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This Post-Approval study is prospective follow-up study designed to evaluate the long-term safety and effectiveness of the Reflection Ceramic Acetabular System.
This Post-Approval study is prospective follow-up study designed to evaluate the long-term safety and effectiveness of the Reflection Ceramic Acetabular System. Randomized Non-inflammatory Arthritis, Randomized Inflammatory and Continued Access Cohorts patients previously enrolled in the IDE study will be evaluated annually through five (5) year follow-up. In addition, all patients enrolled in the original study cohorts as well as the continued access patients will be sent a letter questionnaire annually at the 6-10 year postoperative time point to assess the patient's general well-being and if the study components are still in place
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Reflection Ceramic-Ceramic Hip System (IP) | Active Comparator | Investigational: Reflection Ceramic-Ceramic Hip System. Ceramic femoral head component and the ceramic acetabular cup insert are composed of Biolox forte aluminum oxide material. |
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| Reflection FSO V (5 hole) (Control) | Active Comparator | Control: Reflection FSO V (5 hole). Acetabular shell with a ultra high molecular weight polyethylene insert and an alumina ceramic femoral head with a Synergy or Spectron EF femoral stem. The Synergy femoral stem are composed of implant grade titanium while the Spectron EF stem is composed of implant grade cobalt chrome. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Reflection Ceramic-Ceramic Total Hip Replacement | Device | Intervention: all patients in study required (intervention) a total hip replacement, and were randomized to receive either the (Study Device)Reflection Ceramic Acetabular System or the(Control Device) Reflection FSO V (5 hole)acetabular system. Both arms received either a Synergy porous coated or Spectron EF stem. |
| Measure | Description | Time Frame |
|---|---|---|
| Survival of Hip Implant Based on Number of Hips Requiring Revision | Revisions were assessed cumulatively from Initial Study Period through Post-Approval Study Period and End of Study/Withdrawal. Implant survival was analyzed based on the number of hip revisions that occurred as well as the cohort for each study arm (IP and Control), but further categorized by cohorts within each arm: RNIA = randomized, non-inflammatory arthritis cohort (IP or Control) RIA = randomized, inflammatory arthritis cohort (IP or Control) RR = revision cohort (IP or Control) CAC = continued access cohort (IP only) | Postoperatively through Year 10 |
| Survival of Hip Implant Based on Time Until Revision Required | The survival of the implant was analyzed based on the length of time postoperatively until hip revision surgery was required (cumulatively through Initial Study Period and Post-Approval Study Period) for participants who required a revision surgery during the course of the study. The study arms were further categorized by cohorts within each arm: RNIA = randomized, non-inflammatory arthritis cohort (IP or Control) RIA = randomized, inflammatory arthritis cohort (IP or Control) RR = revision cohort (IP or Control) CAC = continued access cohort (IP only) | Postoperatively through Year 10 |
| Subject Satisfaction Questionnaire | A subject satisfaction questionnaire was conducted at Year 6, Year 7, Year 8, Year 9, and Year 10 postoperatively. The questionnaire was mailed to enrolled subjects each year (Years 6-10). The question was asked "Are you satisfied with hip?" and subjects responded either "yes" or "no". | Year 6 through Year 10 postoperatively |
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Criteria
Inclusion Criteria:
(Patient must meet all of the following characteristics to be enrolled in the study):
Exclusion Criteria:
(Patient with any of the following characteristics must be excluded from the study):
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| Name | Affiliation | Role |
|---|---|---|
| Scott Corpe, M.D. | Medical College of Georgia, Dept of Orthopaedic | Principal Investigator |
| Joseph Zuckerman, M.D. | Hospital of Joint Disease, Orthopaedic Institute | Principal Investigator |
| Jonathan P Garino, M.D. | Presbyterian Medical Center, Dept of Orthopaedic | Principal Investigator |
| Michael J Grecula, M.D. | University of Texas Medical Branch, Dept of Orthopaedic | Principal Investigator |
| James Howe, M.D. | University of Vermont | Principal Investigator |
| Michael Lynch, M.D. | The Memphis Orthopaedic Group, PC | Principal Investigator |
| Norman E Walter, M.D. | Family Orthopaedics | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medical College of Georgia, Department of Orthopaedics | Augusta | Georgia | 30912 | United States | ||
| Family Orthopaedics |
There were 456 subjects (535 hips) enrolled initially at the beginning of the study. For the Post-Approval Study period (Year 6 through Year 10), 29 subjects (10 from the IP group, 19 from the control group) were excluded from analysis in the Intent-to-Treat (ITT) population and thus not included in the Participant Flow or Outcome Measures for this period.
