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NCT06311513 | NOT YET RECRUITING | Anterior Cruciate Ligament Injuries


Concentrated Bone Marrow Aspirate in Revision ACL Reconstruction
Sponsor:

Hospital for Special Surgery, New York

Brief Summary:

The goal of this pilot randomized clinical trial is to look into the efficacy of concentrated bone marrow aspirate (cBMA) in improving post traumatic osteoarthritis (PTOA) symptoms in patients undergoing revision anterior cruciate ligament reconstruction surgery. The main questions it aims to answer are whether clinical outcomes, such as pain, are improved in patients who get cBMA with surgery, if there is a change in circulating markers of inflammation and what part of the cellular and molecular composition of cBMA may explain its effects.

Condition or disease

Anterior Cruciate Ligament Injuries

Post-Traumatic Osteoarthritis of Knee

Bone Marrow Aspirate Concentrate

ACL Injury

Intervention/treatment

Concentrated Bone Marrow Aspirate Injection

Sham Incision

Revision Anterior Cruciate Ligament Reconstruction

Phase

PHASE4

Detailed Description:

Anterior cruciate ligament reconstruction (ACLR) surgery is considered a relatively safe and effective procedure, however, up to 18% of grafts will fail and require revision surgery. Some studies have shown that these patients may be at increased risk of worse clinical outcomes, including fast progression toward post-traumatic osteoarthritis (PTOA). This is likely in part due to the inflammatory environment created within the joint. Concentrated bone marrow aspirate (cBMA) is a regenerative medicine therapy that contains soluble factors and connective tissue progenitor cells which may have immunomodulatory and pro-regenerative potential. The use of this therapy in conjunction with standard of care surgical treatment may help reduce the inflammatory microenvironment inside the joint, therefore modifying the conditions that might lead to developing long term complications such as PTOA. We hypothesize that cBMA treatment at the time of revision ACLR may improve clinical outcomes at 1 year after surgery and reduce the risk of developing PTOA-associated symptoms. Participants will be randomized to either get a cBMA injection (investigational arm) at the time of surgery or a placebo incision (control arm). Biological specimens (blood, urine, synovial fluid), imaging data, functional tests and patient reported clinical outcomes will be measured at different time points during the study, for up to two years after the surgery. This will allow us to evaluate the effect of cBMA in clinical outcomes. Biological specimens will be analyzed using molecular biology techniques to determine their composition, including the concentration of cells and other inflammatory markers.

Study Type : INTERVENTIONAL
Estimated Enrollment : 40 participants
Masking : SINGLE
Primary Purpose : PREVENTION
Official Title : Multi-Center Pilot Study to Evaluate Concentrated Bone Marrow Aspirate (cBMA) as a Treatment to Modify Post-Traumatic Osteoarthritis (PTOA) Following Revision Anterior Cruciate Ligament Reconstruction (ACLR)
Actual Study Start Date : 2024-04
Estimated Primary Completion Date : 2027-12
Estimated Study Completion Date : 2028-12

Information not available for Arms and Intervention/treatment

Ages Eligible for Study: 18 Years to 55 Years
Sexes Eligible for Study: ALL
Accepts Healthy Volunteers:
Criteria
Inclusion Criteria
  • * Males and Females
  • * Age 18 to 55
  • * Previous unilateral ACLR (Anterior Cruciate Ligament Reconstruction) within the last 5 years, and identified as having experienced failure of the primary ACLR
  • * Scheduled to have a revision ACLR surgery, with any graft type (including patellar tendon, hamstring, quad or allograft)
  • * Able to complete all study procedures and participate in a standardized physical therapy program
Exclusion Criteria
  • * History of inflammatory arthritis or joint sepsis
  • * Prior or concurrent total or sub-total meniscectomy
  • * Prior or present avascular necrosis of the index knee
  • * Oral or intra-articular corticosteroid injection within 3 months
  • * Hyaluronic acid or PRP (Platelet-Rich Plasma) injection within 6 months
  • * Use of duloxetine, doxycycline, indomethacin, glucosamine and/or chondroitin (ongoing or within 2 months)
  • * Any clinical or laboratory abnormality greater than grade 3 CTCAE, which in the view of the investigator, will compromise the participant's safety.
  • * Planned arthroplasty in the index knee

Concentrated Bone Marrow Aspirate in Revision ACL Reconstruction

Location Details

NCT06311513


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Locations


Not yet recruiting

United States, Georgia

Emory Orthopaedics & Spine Center

Atlanta, Georgia, United States, 30097

Not yet recruiting

United States, New York

Hospital for Special Surgery

New York, New York, United States, 10021

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