MaioRegen Prime Study for the Treatment of Deep Osteochondral Lesion of the Knee (OSTEOCONFIRM)

Multicenter Prospective Randomized Study of MaioRegenTM Prime vs. Debridement (Surgical Standard of Care (SSOC)) for the Treatment of Osteochondral Lesion of the Knee Joint - OSTEOCONFIRM Study

The present study aims to compare the efficacy and the safety of MaioRegen Prime to Debridement (SSOC) in patients with deep osteochondral lesions of the knee joint. The foreseen population involves patients with osteochondral lesions with different etiology, dimension, shape, and location.

The evaluation will be performed through clinical, subjective and objective assessments.

Study Overview

• Status: Not yet recruiting
• Conditions: Early Osteoarthritis; Osteochondritis Dissecans (OCD); Osteochondral Lesions of the Knee Joint
• Intervention / Treatment: Device: osteochondral scaffold implant; Procedure: SSOC

Detailed Description

This is multicenter, prospective, randomized clinical trial, subjects will be randomized (2:1) to MaioRegen Prime or debridement.

All randomized patients will be followed with post-operative visits at 15 days, 6 weeks, 3, 6, 12, 18 and 24 months after surgery and annually post-24 months visit (until last patient reaches 24 months).

During screening period and at follow-up visits commonly used specific scores will be evaluated: IKDC Subjective Knee Evaluation Form, IKDC Knee Examination Form, KOOS, Tegner Score, VAS pain, PROMIS-29, ICRS Cartilage Repair Assessment and MRI related scores.

• Study Type: Interventional
• Enrollment (Estimated): 400
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Simal Trikam, Clinical Trial Manager; Phone Number: +44 7889983972; Email: strikam@mcra.com
• Study Contact Backup: Name: Roberta Miale, MEng; Phone Number: +39 0546645438; Email: roberta.miale@finceramica.it

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Informed consent prior to any study-related procedures;
2. Male or female patients aged between 18 and 60 years (inclusive);
3. Body Mass Index (BMI) ≤ 35;
4. Up to 3 treatable osteochondral lesions localized in femoral condyles and/or trochlea (the patient might have other lesion in other parts of the joint, but they should not be more severe than ICRS Grade II lesions as determined by baseline MRI);
5. Knee osteochondral lesion(s) (Grade IVa and IVb according to ICRS Classification) or not re-fixable knee Osteochondritis Dissecans lesions as determined by baseline MRI;
6. Lesions with an overall treatable area 1-7 cm2 (as determined by baseline MRI). In case of multiple lesions (maximum 3 lesions) in the same knee compartment a minimum distance of 3 mm is required);
7. IKDC Subjective score at baseline (pre-op evaluation) is less than 70;
8. Non-responsive to physical therapy for at least 6 weeks;
9. Patients physically and mentally willing and able to comply with the post-operative rehabilitation protocol and scheduled clinical and radiographic visits.

Exclusion Criteria:

