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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT02582489
Other study ID # 15090903
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date December 22, 2017
Est. completion date December 31, 2025

Study information

Verified date March 2024
Source Rush University Medical Center
Contact Carla Edwards, PhD
Phone 312-563-5735
Email carla_edwards@rush.edu
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The proposed research study aims to evaluate the effects of autologous bone marrow aspirate concentrate (BMAC) on the development and progression of osteoarthritis (OA) in patients undergoing meniscectomy. This prospective, randomized, double-blind clinical trial will compare patient-reported outcomes, specifically IKDC scores between patients who receive BMAC post-meniscectomy and those who receive a saline control injection. The study will also compare physical examination, MRI, radiographs, and synovial fluid analysis. Our hypothesis is that those who receive the autologous BMAC injection after the procedure will have better outcomes than those who do not.


Description:

Recent studies have demonstrated both the safety of BMAC intra-articular injection and improvements in subjective, patient reported outcomes in patients with existing knee OA. Unfortunately these studies were largely uncontrolled, underpowered, and/or retrospective in nature. Additionally, a recent prospective, randomized clinical study of allograft mesenchymal stem cells (MSCs) injected at a separate time point post surgical intervention has highlighted the ability of MSCs to increase meniscal volume and improve knee pain following injection. This will be the first study to examine the effects of autograft BMAC intra-articular injection in a single-stage procedure and in a prospective, randomized, double-blind fashion. The results of this study, if the null hypothesis is rejected, will have far-reaching implications for the standard of care in meniscal treatment and on OA progression in the knee. Additionally, if the results of this study are favorable in reduction of OA progression this study will change the surgical approach to all axial, synovial joints including the shoulder, elbow, wrist, hip, and ankle.


Recruitment information / eligibility

Status Recruiting
Enrollment 100
Est. completion date December 31, 2025
Est. primary completion date November 30, 2025
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Subject is greater than 18 years old - Written informed consent is obtained - Subject is determined to have a symptomatic meniscal tear requiring a meniscectomy - Meniscal pathology is confirmed through MRI and arthroscopically - Subject agrees to all follow-up evaluations - Osteoarthritis Kellen-Lawrence grade 1-3 on flexion PA and extension AP views Exclusion Criteria: - Any subject lacking decisional capability - Unwillingness to participate in the necessary follow-up - Subject is pregnant or may become pregnant - History of diabetes mellitus - History of rheumatoid arthritis or other autoimmune disorder - History of solid organ or hematologic transplantation - Diagnosis of a non-basal cell malignancy within the preceding 5 years - Infection requiring antibiotic treatment within the preceding 3 months - Osteoarthritis Kellen-Lawrence grade 4 on flexion posterior-anterior (PA) or extension anteroposterior (AP) views - Prior surgery on the index meniscus - Concomitant surgery such as ligament surgery or cartilage repair or restoration - Infection - Prior cortisone/viscosupplementation/ (platelet rich plasma) PRP injection within 6 weeks

Study Design


Related Conditions & MeSH terms


Intervention

Biological:
Bone Marrow Aspirate Concentrate
Subjects undergoing autologous bone marrow aspirate concentrate will receive an intra-articular injection into the affected knee.
Procedure:
Standard Meniscectomy
All subjects will undergo either a partial or complete meniscectomy to treat the torn meniscus.

Locations

Country Name City State
United States Rush University Medical Center Chicago Illinois

Sponsors (1)

Lead Sponsor Collaborator
Rush University Medical Center

Country where clinical trial is conducted

United States, 

References & Publications (6)

Centeno C, Pitts J, Al-Sayegh H, Freeman M. Efficacy of autologous bone marrow concentrate for knee osteoarthritis with and without adipose graft. Biomed Res Int. 2014;2014:370621. doi: 10.1155/2014/370621. Epub 2014 Sep 7. — View Citation

Enea D, Cecconi S, Calcagno S, Busilacchi A, Manzotti S, Gigante A. One-step cartilage repair in the knee: collagen-covered microfracture and autologous bone marrow concentrate. A pilot study. Knee. 2015 Jan;22(1):30-5. doi: 10.1016/j.knee.2014.10.003. Epub 2014 Nov 20. — View Citation

Fortier LA, Potter HG, Rickey EJ, Schnabel LV, Foo LF, Chong LR, Stokol T, Cheetham J, Nixon AJ. Concentrated bone marrow aspirate improves full-thickness cartilage repair compared with microfracture in the equine model. J Bone Joint Surg Am. 2010 Aug 18;92(10):1927-37. doi: 10.2106/JBJS.I.01284. — View Citation

Gobbi A, Karnatzikos G, Scotti C, Mahajan V, Mazzucco L, Grigolo B. One-Step Cartilage Repair with Bone Marrow Aspirate Concentrated Cells and Collagen Matrix in Full-Thickness Knee Cartilage Lesions: Results at 2-Year Follow-up. Cartilage. 2011 Jul;2(3):286-99. doi: 10.1177/1947603510392023. — View Citation

Kim JD, Lee GW, Jung GH, Kim CK, Kim T, Park JH, Cha SS, You YB. Clinical outcome of autologous bone marrow aspirates concentrate (BMAC) injection in degenerative arthritis of the knee. Eur J Orthop Surg Traumatol. 2014 Dec;24(8):1505-11. doi: 10.1007/s00590-013-1393-9. Epub 2014 Jan 8. — View Citation

Vangsness CT Jr, Farr J 2nd, Boyd J, Dellaero DT, Mills CR, LeRoux-Williams M. Adult human mesenchymal stem cells delivered via intra-articular injection to the knee following partial medial meniscectomy: a randomized, double-blind, controlled study. J Bone Joint Surg Am. 2014 Jan 15;96(2):90-8. doi: 10.2106/JBJS.M.00058. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary International Knee Documentation Committee (IKDC) Score The primary outcome measure will be the IKDC score at one year follow-up One Year
Secondary Patient reported outcomes throughout follow-up period Patient reported outcomes will include change in scores from preoperative to Postoperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) 7-10 days, 6 weeks, 3 months, 6 months, 1 year, 2 years
Secondary Synovial fluid analysis To investigate any changes in synovial fluid markers of osteoarthritis. 2 weeks, 6 weeks
Secondary Radiographic analysis The degree of OA will be examined in all patients preoperatively and at subsequent follow-up visits at 1 and 2 years. 1 year, 2 years
Secondary Patient reported outcomes throughout follow-up period (VAS) Visual Analog Score (VAS) 7-10 days, 6 weeks, 3 months, 6 months, 1 year, 2 years
Secondary Patient reported outcomes throughout follow-up period (IKDC) International Knee Documentation Committee form (IKDC) 7-10 days, 6 weeks, 3 months, 6 months, 1 year, 2 years
Secondary Patient reported outcomes throughout follow-up period (KOOS) Knee injury and Osteoarthritis Outcome Score (KOOS) 7-10 days, 6 weeks, 3 months, 6 months, 1 year, 2 years
Secondary Patient reported outcomes throughout follow-up period (SF-12) (Short Form Health Survey) SF-12 7-10 days, 6 weeks, 3 months, 6 months, 1 year, 2 years