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Trial registered on ANZCTR
Registration number
ACTRN12619000394145
Ethics application status
Approved
Date submitted
21/02/2019
Date registered
12/03/2019
Date last updated
3/12/2020
Date data sharing statement initially provided
12/03/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Skull repair using adult stem cells and a dissolving scaffold
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Scientific title
Cranial Reconstruction Using Mesenchymal Stromal Cells and Resorbable Biomaterials in adults with a cranial defect.
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Secondary ID [1]
297466
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NCT01742260
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Secondary ID [2]
297467
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2012/022238
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Secondary ID [3]
297468
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2012/047
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Universal Trial Number (UTN)
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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:
Surgically-Created Resection Cavity
311660
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Condition category
Condition code
Musculoskeletal
310281
310281
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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 intervention is cranioplasty.
a) any physical or informational materials used,
Patient Information Sheets (PIS) will be provided to each patient enrolled in the trial.
b) each of the procedures, activities, and/or processes used,
1. Patient consent
2. Stem Cell Collection
• Blood Test
• Bone Marrow Aspirate
• MSC processing
• Delivery of Intervention by Haematologist
3. Insertion of cranioplasty
c) who will deliver the intervention,
Consultant Haematologist with regard to stem cells
Consultant Neurosurgeon with regard to cranioplasty insertion
d) the mode of delivery,
Face to face and in theatre
e) the number of times the intervention will be delivered and over what period of time,
Once at time of theatre.
f) the location/setting where the intervention occurs.
Major Public Hospital
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Intervention code [1]
313720
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Treatment: Surgery
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
319174
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Failure of cranioplasty implant - The primary outcome measures will be failure of the tissue engineered construct such that it requires removal ( for example due to infection, resorption, dislodgement or cosmetic failure), as well as any significant adverse events attributable to treatment allocation.
This is a composite outcome
Assessment
Infection: clinical assessment by Neurosurgeon
Resorption: CT scan at 12 most post op radiological assessment
Cosmesis: Assessment by Neurosurgeon at 3months, 6 months and 12months.
Position of plate: CT scan day Post op day 1
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Assessment method [1]
319174
0
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Timepoint [1]
319174
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12 months
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Secondary outcome [1]
367179
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Quantitative bone density of the tissue engineered construct and adjacent bone from CT scan at 12 months.
Assessment: CT scan, analysis of Hounsfield units of host bone and of tissue engineered construct
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Assessment method [1]
367179
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Timepoint [1]
367179
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12 months
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Secondary outcome [2]
367180
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Assessment of cosmesis by photography
Assessment: clinical photography at 3, 6 and 12 months.
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Assessment method [2]
367180
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Timepoint [2]
367180
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12 months
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Eligibility
Key inclusion criteria
- All adult patients (age > 18 years) who have a cranial defect that requires reconstruction with a defect size of less than 110 x 180mm.
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Minimum age
18
Years
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Maximum age
No limit
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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
- Patients who have had a previous cranial infection
- Positive bone marrow aspirate on testing for microcontamination
- Positive testing for infectious disease
- Patients who have neurocognitive difficulties and are as such unable to provide
informed consent
- Patients with an ongoing intracranial infection following craniotomy
- Pregnant or breastfeeding females
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
6/02/2019
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Date of last participant enrolment
Anticipated
6/02/2021
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Actual
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Date of last data collection
Anticipated
31/12/2022
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Actual
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Sample size
Target
20
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Accrual to date
1
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
13212
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Royal Perth Hospital - Perth
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Recruitment hospital [2]
13213
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Fiona Stanley Hospital - Murdoch
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Recruitment hospital [3]
13214
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Sir Charles Gairdner Hospital - Nedlands
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Recruitment postcode(s) [1]
25769
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6000 - Perth
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Recruitment postcode(s) [2]
25770
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6150 - Murdoch
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Recruitment postcode(s) [3]
25771
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6009 - Nedlands
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Funding & Sponsors
Funding source category [1]
302036
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Government body
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Name [1]
302036
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WA State Health Research Advisory Council
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Address [1]
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189 Royal St, Perth WA 6004
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Country [1]
302036
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Australia
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Primary sponsor type
Individual
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Name
Stephen Honeybul
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Address
Royal Perth Hospital
197 Wellington St Perth WA 6000
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Country
Australia
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Secondary sponsor category [1]
301845
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None
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Name [1]
301845
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Address [1]
301845
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Country [1]
301845
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
302719
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Royal Perth Hospital EC00270
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Ethics committee address [1]
302719
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Royal Perth Hospital 197 Wellington St Perth WA 6000
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Ethics committee country [1]
302719
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Australia
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Date submitted for ethics approval [1]
302719
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04/04/2012
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Approval date [1]
302719
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14/09/2012
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Ethics approval number [1]
302719
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Summary
Brief summary
Brief Summary Cranial reconstruction using mesenchymal stromal cells and resorbable biomaterials, will result in the patient producing their own bone to fill the void which will reduce the risk of infection and resorption, lead to a better cosmetic result and obviate any long term consequence of having a synthetic material in vivo. Introduction: There are several reasons that parts of the skull may need to be removed: - After trauma to relieve brain swelling - During brain surgery (for brain cancer) - After trauma where the bone is so badly fractured/fragmented it needs to be removed. In all but the last case the bone flap is temporarily stored in a freezer and once the brain swelling has subsided it is reinserted. This procedure is called "autologous cranioplasty"; autologous, because it originally came from the patient and cranioplasty, referring to the repair. Although this is a straightforward procedure, there are a number of complications including infection and bone resorption that can occur. This study: Stromal cells have a proven ability to aid in bony healing. Furthermore stromal cells on a ceramic framework encased in a plastic scaffold have been shown in a small clinical trial to lead to healing of skull defects. In the present study, it is proposed to add stromal cells, either autologous or allogeneic, to a resorbable ceramic material and insert into the skull. The ceramic is designed to dissolve away over time as the body's own blood vessels and cells populate the construct and create the patient's new bone. It has been proven that without the encouragement of the cells and temporary scaffold materials, a hole in the skull will not heal. Given the incidence of bone resorption/infection and metal plate infection using traditional methods, it would seem prudent to provide a construct that will allow controlled replacement with the patient's own bone, thus negating any adverse long-term complications with synthetic materials that remain for life.
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Trial website
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Trial related presentations / publications
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Public notes
The reason for listing the trial on ANZCTR is twofold. Firstly the person responsible for registering the trial in the US (clinicaltrials.org) retired and then could not login, and despite numerous attempts we were unsuccessful in gaining access . Secondly, we were advised by our ethics committee that it would be appropriate to register the trial with the ANZCTR,
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Contacts
Principal investigator
Name
91150
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Dr Stephen Honeybul, MD
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Address
91150
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Royal Perth Hospital
197 Wellington St, Perth WA 6000
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Country
91150
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Australia
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Phone
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+61 892242500
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Fax
91150
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Email
91150
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[email protected]
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Contact person for public queries
Name
91151
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Alan Kop
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Address
91151
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Royal Perth Hospital
197 Wellington St, Perth WA 6000
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Country
91151
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Australia
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Phone
91151
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+61 892242500
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Fax
91151
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Email
91151
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[email protected]
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Contact person for scientific queries
Name
91152
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Alan Kop
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Address
91152
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Royal Perth Hospital
197 Wellington St, Perth WA 6000
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Country
91152
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Australia
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Phone
91152
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+61 892242500
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Fax
91152
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Email
91152
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Need to ensure participant privacy.
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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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