1. IKDC subjective score at Baseline is more than or equal to 70;
2. KOOS Pain Subscale score at baseline is less than 20 or more than 65 (scale: maximum pain = 0, pain free = 100);
3. Osteochondral tibial plateau and/or patella defects;
4. Patients affected by advanced osteoarthritis in the index knee (Kellgren and Lawrence classification 3 or 4);
5. Bony defect depth deeper than 5 mm, according to baseline MRI, measured from the original subchondral bone plate level;
6. Uncontained defects: lack of vital bone wall at least 2 mm thick, completely surrounding the lesion - based on MRI;
7. Patients with untreated patellofemoral malalignment or who have undergone realignment procedures within 6 months;
8. Patients with bone fracture or uncorrected malalignment more than 5 degrees varus or valgus according to standing X-ray.
9. Patients previously treated for total or partial meniscectomy in the specific index knee compartments (more than 50% of the meniscus in the index compartments is missing);
10. Patient requiring total or partial meniscectomy to be performed concomitantly, involving more than 50% of one or both menisci in the index knee compartment (lack of functional remaining meniscus, at least 5mm rim at the end of the procedure); and patient requiring ligamentoplasty and high tibial osteotomy (HTO) to be performed concomitantly;
11. Untreated knee ligament instability or treated within 6 months;
12. Kissing (counterposed) osteochondral lesions;
13. Significant instability of the index knee according to IKDC Knee Examination Form 2000: Grade C (abnormal) or D (severely abnormal).
14. Patients affected by any concomitant painful or disabling disease of the spine, hips, or lower limbs, including the contralateral knee, that would interfere with the evaluation of the index knee;
15. Patients affected by bilateral knee lesions that need treatment;
16. Intra-articular steroid injections within 3 months;
17. Any previous cartilage repair procedure (such as: microfracture, Osteochondral autograft transplantation system (OATS), Autologous Matrix Induced Chondrogenesis, (AMIC), Autologous Chondrocyte Implantation (ACI) with or without use of a scaffold (matrix) in the index knee within one year or debridement within 6 months;
18. Patients affected by osteoporosis (established through x-ray tests, called DEXA scans, bone density, etc. Criteria for osteoporosis: T-score is < - 2.5 SD), chondrodysplasia, or osteogenesis imperfecta;
19. Patients affected by known allergy to equine collagen or calcium-phosphates;
20. Patients who underwent chemotherapy in the past 12 months;
21. Patients with a known history of any significant systemic disease (such as but not limited to: HIV, hepatitis, HTLV, syphilis, coagulopathies, insulin dependent diabetes mellitus etc.) or affected by a significant malignancy;
22. Participation in other clinical trials within 90 days prior to the study or concurrent with the study;
23. Patient who is pregnant (or intends to become pregnant within one-year post-op) or breastfeeding;
24. Known drugs or alcohol abuse;
25. Any evidence of active infection anywhere in the body. Urinary Tract Infection (UTI) patients can be included following antibiotic treatment, and provided that two consecutive cultures are negative (taken within at least 2 weeks of each other);
26. Any known history of intra-articular or osseous infection of the index knee;
27. Patients affected by a known history of inflammatory arthropathy or crystal-deposition arthropathy;
28. Prisoners;
29. The existence of any surgical or medical condition that, in the judgement of the Investigator, might compromise patient safety or the outcome of the study;
30. Any medical conditions or implants that would prevent the participant from undergoing an MRI, including but not limited to pacemakers, clips, cochlear implants, or metal shrapnel.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: MaioRegen Prime; Medical Device: MaioRegen Prime implant	Device: osteochondral scaffold implant; three layered biomimetic osteochondral scaffold implant for osteochondral lesions of the knee
Active Comparator: Surgical Standard of Care (SSOC); Debridement	Procedure: SSOC; Debridement