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| ID | Title | Description |
|---|---|---|
| FG000 | Reflection Ceramic-Ceramic Hip System (IP) | Investigational: Reflection Ceramic-Ceramic Hip System. Ceramic femoral head component and the ceramic acetabular cup insert are composed of Biolox forte aluminum oxide material. Reflection Ceramic-Ceramic Total Hip Replacement: Intervention: all patients in study required (intervention) a total hip replacement, and were randomized to receive either the (Study Device)Reflection Ceramic Acetabular System or the(Control Device) Reflection FSO V (5 hole)acetabular system. Both arms received either a Synergy porous coated or Spectron EF stem. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Initial Study (Year 1 up to Year 6) |
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| Reflection FSO V Total Hip Replacement | Device | Intervention: all patients in study required (intervention) a total hip replacement, and were randomized to receive either the (Study Device)Reflection Ceramic Acetabular System or the(Control Device) Reflection FSO V (5 hole)acetabular system. Both arms received either a Synergy porous coated or Spectron EF stem. |
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| Flint |
| Michigan |
| 48507 |
| United States |
| Hospital of Joint Disease, Orthopaedic Institute | New York | New York | 10003 | United States |
| Presbyterian Medical Center, Department of Orthopaedic Surgery | Philadelphia | Pennsylvania | 19104-2699 | United States |
| The Memphis Orthopaedic Group, PC | Memphis | Tennessee | 38104 | United States |
| University of Texas Medical Branch, Dept of Orthopaedics and Rehab | Galveston | Texas | 77555 | United States |
| University of Vermont College of Medicine | Burlington | Vermont | 05405 | United States |
| FG001 | Reflection FSO V (5 Hole) (Control) | Control: Reflection FSO V (5 hole). Acetabular shell with a ultra high molecular weight polyethylene insert and an alumina ceramic femoral head with a Synergy or Spectron EF femoral stem. The Synergy femoral stem are composed of implant grade titanium while the Spectron EF stem is composed of implant grade cobalt chrome. Reflection FSO V Total Hip Replacement: Intervention: all patients in study required (intervention) a total hip replacement, and were randomized to receive either the (Study Device)Reflection Ceramic Acetabular System or the(Control Device) Reflection FSO V (5 hole)acetabular system. Both arms received either a Synergy porous coated or Spectron EF stem. |
| COMPLETED |
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| NOT COMPLETED |
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| Post-Approval Study (Year 6 to Year 10) |
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| ID | Title | Description |
|---|---|---|
| BG000 | Reflection Ceramic-Ceramic Hip System (IP) | Investigational: Reflection Ceramic-Ceramic Hip System. Ceramic femoral head component and the ceramic acetabular cup insert are composed of Biolox forte aluminum oxide material. Reflection Ceramic-Ceramic Total Hip Replacement: Intervention: all patients in study required (intervention) a total hip replacement, and were randomized to receive either the (Study Device)Reflection Ceramic Acetabular System or the(Control Device) Reflection FSO V (5 hole)acetabular system. Both arms received either a Synergy porous coated or Spectron EF stem. |
| BG001 | Reflection FSO V (5 Hole) (Control) | Control: Reflection FSO V (5 hole). Acetabular shell with a ultra high molecular weight polyethylene insert and an alumina ceramic femoral head with a Synergy or Spectron EF femoral stem. The Synergy femoral stem are composed of implant grade titanium while the Spectron EF stem is composed of implant grade cobalt chrome. Reflection FSO V Total Hip Replacement: Intervention: all patients in study required (intervention) a total hip replacement, and were randomized to receive either the (Study Device)Reflection Ceramic Acetabular System or the(Control Device) Reflection FSO V (5 hole)acetabular system. Both arms received either a Synergy porous coated or Spectron EF stem. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Customized | Mean | Standard Deviation | Years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
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| Height | Mean | Standard Deviation | cm |
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| Weight | Mean | Standard Deviation | kg |
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| Body mass index (BMI) | Mean | Standard Deviation | kg/m^2 |
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| Previous surgery on affected hip | Count of Participants | Participants |
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| Other joint involvement | Count of Participants | Participants |
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| Physical activity | Count of Participants | Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Survival of Hip Implant Based on Number of Hips Requiring Revision | Revisions were assessed cumulatively from Initial Study Period through Post-Approval Study Period and End of Study/Withdrawal. Implant survival was analyzed based on the number of hip revisions that occurred as well as the cohort for each study arm (IP and Control), but further categorized by cohorts within each arm: RNIA = randomized, non-inflammatory arthritis cohort (IP or Control) RIA = randomized, inflammatory arthritis cohort (IP or Control) RR = revision cohort (IP or Control) CAC = continued access cohort (IP only) | All hips/participants were assessed using the ITT population, which excluded 29 enrolled participants from analysis not meeting ITT criteria. | Posted | Count of Units | Hips | Postoperatively through Year 10 | Hips | Hips |
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| Primary | Survival of Hip Implant Based on Time Until Revision Required | The survival of the implant was analyzed based on the length of time postoperatively until hip revision surgery was required (cumulatively through Initial Study Period and Post-Approval Study Period) for participants who required a revision surgery during the course of the study. The study arms were further categorized by cohorts within each arm: RNIA = randomized, non-inflammatory arthritis cohort (IP or Control) RIA = randomized, inflammatory arthritis cohort (IP or Control) RR = revision cohort (IP or Control) CAC = continued access cohort (IP only) | Analysis is presented by individual hip ID numbers to demonstrate time before a revision was required as well as the corresponding cohorts of each. All hips/participants were assessed using the ITT population, which excluded 29 enrolled participants from analysis not meeting ITT criteria. | Posted | Number | survival time in years | Postoperatively through Year 10 | Hips | Hips |
