Prospective Multicenter Observational Study on the Use of NEOCEMENT® for the Treatment of Bone Defects

Study Overview
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Brief Summary
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Neocement is a CE marked device, registered in INFARMED (Portuguese National Competent Authority) and Department of Planning and Organisation of the National Health Service - General board of Medical Devices, pharmaceutical services, and safety in healthcare (Italy). This protocol does not include any new intended uses, new populations, new materials or design changes.

Detailed Description
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Neocement developed by Bioceramed is a calcium phosphate cement, composed of a liquid and a solid phase that upon mixing form a mouldable paste which hardens within 4-8 minutes due to an isothermal reaction. This device is intended to be used in filling bony voids or gaps in the extremities, which have either been surgically created, or the result of traumatic injury to the bone and are not intrinsic to the stability of the bony structure. Hence, it is intended to be used by healthcare professionals (surgeons) when bone ingrowth and consolidation are required. Neocement is contraindicated to use in load bearing applications, and must not be used where the implantation site is unstable and not rigidly fixed. Additionally, it is also not indicated to use in cases where the implantation site presents infection, nor in cases where poor bone healing would be expected, such as metabolic, immunologic or systemic disorders. Bone grafting technique has been employed for several decades by orthopaedic surgeons to potentiate the process of bone repair across all orthopaedics' subspecialties. Despite autografts with cancellous bone being considered the gold standard for bone regeneration due to their osteogenic elements, there are numerous disadvantages associated to this technique, including extended surgical time, local pain and swelling from donor segments. The use of synthetic substitutes, like calcium phosphate cements, have significant advantages, including decreased risk of infection from human pathogens, and unlimited availability in various shapes and sizes. Thus, reconstruction and/or filling of bone defects caused by trauma, disease, or tumour resection in long bones using calcium phosphate cements has proven to be an effective and safe alternative to reduce donor-site morbidity associated to autografting, whilst providing support for bone regeneration.

Official Title
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Prospective Multicenter Observational Study on the Use of NEOCEMENT® for the Treatment of Bone Defects

Conditions
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Bone Deformity

Intervention / Treatment
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* Device: Neocement


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with bone defect treatment who meet predefined criteria in Instructions For Use (IFU) of Neocement® / Neocement® Inject P. Age ≥ 18 years of both genders (male and female) Patient signed informed consent form (for data collection) Bone defects surgically created or osseous defects created from traumatic injury to the bone Bone skeletal defects that are not intrinsic to the stability of bone structure OR site which can be stabilized Exclusion Criteria: Acute or chronic infection at the surgical site; Metabolic bone diseases; Severe degenerative disease conditions in which general bone grafting is not advisable; Active malignancy. Inability to understand consent and objectives of the study; Pregnant women or breastfeeding women; Unable to undergo medical monitoring for geographical, social or psychological reasons.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Device: Neocement|Bone graft substitutes|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Bone consolidation (Neer/ RUST classification) | Neer classification is used for trabecular bone: Healed: Cyst filled by new bone, with or without small radiolucent area(s) < 1 cm in size Healing with defects: Radiolucent area(s) < 50% of the diameter of bone, with enough cortical thickness to prevent fracture Persistent cyst: Radiolucent area > 50% of diameter of the bone and with a thin cortical rim. No increase in the size of the cyst. Recurrent cyst: Cyst reappeared in a previously obliterated area, or a residual radiolucent area has increased in size) RUST is classified according to the scores: Score 1: Fracture Line, No Callus Score 2: Fracture Line, Visible Callus Score 3: Fracture Line, Bridging Callus Score 4: No fracture line, remodelled | 24 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional scores | Functional scores are classified as Hip disability and Osteoarthritis Outcome Score, Knee disability and Osteoarthritis Outcome Score, Foot and Ankle Ability Measure, where 0 points is the worst possible score and 100 points is the best possible score. | 24 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Real-world study, Bone cement, Observational study