Intra-articular Autologous Bone Marrow Aspirate Injection for Knee Osteoarthritis

January 13, 2020 updated by: Hospital for Special Surgery, New York

Intra-articular Autologous Bone Marrow Aspirate Injection for the Treatment of Knee Osteoarthritis: a Pilot Study With Radiological Follow-up

Knee osteoarthritis (OA) is a leading cause of disability. The objectives of treatment are to reduce pain, improve function, and slow down further breakdown of the knee. Recently, research on nonsurgical treatment options for knee OA has increased significantly. One potential treatment of interest is the use of stem cell injections. Stem cells are one's own cells that have the ability to divide into other types of cells, and may cause regrowth of cartilage when injected into the knee. There have been few, but promising, studies that show improvements in pain and function with stem cell injections in those with knee OA. Therefore, more research is needed to identify patients who might benefit from this injection. This pilot study will look at changes in pain and function for 20 patients at 1, 3, 6, and 12 months after a stem cell injection into the knee. Patients will also undergo magnetic resonance imaging at 6 months and 12 months following the injection.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

13

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • New York
      • New York, New York, United States, 10021
        • Hospital for Special Surgery

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 79 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • >=3 months of symptomatic knee OA unresponsive to at least two of the following: activity modification, physical therapy, bracing, assistive devices, acupuncture, non-steroidal anti-inflammatory medications, local steroid injections, and hyaluronic acid injections
  • Radiographically confirmed Kellgren-Lawrence I-II knee OA (mild knee OA; no bone-on-bone)
  • Age 18-79 years

Exclusion Criteria:

  • Presence of loose bodies on baseline magnetic resonance imaging
  • Clinically and radiologically confirmed anterior/posterior cruciate ligament deficiences
  • History of meniscal injury other than degenerative meniscal tears
  • Previous knee surgery
  • Presence of a degenerative meniscal tear causing mechanical symptoms such as locking, buckling, or give-way
  • Intra-articular injection to affected knee within 6 weeks of intra-articular BMA injection
  • Mechanical axis deviation greater than 7 degrees
  • Intolerance to acetaminophen or hydrocodone (i.e., Vicodin)
  • Use of non-steroidal anti-inflammatory drugs <1 weeks prior to BMA
  • Injection of the joint scheduled for treatment within 3 months of BMA injection
  • Body mass index of 30 or more
  • History of drug abuse
  • Current cigarette smokers
  • Current use of systemic steroids
  • History of or current alcohol abuse or dependence
  • History of anemia, bleeding disorders, or inflammatory joint disease
  • Active infection
  • Active malignancy per medical or surgical history, diagnosed by primary case physician or treating specialist, undergoing treatment, has undergone treatment, or has declined treatment
  • Inability to refrain from statin regimen from 1 month pre-injection to 1 month post-injection
  • Pregnancy or breastfeeding at time of treatment
  • Participating or planning to participate in a worker's compensation program at the time of treatment or follow-up period
  • Pending or planned legal action pertaining to knee pain
  • Non-English speaking

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Bone Marrow Aspirate (BMA) Injection
Procedure: BMA Injection
Bone marrow will be aspirated from the iliac crest and injected into the knee.
Biological: BMA
Bone marrow will be aspirated from the iliac crest.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Knee Injury and Osteoarthritis Outcome Score (KOOS) Jr.
Time Frame: 1 month after date of injection
The KOOS Jr. measures patient-reported pain and function. The score ranges from 0-100, with 0 representing total knee disability and 100 representing perfect knee health.
1 month after date of injection
KOOS Jr.
Time Frame: 3 months after date of injection
The KOOS Jr. measures patient-reported pain and function. The score ranges from 0-100, with 0 representing total knee disability and 100 representing perfect knee health.
3 months after date of injection
KOOS Jr.
Time Frame: 6 months after date of injection
The KOOS Jr. measures patient-reported pain and function. The score ranges from 0-100, with 0 representing total knee disability and 100 representing perfect knee health.
6 months after date of injection
KOOS Jr.
Time Frame: 12 months after date of injection
The KOOS Jr. measures patient-reported pain and function. The score ranges from 0-100, with 0 representing total knee disability and 100 representing perfect knee health.
12 months after date of injection

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain
Time Frame: 1 month, 3 months, 6 months, and 12 months after date of injection
Pain will be assessed using the numerical rating scale (NRS), which is on a scale of 0-10. 10 represents worst pain, and 0 represents no pain.
1 month, 3 months, 6 months, and 12 months after date of injection
Degree of cartilage change
Time Frame: 6 months (first 5 patients only) and 12 months after date of injection
Cartilage change will be assessed via magnetic resonance imaging.
6 months (first 5 patients only) and 12 months after date of injection
Presence of side effects
Time Frame: 1 month, 3 months, 6 months, and 12 months after date of injection
The presence of side effects, including increased pain, bleeding, infection, and motor-sensory deficits, will be documented.
1 month, 3 months, 6 months, and 12 months after date of injection

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Hospital for Special Surgery, New York

Investigators

  • Principal Investigator: Gregory Lutz, Hospital for Special Surgery, New York

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 28, 2017

Primary Completion (Actual)

August 12, 2019

Study Completion (Actual)

October 1, 2019

Study Registration Dates

First Submitted

April 20, 2017

First Submitted That Met QC Criteria

April 25, 2017

First Posted (Actual)

April 26, 2017

Study Record Updates

Last Update Posted (Actual)

January 14, 2020

Last Update Submitted That Met QC Criteria

January 13, 2020

Last Verified

January 1, 2020

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2016-0435

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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