Bone Marrow Edema Clinical Trial
Official title:
Treatment of Bone Marrow Edema Lesions of the Knee With Percutaneous Grafting
Verified date | April 2019 |
Source | University of Sao Paulo General Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Objective
1. To evaluate the technique of percutaneous grafting with bone substitute in the knee as
to its applicability and technical feasibility.
2. Evaluate the results regarding functional improvement and prevention of the evolution of
joint cartilage degeneration.
Material and methods Twenty patients from the Knee Group clinic who meet the criteria will be
selected.
Magnetic resonance imaging will be analyzed on the PACS server. Through the resonance will be
performed evaluation of the size of the bone edema in volume and its proportion in relation
to the size of the affected condyle or tibial plateau and the cartilage of the femoro-tibial
joint. The lesions will then be mapped in the coronal and sagittal plane.
Radiographs will be taken in antero-posterior, profile, Rosenberg knee and lower limb views.
Evaluation of the patients will be performed by the visual analog pain scale and by the KOOS,
IKDC and SF-36v1 indices.
Description of Surgical Technique After the mapping the patient will be submitted to the
procedure. The procedure consists in the application of a bone substitute based on injectable
calcium phosphate in the area of bone edema previously mapped with the aid of radioscopy to
guide. After confirming the proper positioning of the guidewire, a trephine is introduced
through which the product will be injected. GRAFTYS HBS® (Graftys, Aix en Provence, France)
will be used.
The procedures will be performed in a surgical center, with conventional antisepsis and
asepsis techniques and under spinal anesthesia. The patient will be hospitalized and must be
discharged on the first postoperative day. After the procedure the patients will be under
partial load as tolerated for two weeks with free range of motion and will start
physiotherapy after 2 weeks of the procedure. During hospitalization the patient will receive
analgesia with intravenous Dipirone 1g every 6 hours associated with Tramadol 100mg
intravenously every 8 hours if severe pain. After discharge the patient will receive
analgesia with dipyrone 1g orally every 6 hours associated with Tramadol 100mg orally every 8
hours if severe pain, and Tramadol used by the patient was quantified.
Patients will then be re-evaluated at 1, 3, 12, 24 and 48 weeks with the same previous
criteria and at 12 months new MRI with the same previous protocol will be performed.
Status | Completed |
Enrollment | 20 |
Est. completion date | December 30, 2018 |
Est. primary completion date | December 30, 2018 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 40 Years to 85 Years |
Eligibility |
Inclusion Criteria: - Age 40 to 85 years - Gender: both genders - Knee pain for at least 6 months - Hypercaption lesion in subchondral region of tibial plateau or femoral condyle in T2-weighted magnetic resonance imaging with fat suppression. Exclusion Criteria: - Rheumatologic diseases diagnosed in treatment - Renal insufficiency requiring hemodialysis - Not ambulatory - Knee osteoarthrosis with Kellegren / Lawrence classification greater than 3 - Alignment in varus or valgus greater than 8 degrees in relation to the mechanical axis - Radiographic changes in the femoro-patellar joint associated with symptoms of anterior knee pain |
Country | Name | City | State |
---|---|---|---|
Brazil | Hospital das Clinicas - University of Sao Paulo | Sao Paulo |
Lead Sponsor | Collaborator |
---|---|
University of Sao Paulo General Hospital |
Brazil,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Knee injury and Osteoarthritis Outcome Score | Evatualion of Pain, other Symptoms, Function in daily living, Function in sport and recreation and knee related Quality of life | Pre-operative | |
Primary | Knee injury and Osteoarthritis Outcome Score | Evatualion of Pain, other Symptoms, Function in daily living, Function in sport and recreation and knee related Quality of life, comparative with pre-optative evaluation | 1 week postoperative | |
Primary | Knee injury and Osteoarthritis Outcome Score | Evatualion of Pain, other Symptoms, Function in daily living, Function in sport and recreation and knee related Quality of life, comparative with pre-optative evaluation | 3 weeks postoperative | |
Primary | Knee injury and Osteoarthritis Outcome Score | Evatualion of Pain, other Symptoms, Function in daily living, Function in sport and recreation and knee related Quality of life, comparative with pre-optative evaluation | 6 weeks postoperative | |
