Knee Osteoarthritis Clinical Trial
Official title:
A Prospective Randomized Comparative Clinical Trial Evaluating the Effects of Autologous Microfractured Adipose Tissue (α MAT) Versus Steroid Injection in Knee Osteoarthritis (STα MAT-knee Study)
Knee Osteoarthritis (OA) is a common degenerative knee condition of the knee which is treated symptomatically. Knee cartilage tissue has little regenerative ability With the developments in regenerative medicine, stem cells might also be used in knee OA. Recently, adipose tissue has been identified as means for autologous mesenchymal stem cells (aMAT) using non-enzymatic method. Lipogems® is FDA-approved closed-system and directly producing ready-to-use aMAT. Some observational studies showed its potential in knee chondropathy. With no clinical trial done as yet, the investigators will hereby study the comparative efficacy of corticosteroid (current practice) versus Lipogems® in patients with knee OA. The knee MRI changes, clinical and patient-based outcomes will compared between baseline and throughout till 6 months after treatment. This study aims to show the comparative efficacy of Lipogems® as compared to corticosteroid in knee OA patients and to demonstrate its cartilage regeneration potential, which will ultimately deter surgery.
Knee Osteoarthritis (OA) is a common degenerative condition of the knee. Its current
management is symptomatic. These patients might eventually need total knee arthroplasty
(TKA). With the developments in regenerative medicine, stem cell has been suggested as means
to regenerate the knee cartilage tissue which otherwise has little regenerative ability.
Initially, stem cells were obtained from bone marrow cells; however, now they can also be
obtained from adipose tissue through liposuction. With developments of less invasive
liposuction techniques, adipose tissue has been identified as means for autologous
mesenchymal stem cells (aMAT). There are two ways of obtaining aMAT form adipose tissue:
enzymatic, which has controversies related to Good Manufacturing Practice and low yield, and
non-enzymatic method which was recently further developed to a closed-system and directly
ready-to-use aMAT producing Lipogems®. Lipogems® is FDA-approved for several applications
including orthopedic use. A couple of case reports and cohort studies showed its potential
use in knee chondropathy. Until now, no clinical trials compared its effect to the knee OA
standard of care which is the intra-articular corticosteroid injection. Here, the
investigators will study the comparative efficacy of corticosteroid versus Lipogems® in
patients with knee OA.
This randomized clinical trial will include 48 patients with symptomatic knee OA ≥ 45 years
old with no contraindication of corticosteroid and/or Lipogems® use. These patients will be
divided equally into two groups: group S who will receive intra-articular corticosteroid knee
injection and group L whose aMAT will be harvested using Lipogems® and be injected
intra-articularly. The knee pain, clinical parameters, and patient-related outcome measures
(knee injury and osteoarthritis outcome score and Lipogems® Questionnaire-knee) will be
assessed at baseline, 2-week, 6-week, 3-month, and 6-month. Also, knee MRI will be done at
baseline and 6-months to visualize any changes (MRI Osteoarthritis knee score). These
outcomes will be evaluated over the 6-month period and the difference between baseline and
follow-up will be compared between the two groups.
This study aims to show the comparative efficacy of Lipogems® as compared to corticosteroid
in knee OA patients and to demonstrate its cartilage regeneration potential, which will
ultimately deter surgery.
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