hemostatic techniques such as cautery and manual compression
Receives: Drug: FLOSEAL Hemostatic Matrix + Standard of care

What is being measured

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

  1. Change in Hemoglobin (Hgb) Level at Day 2 Post-operatively

    Measured: Pre-operative and 2 days post-operatively

  2. Proportion of Participants Who Have Adverse Events Related to Investigational Product (IP)

    • Proportion of Participants who have serious injuries (SIs) related to IP
    • Proportion of Participants who have non-serious adverse events (non-SAEs) related to IP

    Measured: Throughout the study period, 1 year and 4 months

Secondary outcomes (32)
  1. Change in Hemoglobin (Hgb) Levels at Day 1 Post-operatively

    Measured: Pre-operative and day 1 post-operatively

  2. Change in Hemoglobin (Hgb) Levels at Day 3 Post-operatively

    Participants who required a transfusion prior to the outcome assessments were excluded from the efficacy analyses of Hgb levels.

    Measured: Pre-operative and day 3 post-operatively

  3. Change From Baseline in Hematocrit (Hct) at Postoperative Day 1

    Participants who required a transfusion prior to the outcome assessments were excluded from the efficacy analyses of Hct levels.

    Measured: Pre-operative and day 1 post-operatively

  4. Change From Baseline in Hematocrit (Hct) at Postoperative Day 2

    Measured: Pre-operative and day 2 post-operatively

  5. Change From Baseline in Hematocrit (Hct) at Postoperative Day 3

    Measured: Pre-operative and day 3 post-operatively

  6. Total Tourniquet Time

    Measured from the time point of the tourniquet inflation to deflation using the same watch/clock

    Measured: Intra-operatively (on day of surgery = Day 0)

  7. Amount of FLOSEAL Applied

    Measured: Intra-operatively (Day 0)

  8. Duration of Surgery

    Measured: Time from first incision to complete wound closure (Day 0)

  9. Transfusion Requirements - Packed Red Blood Cells

    Measured: Intra-operatively (Day 0) thru Postoperative Day 3

  10. Total Drain Output at Day 1 Post-operatively

    Measured: 1 day post-operatively

  11. Pain Management - Number of Days When Pain Medication Was Used

    Each participant kept a knee pain management diary. The diary was used to document the pain medication taken on a daily basis.

    While the participants were hospitalized, either they filled out the diary, or study team members collected the pain diary data and filled out the diary.

    Measured: Pre-operatively (Day -1 to Day 0); and post-operatively daily thru week 6

  12. Visual Analogue Scale (VAS) Pain Scores

    Participant rated assessment of the level of pain they are experiencing with their operated knee. The VAS Pain Scale rates pain on a scale from 0 (no pain) to 10 (worst possible pain). For the pain scale, a higher score indicates worse pain.

    Measured: Pre-operatively (Day -1 to Day 0) and post-operatively at Day 3, Week 1, 2 and 6

  13. Change From Baseline in Visual Analogue Scale (VAS) Pain Scores at Postoperative Day 3

    Participant rated assessment of the level of pain they are experiencing with their operated knee. The VAS Pain Scale rates pain on a scale from 0 (no pain) to 10 (worst possible pain). For the pain scale, a higher score indicates worse pain.

    Measured: Pre-operatively (Day -1 to Day 0) and post-operatively at Day 3

  14. Change From Baseline in Visual Analogue Scale (VAS) Pain Scores at Postoperative Week 1

    Participant rated assessment of the level of pain they are experiencing with their operated knee. The VAS Pain Scale rates pain on a scale from 0 (no pain) to 10 (worst possible pain). For the pain scale, a higher score indicates worse pain.

    Measured: Pre-operatively (Day -1 to Day 0) and post-operatively at Week 1

  15. Change From Baseline in Visual Analogue Scale (VAS) Pain Scores at Postoperative Week 2

    Participant rated assessment of the level of pain they are experiencing with their operated knee. The VAS Pain Scale rates pain on a scale from 0 (no pain) to 10 (worst possible pain). For the pain scale, a higher score indicates worse pain.

    Measured: Pre-operatively (Day -1 to Day 0) and post-operatively at Week 2

  16. Change From Baseline in Visual Analogue Scale (VAS) Pain Scores at Postoperative Week 6

    Participant rated assessment of the level of pain they are experiencing with their operated knee. The VAS Pain Scale rates pain on a scale from 0 (no pain) to 10 (worst possible pain). For the pain scale, a higher score indicates worse pain.

    Measured: Pre-operatively (Day -1 to Day 0) and post-operatively at Week 6

  17. Western Ontario and McMaster Universities (WOMAC) Function Index Scores

    A well-validated scale to reflect problems in people with lower limb issues.

    1. Pain scale (5 items): 0 (none) to 10 (extreme pain) is used to grade each item, higher scores indicate greater pain. The overall pain scale = 0 (no pain) to 50 (extreme pain)
    2. Stiffness scale (2 items): 0 (none) to 10 (extreme stiffness) is used to grade each item, higher scores indicate greater stiffness. The overall stiffness scale = 0 (no stiffness) to 20 (extreme stiffness)
    3. Physical Activity Difficulty (PAD) scale (17 items): 0 (none) to 10 (extreme PAD) is used to grade each item, with higher scores indicating greater PAD. The overall PAD scale = 0 (no PAD) to 170 (extreme PAD)

    Averages calculated by taking sum of all individual item scores listed above and dividing by total number of items, range = 0 (no issues) to 10 (extreme issues).