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| Primary | Subject Satisfaction Questionnaire | A subject satisfaction questionnaire was conducted at Year 6, Year 7, Year 8, Year 9, and Year 10 postoperatively. The questionnaire was mailed to enrolled subjects each year (Years 6-10). The question was asked "Are you satisfied with hip?" and subjects responded either "yes" or "no". | The number analyzed include all enrolled subjects who responded to the questionnaire at each time point. | Posted | Count of Participants | Participants | Year 6 through Year 10 postoperatively |
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AEs were collected from enrollment through the end of the study/subject withdrawal whichever came first (up to 10 years). However, after the 5-year study report was presented to the FDA, only subject deaths were collected for AEs. The 6-10 year study requirement from the FDA included revision information, deaths, and subject satisfaction collection only.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Reflection Ceramic-Ceramic Hip System (IP) | Investigational: Reflection Ceramic-Ceramic Hip System. Ceramic femoral head component and the ceramic acetabular cup insert are composed of Biolox forte aluminum oxide material. Reflection Ceramic-Ceramic Total Hip Replacement: Intervention: all patients in study required (intervention) a total hip replacement, and were randomized to receive either the (Study Device)Reflection Ceramic Acetabular System or the(Control Device) Reflection FSO V (5 hole)acetabular system. Both arms received either a Synergy porous coated or Spectron EF stem. | 18 | 308 | 18 | 308 | 0 | 308 |
| EG001 | Reflection FSO V (5 Hole) (Control) | Control: Reflection FSO V (5 hole). Acetabular shell with a ultra high molecular weight polyethylene insert and an alumina ceramic femoral head with a Synergy or Spectron EF femoral stem. The Synergy femoral stem are composed of implant grade titanium while the Spectron EF stem is composed of implant grade cobalt chrome. Reflection FSO V Total Hip Replacement: Intervention: all patients in study required (intervention) a total hip replacement, and were randomized to receive either the (Study Device)Reflection Ceramic Acetabular System or the(Control Device) Reflection FSO V (5 hole)acetabular system. Both arms received either a Synergy porous coated or Spectron EF stem. | 7 | 148 | 7 | 148 | 0 | 148 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Complications related to an infection | Skin and subcutaneous tissue disorders | Proprietary system | Systematic Assessment |
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| Injuries sustained during a house fire | Injury, poisoning and procedural complications | Proprietary system | Systematic Assessment |
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| Found during a death index search, reason unknown | General disorders | Proprietary system | Systematic Assessment |
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| Unknown, not reported by site | General disorders | Proprietary system | Systematic Assessment |
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| Overdose | Injury, poisoning and procedural complications | Proprietary system | Systematic Assessment |
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| Emphysema | Respiratory, thoracic and mediastinal disorders | Proprietary system | Systematic Assessment |
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| Heart failure | Cardiac disorders | Proprietary system | Systematic Assessment |
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| Cancer | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Proprietary system | Systematic Assessment |
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| Myelodysplastic leukemia | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Proprietary system | Systematic Assessment |
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| Cardiac arrest | Cardiac disorders | Proprietary system | Systematic Assessment |
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There were no limitations or caveats determined during the course of the study.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Rachael Winter, Director, Global Clinical Operations | Smith & Nephew, Inc. | +44 1482 673475 | rachael.winter@smith-nephew.com |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D010020 | Osteonecrosis |
| ID | Term |
|---|---|
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
| D001847 | Bone Diseases |
| D009336 | Necrosis |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D019644 | Arthroplasty, Replacement, Hip |
| ID | Term |
|---|---|
| D019643 | Arthroplasty, Replacement |
| D001178 | Arthroplasty |
| D019637 | Orthopedic Procedures |
| D013514 | Surgical Procedures, Operative |
| D019651 | Plastic Surgery Procedures |
| D019919 | Prosthesis Implantation |
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| Death |
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| Lost to Follow-up |
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| Withdrawn for Site Termination |
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| Male |
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| No |
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| No |
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| Light |
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| Moderate |
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| Intense |
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| Hips Not Requiring Revision |
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| Reflection FSO V (5 Hole) (Control) |
Control: Reflection FSO V (5 hole). Acetabular shell with a ultra high molecular weight polyethylene insert and an alumina ceramic femoral head with a Synergy or Spectron EF femoral stem. The Synergy femoral stem are composed of implant grade titanium while the Spectron EF stem is composed of implant grade cobalt chrome. Reflection FSO V Total Hip Replacement: Intervention: all patients in study required (intervention) a total hip replacement, and were randomized to receive either the (Study Device)Reflection Ceramic Acetabular System or the(Control Device) Reflection FSO V (5 hole)acetabular system. Both arms received either a Synergy porous coated or Spectron EF stem. |
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| RR Cohort |
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| CAC Cohort |
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| No |
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| No |
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| No |
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| No |
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