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Division of Orthopaedics

Clinical Trials

The Division is involved in a number of active clinical trials, including:

  • Functional outcomes following orthopaedic surgery
  • Simple Bone Cysts in Kids
  • Retro versus Trans Articular Drilling for Juvenile Osteochondritis
    Dissecans of the Knee
  • Quantitative ultrasound for the evaluation of simple bone cyst healing

Recently completed trials include:

 

In progress

Functional Outcomes Following Orthopaedic Surgery based on Gait Laboratory Analysis versus Observational Analysis: A Randomized Controlled Trial

SickKids Principal Investigator: Dr. Unni Narayanan

Funding: CIHR

A randomized, multi-centre trial to evaluate the effectiveness of gait analysis for decision making and its impact on functional outcomes following multi-level orthopaedic surgery for children with ambulatory cerebral palsy

See more about this clinical trial.
 

 

Simple Bone Cysts in Kids (SBoCK)

SickKids Principal Investigators: Dr. James G. Wright and Dr. Sevan Hopyan

Funding: CIHR

Simple bone cysts (SBCs) are cysts filled with fluid that occur most frequently in the long bones of children. There are many ways to treat SBCs but it is unclear if one is better than another. This trial follows the prior SBC study comparing the effectiveness of curettage with puncture alone and followed by injection with a bone substitute, two common surgical procedures for the treatment of SBCs.

See more about this clinical trial:

Retro versus Trans Articular Drilling for Juvenile Osteochondritis Dissecans of the Knee: A Multicenter, Randomized Controlled Study

SickKids Principal Investigator: Dr. Lucas Murnaghan

Comparing post-operative patient functioning associated with the two surgical techniques commonly used to treat stable OCD lesions that do not show healing from non-surgical treatment.  

See more about this clinical trial.
 

Quantitative Ultrasound For The Evaluation Of Simple Bone Cyst Healing

SickKids Principal Investigators: Dr. James G. Wright and Dr. Andrew Howard

Simple bone cysts (SBCs), also known as unicameral bone cysts (UBCs), are benign bone lesions. Literature to date describes little agreement between clinicians on specific prognostic criteria for the prediction of cyst healing, recurrence or fracture. Evidence has shown that bone mineral density (BMD) is a reliable indicator of risk to SBC patients given its association with the mechanical properties of bone. There has been further exploration into the use of quantitative ultrasound to assess bone density by measuring the velocity of the ultrasound transmission over the bone. To determine whether the QUS can provide prognostic information with respect to cyst healing, recurrence or fracture with a SBC, further study is needed.

See more about this clinical trial.

 

Effectiveness of Casting for the Treatment of Recurrent Idiopathic Clubfoot

Sickkids Principal Investigator: Dr. James G. Wright

Idiopathic clubfoot or talipes equinovarus, is a congenital deformity characterized by the inward turning and downward positioning of the foot at birth. Serial casting followed by a period of brace wear has been accepted as the standard for the correction of idiopathic clubfoot. Following correction, recurrence requiring further casting is unfortunately common in about 25% of patients. Literature to date examining the success and failure of this treatment method for this patient population has been limited by short follow-up periods which impedes the ability of clinicians’ to determine the long term effectiveness of the Ponseti method for recurrent clubfoot.


 

Completed


A Comparison of Casting and External Fixation for Paediatric Femoral Shaft  Fractures

SickKids Principal Investigator: Dr. James G. Wright

Treatments for femoral fractures in children vary and have been investigated only in case series. This multi-centre randomized trial compares malunion rates after external fixation and after early application of a hip spica cast for paediatric femoral shaft fractures.

 

A Randomized Clinical Trial Comparing the Moss Miami and Universal Instrumentation Systems for Adolescent Idiopathic Scoliosis

SickKids Principal Investigator: Dr. James G. Wright

Although many techniques for the surgical treatment of scoliosis have been described, few trials compare implant systems and the relationship between surgeons' preferences for implants and patient outcomes is unknown. The purpose of this study was to compare the quality of life and curve correction associated with use of the Moss Miami system and the Universal Spine System for spinal fusion in patients with adolescent idiopathic scoliosis.

Funding: Canadian Institutes Health Research (CIHR) Industrial Partnership with DePuy AcroMed-Johnson and Johnson Medical Products and Synthes, Canada.

Simple Bone Cyst Trial

SickKids Principal Investigator: Dr. James G. Wright

Funding: Pediatric Orthopaedic Society of North America (POSNA), Salter Chair in Surgical Research, and Shriners Hospitals for Children

Simple bone cysts are common benign lesions in growing children that predispose them to fracture and are sometimes painful. The purpose of this trial was to compare rates of healing of simple bone cysts treated with intralesional injections of bone marrow with rates of healing of those treated with methylprednisolone acetate.

 

Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST)

SickKids Principal Investigator: Dr. James G. Wright

Funding: NIH, Children's Miracle Network, Shriners Hospitals for Children, CIHR

Adolescent idiopathic scoliosis (AIS) is a structural curve of the spine with no clear underlying cause. Bracing is currently the standard of care for preventing curve progression and treating AIS. However, the effectiveness of bracing remains unclear. The purpose of this study is to compare the risk of curve progression in adolescents with AIS who wear a brace versus those who do not and to determine whether there are reliable factors that can predict the usefulness of bracing for a particular individual with AIS.

The results of this trial were e-published in The New England Journal of Medicine on October 17, 2013. Please see http://www.nejm.org/doi/full/10.1056/NEJMoa1307337 for the full text.

Principal Investigators:
Dr. Lori A. Dolan (University of Iowa)
Dr. Stuart Weinstein (University of Iowa)
Dr. Jim Wright (HSC)

Project Director: Dr. Lori A. Dolan

Collaborators at SickKids:
Dr. Ben Alman
Dr. Andrew Howard

Additional Publications:
1. Weinstein SL, Dolan LA, Wright JG, Dobbs MB. Design of the Bracing in Adolescent Idiopathic Scoliosis Trial (BrAIST). Spine (Phila Pa 1976). 2013 Oct 1;38(21):1832-41. doi: 10.1097/01.brs.0000435048.23726.3e.

For more information about the study results, please visit: http://clinicaltrials.gov/ct2/show/results/NCT00448448

 

A Double-Blind, RCT Comparing Botox and Placebo in the Treatment of Idiopathic Clubfoot

SickKids Principal Investigators: Dr. James G. Wright and Dr. Andrew Howard

To determine the effectiveness of Botox in treating patients with idiopathic clubfoot by comparing outcomes of subjects treated with manipulation and casting plus Botox to those treated with manipulation and casting plus placebo.

For additional information, please visit: http://clinicaltrials.gov/ct2/show/study/NCT00152347?term=botox+placebo+clubfoot&rank=1

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