Primary | Knee injury and Osteoarthritis Outcome Score | Evatualion of Pain, other Symptoms, Function in daily living, Function in sport and recreation and knee related Quality of life, comparative with pre-optative evaluation | 12 weeks postoperative | |
Primary | Knee injury and Osteoarthritis Outcome Score | Evatualion of Pain, other Symptoms, Function in daily living, Function in sport and recreation and knee related Quality of life, comparative with pre-optative evaluation | 24 weeks postoperative | |
Primary | Knee injury and Osteoarthritis Outcome Score | Evatualion of Pain, other Symptoms, Function in daily living, Function in sport and recreation and knee related Quality of life, comparative with pre-optative evaluation | 48 weeks postoperative | |
Primary | International Knee Documentation Committee | knee-specific patient-reported outcome measure | Pre-operative | |
Primary | International Knee Documentation Committee | knee-specific patient-reported outcome measure, comparative with pre-optative evaluation | 1 week postoperative | |
Primary | International Knee Documentation Committee | knee-specific patient-reported outcome measure, comparative with pre-optative evaluation | 3 weeks postoperative | |
Primary | International Knee Documentation Committee | knee-specific patient-reported outcome measure comparative with pre-optative evaluation | 6 weeks postoperative | |
Primary | International Knee Documentation Committee | knee-specific patient-reported outcome measure, comparative with pre-optative evaluation | 12 weeks postoperative | |
Primary | International Knee Documentation Committee | knee-specific patient-reported outcome measure, comparative with pre-optative evaluation | 24 weeks postoperative | |
Primary | International Knee Documentation Committee | knee-specific patient-reported outcome measure, comparative with pre-optative evaluation | 48 weeks postoperative | |
Primary | Short Form 36 Health Survey | Patient-reported survey of patient health | Pre-operative | |
Primary | Short Form 36 Health Survey | Patient-reported survey of patient health, comparative with pre-optative evaluation | 24 weeks postoperative | |
Primary | Short Form 36 Health Survey | Patient-reported survey of patient health, comparative with pre-optative evaluation | 48 weeks postoperative | |
Primary | Visual analog scale for Pain | Unidimensional measure of pain intensity | Pre-operative | |
Primary | Visual analog scale for Pain | Unidimensional measure of pain intensity, comparative with pre-optative evaluation | 1 Week postoperative | |
Primary | Visual analog scale for Pain | Unidimensional measure of pain intensity, comparative with pre-optative evaluation | 3 weeks postoperative | |
Primary | Visual analog scale for Pain | Unidimensional measure of pain intensity, comparative with pre-optative evaluation | 6 weeks postoperative | |
Primary | Visual analog scale for Pain | Unidimensional measure of pain intensity, comparative with pre-optative evaluation | 12 weeks postoperative | |
Primary | Visual analog scale for Pain | Unidimensional measure of pain intensity, comparative with pre-optative evaluation | 24 weeks postoperative | |
Primary | Visual analog scale for Pain | Unidimensional measure of pain intensity, comparative with pre-optative evaluation | 48 weeks postoperative | |
Secondary | Edema Volume evaluation | MRI evaluation | 1 year postoperative |
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT03110224 -
SCP® Observational Study of the Knee
|
||
Recruiting |
NCT03699046 -
Evaluating the Effectiveness of Subchondroplasty for Treating Bone Marrow Lesions of the Knee
|
N/A | |
Recruiting |
NCT05596591 -
Focused Extracorporeal Shockwave Therapy for Knee Arthritis
|
N/A | |
Completed |
NCT01348269 -
Assessment of Efficacy of Zoledronic Acid in the Treatment of Bone Marrow Edema Syndrome
|
Phase 3 | |
Recruiting |
NCT04895228 -
Impact of Sacroiliac Joint Injection on Bone Marrow Edema
|
N/A | |
Completed |
NCT03112200 -
Subchondroplasty® Knee RCT
|
N/A | |
Active, not recruiting |
NCT03494660 -
SCP Hip Outcomes Study
|
||
Completed |
NCT01621893 -
Evaluation of Subchondroplasty™ for Defects Associated With Bone Marrow Lesions
|
||
Terminated |
NCT03112122 -
Study for the Treatment of the Bone Marrow Edema:Core Decompression VS Bone Marrow Concentrate (BMC) VS Bone Substitute
|
Phase 4 | |
Completed |
NCT03430219 -
Subchondroplasty Procedure in Patients With Bone Marrow Lesions
|
||
Recruiting |
NCT03921489 -
Subchondroplasty for Treatment of Bone Marrow Edema in the Foot and Ankle
|
||
Terminated |
NCT03829644 -
Lumbar Bracing for People With Type I Modic Changes
|
N/A | |
Recruiting |
NCT04963127 -
Prospective Study of Diagnostic Accuracy of Spectral CT for the Detection of Bone Marrow Edema
|
||
Completed |
NCT04905394 -
Clinical and Radiological Outcomes of Subchondroplasty in the Treatment of Bone Marrow Edema of the Knee
|
N/A |