    Total Scores calculated by taking sum of all individual item scores listed above, range = 0 (no issues) to 240 (extreme issues)

    Postoperative (Postop)

    Measured: Pre-operatively (Day -1 to Day 0), and post-operatively at Day 3 and Week 1, 2 and 6

  18. Change From Baseline at Postoperative Day 3, Week 1, Week 2, and Week 6 in Western Ontario and McMaster Universities (WOMAC) Scores

    A well-validated scale to reflect problems in people with lower limb issues.

    1. Pain scale (5 items): 0 (none) to 10 (extreme pain) is used to grade each item, higher scores indicate greater pain. The overall pain scale = 0 (no pain) to 50 (extreme pain)
    2. Stiffness scale (2 items): 0 (none) to 10 (extreme stiffness) is used to grade each item, higher scores indicate greater stiffness. The overall stiffness scale = 0 (no stiffness) to 20 (extreme stiffness)
    3. Physical Activity Difficulty (PAD) scale (17 items): 0 (none) to 10 (extreme PAD) is used to grade each item, with higher scores indicating greater PAD. The overall PAD scale = 0 (no PAD) to 170 (extreme PAD) Averages calculated by taking sum of all individual item scores listed above and dividing by total number of items, range = 0 (no issues) to 10 (extreme issues).

    Total Scores calculated by taking sum of all individual item scores listed above, range = 0 (no issues) to 240 (extreme issues).

    Postoperative (Postop)

    Measured: Pre-operatively (Day -1 to Day 0), and post-operatively at Day 3 and Week 1, 2 and 6

  19. Quality of Life (Utilizing the Short Form 36 Health Survey [SF-36]) Measured Preoperatively (Baseline), and Postoperatively at Week 1, 2, and 6

    Physical Functioning (PF); Role Limitation Due to Physical Health (RP); Bodily Pain (BP); General Health (GH); Vitality (VT); Social Functioning (SF); Role Limitation Due to Emotional Problems (RE); Mental Health (MH), Physical Component Score (PCS); Mental Component Score (MCS). Scores range 0-100, higher scores represent better health. There is no total overall score; scoring is done for subscores and summary scores. Scores were included where data was available.

    Measured: Preoperative, and Postoperative Weeks 1, 2, and 6

  20. Change From Baseline in SF-36 Scores at Postoperative Weeks 1, 2, and 6

    Physical Functioning (PF); Role Limitation Due to Physical Health (RP); Bodily Pain (BP); General Health (GH); Vitality (VT); Social Functioning (SF); Role Limitation Due to Emotional Problems (RE); Mental Health (MH), Physical Component Score (PCS); Mental Component Score (MCS). Scores range 0-100, higher scores represent better health. There is no total overall score; scoring is done for subscores and summary scores. Scores were included where data was available.

    Change in SF-36 Scores From Baseline = (Postoperative Week 1,2, or 6 Scores) - (Baseline Scores).

    Measured: Baseline and Postoperative Weeks 1, 2, and 6

  21. Length of Hospital Stay

    Measured: From the day of hospitalization to the day of discharge

  22. Proportion of Participants With Transfusion Requirements

    Measured: Intra-operative

  23. Proportion of Participants With Wound Complications (ie, Hematoma, Cellulitis, Dehiscence, Superficial or Deep Infection, and Persistent Drainage)

    Measured: Day 0; Post-operative Days 1, 3 and Weeks 1, 2, 6

  24. Proportion of Participants With Any Adverse Events or Serious Injuries During or After Surgery

    Measured: Day 0; Post-operative Days 1, 3 and Weeks 1, 2, 6

  25. Rehabilitation Parameter by Study Day- Number of Participants Who Saw Their Physical Therapist

    The number of participants responding affirmative in their rehabilitation diaries for each day

    Measured: 60 days

  26. Rehabilitation Parameter by Study Day- Number of Participants Who Were Able to Walk Without Assistance

    The number of participants responding affirmative in their rehabilitation diaries for each day

    Measured: 60 days

  27. Rehabilitation Parameter by Study Day- Number of Participants Who Were Using a Walker

    The number of participants responding affirmative in their rehabilitation diaries for each day

    Measured: 60 days

  28. Rehabilitation Parameter by Study Day- Number of Participants Who Were Using a Walking Cane

    The number of participants responding affirmative in their rehabilitation diaries for each day

    Measured: 60 days

  29. Rehabilitation Parameter by Study Day- Number of Participants Who Were Using a Wheelchair

    The number of participants responding affirmative in their rehabilitation diaries for each day

    Measured: 60 days

  30. Rehabilitation Parameter by Study Day- Number of Participants Who Were Using a Another Walking Device (Other Than a: Walker, Walking Cane, or Wheelchair)

    The number of participants responding affirmative in their rehabilitation diaries for each day

    Measured: 60 days

  31. Rehabilitation Parameter by Study Day- Number of Participants Who Cannot Get Out of Bed

    The number of participants responding affirmative in their rehabilitation diaries for each day

    Measured: 60 days

  32. Rehabilitation Parameter by Study Day- Number of Participants Who Had Someone Helping Them to Walk

    The number of participants responding affirmative in their rehabilitation diaries for each day

    Measured: 60 days

Timeline

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

  1. First posted5 Aug 2011 (estimated)
  2. Study startSep 2011
  3. Primary completionJan 2013
  4. Study completionJan 2013

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
137 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01410240
Sponsor's protocol ID
611001
Status last verified
May 2014
First submitted
1 Aug 2011
Last updated
6 Jun 2014
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study of Knee Replacement Surgery and Osteoarthritis, run by Baxter Healthcare Corporation at 12 sites in United States.

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 7 inclusion and 21 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: finished, as of the sponsor's last update on 6 Jun 2014. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in United States. 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.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 6 Jun 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Hemoglobin (Hgb) Level at Day 2 Post-operatively (time frame: Pre-operative and 2 days post-operatively). 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?
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 6 Jun 2014.

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