- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04739930
Autologous Bone Marrow Concentrate in Knee Osteochondral Allograft Transplantation
January 12, 2023 updated by: Rush University Medical Center
Prospective, Randomized, Single Blind Clinical Trial to Investigate the Impact of Autologous Bone Marrow Concentrate in Knee Osteochondral Allograft Transplantation
The goal of this study is to establish if mesenchymal stem cell augmentation improves graft incorporation and to analyze the cytokine environment of the joint after osteochondral allograft transplantation (OCA) with and without intra-articular bone marrow aspirate concentrate (BMAC) injection.
Information learned from this study can be used to biochemically compare treatment response and to assess emerging therapeutic options that may positively alter the biochemical environment in patients who suffer from articular cartilage disorders.
Study Overview
Status
Completed
Conditions
Detailed Description
Articular cartilage injuries in the knee continue to grow in number as detection and treatment options have advanced.
Treatment options, including microfracture, autologous chondrocyte (cells that make cartilage) implantation, osteochondral grafting and meniscus transplantation can hopefully deter the progression of degeneration and have promise to function as disease modifying solutions.
Osteochondral allograft transplantation (OCA) has emerged as a preferred method of treating large focal chondral defects as it structurally replaces the cartilage and often involved sub-chondral bone with native hyaline cartilage and bone.
The results of OCA are successful with greater than 85% survival at 5-year follow-up.
Failure can occur due to a lack of boney integration or low chondrocyte viability.
Therefore, anything to enhance the graft augmentation process may be useful in preventing failure.
The purpose of this prospective, randomized study is to determine the effect of bone marrow aspirate concentrate (BMAC) containing bone marrow derived mesenchymal stem cells on improving graft incorporation and preventing failure.
The effect of BMAC on the graft and intra-articular knee environment will be evaluated using 3 techniques: computed tomography (CT) imaging, synovial fluid cytokine analysis, and serum biomarker analysis.
Information learned from this study can be used to biochemically compare treatment response and to assess emerging therapeutic options that may positively alter the biochemical environment in patients undergoing osteochondral allograft transplantation.
Study Type
Interventional
Enrollment (Actual)
33
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
-
-
Illinois
-
Chicago, Illinois, United States, 60612
- Rush University Medical Center
-
-
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 50 years (Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
• Patients aged 18-50 with a cartilage defect indicated for treatment with osteochondral allograft
Exclusion Criteria:
- Patients with known rheumatoid arthritis, any other inflammatory arthropathy or synovial tissue disorder.
- Patients with known bipolar osteoarthritis of the knee as determined by the treating physician, greater than Kellegren-Lawrence Grade 3 on x-ray imaging
- Patient with a known infection or history of infection in the affected knee
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: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Bone Marrow Aspiration Group
A bone marrow aspiration will be performed from the iliac crest.
The bone marrow aspirate will be processed using a bone marrow aspirate concentrate (BMAC) harvesting system.
The osteochondral allograft plug will then be soaked in the BMAC for a minimum 2 minutes prior to implantation.
The remaining BMAC will be placed in the defect site prior to plug implantation.
|
Autologous bone marrow aspirate will be processed and concentrated to a bone marrow aspirate concentrate (BMAC) containing bone marrow derived mesenchymal stem cells and delivered to the site of operation in the treatment group
|
Sham Comparator: Control
The control group will receive a 0.5cm sham incision over the iliac crest, but bone marrow aspiration will not be performed.
The osteochondral allograft plug will not be soaked in BMAC prior to implantation.
|
0.5cm sham incision over the iliac crest
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Synovial Fluid Cytokine Measurement
Time Frame: Up to 52 weeks
|
To measure the amount of cytokines and cartilage biomarkers in the synovial fluid of patients undergoing osteochondral allograft transplantation with and without BMAC augmentation at different time points
|
Up to 52 weeks
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Radiographic analysis
Time Frame: Day 1, Post-operative 2 weeks, 6 weeks, 12, weeks, 24 weeks, 52 weeks
|
Changes in graft status will be analysed using radiographic analysis
|
Day 1, Post-operative 2 weeks, 6 weeks, 12, weeks, 24 weeks, 52 weeks
|
Computed Tomography (CT) analysis
Time Frame: Post-operative 24 weeks
|
Changes in graft status will be analysed using Computed Tomography (CT) analysis
|
Post-operative 24 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Adam Yanke, MD, Faculty
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)
March 2, 2018
Primary Completion (Actual)
January 12, 2023
Study Completion (Actual)
January 12, 2023
Study Registration Dates
First Submitted
December 24, 2020
First Submitted That Met QC Criteria
February 1, 2021
First Posted (Actual)
February 5, 2021
Study Record Updates
Last Update Posted (Estimate)
January 13, 2023
Last Update Submitted That Met QC Criteria
January 12, 2023
Last Verified
January 1, 2023
More Information
Terms related to this study
Other Study ID Numbers
- 17121805
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
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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