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Superiority of MaioRegen Prime vs Debridement	The primary endpoint is the success rate defined as a composite binary endpoint, where a patient is a success if they meet all of the following criteria: At least a 15 points IKDC increase at 24 months; Lack of SAE related to MaioRegen treatment or debridement during the 24-month follow-up; Lack of related re-intervention after MaioRegen treatment or debridement during the 24-month follow-up	baseline, 24 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Score at 24 months of MaioRegen Prime compared to debridement	Subjective, knee-specific rating scale that is considered one of the most reliable assessment tools in the evaluation of knee pathologies. All questions examines 3 categories: symptoms, sports activity, and knee function. The IKDC Subjective Knee Evaluation Form is graded by adding the results of each item's scores, and then converting the result to a scale from 0 to 100. Higher scores indicate higher levels of function and lower levels of symptoms, (i.e., a better outcome).	baseline, 24 months
Rate of responder in IKDC Subjective Knee Evaluation at 24 months of MaioRegen Prime compared to debridement as defined as improvement in IKDC Subjective Knee Evaluation of ≥15 points	The new IKDC Subjective Knee Evaluation Form, published in 2000, is considered one of the most reliable assessment tools in the evaluation of knee pathologies. All questions examines 3 categories: symptoms, sports activity, and knee function. The IKDC Subjective Knee Evaluation Form is graded by adding the results of each item's scores, and then converting the result to a scale from 0 to 100. Higher scores indicate higher levels of function and lower levels of symptoms, (i.e., a better outcome).	baseline, 24 months
Proportion of patients without SAEs related to MaioRegen treatment or debridement treatment during the 24-month follow-up period		baseline, 24 months
Proportion of patients without related re-intervention after MaioRegen treatment or debridement treatment at 24 month follow-up period		baseline, 24 months
Change from baseline in average overall KOOS score (Knee Injury and Osteoarthritis Outcome Score)	KOOS score consists of 5 subscales and covers: pain (9 items), symptoms (7 items, two of which are related to stiffness), functions and activities of daily living (17 items), physical function, sports and leisure activities (5 items) and quality of life in relation to the knee (4 items). Each question uses a 0 (no problem/difficulty) to 4 (extreme problem/difficulty) response, which is then converted into the final 0-100 score for each subscale, indicating the percentage of the total possible score achieved, with 0 representing extreme knee problems (i.e., worse outcome) and 100 representing no knee problems (i.e., better outcome).	baseline, 12, 18, and 24 months
Change from pre-injury and from baseline in Tegner score	Tegner activity level scale allows to know the level of physical activity carried out by the patients. Tegner's activity scale classifies the activity according to work and sports activities on a scale from 0 to 10, where 0 is being on sick leave/disabled due to knee issues, and 10 is elite, international competitive sports.	baseline, 12 months, 18 months, 24 months
Change from baseline in IKDC (International Knee Documentation Committee) Knee Examination Objective Form	The IKDC objective examination form uses a 0-100 scale, calculated by summing seven parameters related to knee function. The presence of effusions and degree of knee motion are assessed; the worst value of any of these parameters determines the final IKDC grade. There are four grades (A, B, C, D) that identify a knee rated as normal, near normal, abnormal, and severely abnormal, respectively.	baseline, 12 months, 18 months, 24 months
Change from baseline in VAS (visual analogue scale) pain	The VAS scale is a 0-cm line tool to measure pain intensity, with "no pain" at 0 and "worst pain imaginable" at 10, where patients mark their pain level	baseline, 12 months, 18 months, 24 months
PROMIS-29 (Patient-Reported Outcomes Measurement Information System): Patient's QOL (quality of life) improvement	The PROMIS-29 uses a T-score metric (mean 50, SD 10) to assess 7 domains (Physical Function, Fatigue, Depression, Anxiety, Pain Interference, Sleep Disturbance, and Social Participation) with 4 questions with an additional pain intensity numeric rating scale (NRS, 0-10 score). There is no total score, but each axis forms its own score.	baseline, 12 months, 18 months and 24 months
MRI evaluation: MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) 2.0 Knee Score	MOCART 2.0 score allows the assessment of both cartilage tissue repair and the structures surrounding it. It is a 0-100 point MRI-based system for evaluating cartilage repair, updating the original MOCART by focusing on nine key variables like defect filling (in 25% increments), integration to native cartilage, surface, signal intensity, bony changes (overgrowth/defect), marrow edema, and subchondral cysts. 100 represents the best score and a score of 0 represents the worst score.	baseline, 12 months, 24 months

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Safety Outcome	Adverse Events rate per type, severity, seriousness, and relatedness to the treatment, including Serious Adverse Events and Serious Adverse Device Effect, Adverse Device Effect, Unanticipated Adverse Device Effect, Re-operations, Complaint and Treatment Failures up to 24 months will be evaluated and adjudicated by CEC members.	24 monhs

Collaborators and Investigators

• Sponsor: Fin-Ceramica Faenza Spa

Study record dates

Study Major Dates

• Study Start (Estimated): May 1, 2026
• Primary Completion (Estimated): April 30, 2031
• Study Completion (Estimated): April 30, 2031

Study Registration Dates

• First Submitted: January 7, 2026
• First Submitted That Met QC Criteria: January 8, 2026
• First Posted (Estimated): January 12, 2026

Study Record Updates

• Last Update Posted (Estimated): January 12, 2026
• Last Update Submitted That Met QC Criteria: January 8, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: OCD; knee; scaffold; osteochondral lesion; biomimetic; MaioRegen Prime
• Additional Relevant MeSH Terms: Bone Diseases; Musculoskeletal Diseases; Arthritis; Joint Diseases; Rheumatic Diseases; Osteochondritis; Osteoarthritis; Osteochondritis Dissecans
• Other Study ID Numbers: ORT-24

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: Yes