Systemic Biochemical Signature and Functional Quality Index of Calcaneal Bone Marrow Aspirate in Adults Undergoing Foot or Ankle Surgery (IQF-BMA)

August 30, 2026 updated by: Universidade Sao Francisco

Systemic Biochemical Signature in Adults Undergoing Foot or Ankle Surgery: Integrating Routine Laboratory Markers to Assess the Functional Quality of Calcaneal Bone Marrow Aspirate Mesenchymal Stem Cells in a Prospective Cohort

This observational prospective cohort study will evaluate whether routine blood tests are associated with the functional quality of calcaneal bone marrow aspirate mesenchymal stem cells in adults undergoing clinically indicated foot or ankle surgery at a university hospital in Brazil. Participants aged 40 to 80 years, with or without comorbidities, including type 2 diabetes mellitus and, when present, active Wagner grade 2-4 diabetic foot ulcers, will be eligible for inclusion.

Before surgery, participants will undergo routine blood tests, including complete blood count, glucose and lipid profile, mineral-renal markers, and tissue damage markers. During the clinically indicated surgery, calcaneal bone marrow aspirate will be collected from the same operative field. Mesenchymal stem cells will be isolated and evaluated in the laboratory for clonogenic capacity, osteogenic and adipogenic differentiation, cellular senescence, and secretion of inflammatory and anti-inflammatory cytokines.

A composite Functional Quality Index of Bone Marrow Aspirate (IQF-BMA) will be constructed from routine laboratory markers to characterize inflammatory, metabolic, mineral-renal, and tissue-damage burden. The primary objective is to examine the association between the IQF-BMA and mesenchymal stem cell functional outcomes, particularly clonogenic capacity. This exploratory study will not be used to guide individual treatment decisions.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

This is a single-center, observational, prospective cohort study conducted at a university hospital in Brazil. The study will enroll 40 adults aged 40 to 80 years who are undergoing clinically indicated foot or ankle surgery. Participants may present with or without comorbidities, including type 2 diabetes mellitus and, when present, active Wagner grade 2-4 diabetic foot ulcers. These clinical characteristics will be recorded as observational variables and will not define intervention assignments or separate study arms. All participants will provide written informed consent before any study procedures.

Before surgery, participants will undergo a panel of routine laboratory tests covering four domains: inflammatory burden, including complete blood count, derived inflammatory indices, and albumin; glycometabolic burden, including fasting glucose, oral glucose tolerance test when clinically feasible, HbA1c, triglycerides, and cholesterol profile; mineral-renal burden, including creatinine, urea, ionized calcium, phosphorus, magnesium, alkaline phosphatase, parathyroid hormone, and 25-OH vitamin D; and tissue-energetic damage, including lactate dehydrogenase, AST, and ALT.

During the clinically indicated orthopedic surgery, calcaneal bone marrow aspirate will be collected from the same operative field. Mesenchymal stem cells will be isolated, cultured, and evaluated using standardized functional assays, including clonogenic capacity, osteogenic differentiation, adipogenic differentiation, cellular senescence, cytokine secretion, and cellular viability.

The Functional Quality Index of Bone Marrow Aspirate (IQF-BMA) will be constructed from standardized routine laboratory variables representing inflammatory, glycometabolic, mineral-renal, and tissue-energetic domains. The primary analysis will examine the association between the IQF-BMA and the clonogenic capacity of calcaneal bone marrow mesenchymal stem cells. Secondary analyses will examine associations between laboratory markers or the composite index and other cellular functional outcomes. Results will be reported primarily as effect estimates and 95% confidence intervals to support the planning of future, larger studies.

Study Type

Observational

Enrollment (Estimated)

40

Contacts and Locations

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

Study Contact

Study Contact Backup

Study Locations

  • Brazil
    • São Paulo
      • Bragança Paulista, São Paulo, Brazil, 12916900

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Adults aged 40 to 80 years undergoing clinically indicated foot or ankle surgery at a university hospital in Brazil. Participants may have comorbidities, including type 2 diabetes mellitus and, when present, active Wagner grade 2-4 diabetic foot ulcers. All participants will undergo standardized preoperative blood collection and intraoperative calcaneal bone marrow aspirate collection for observational laboratory analyses.

Description

Inclusion Criteria

  • Age 40 to 80 years.
  • Scheduled for clinically indicated foot or ankle surgery at the participating university hospital.
  • Ability to understand the study procedures and provide written informed consent.
  • Willingness to provide preoperative blood samples and intraoperative calcaneal bone marrow aspirate according to the study protocol.
  • Participants may have comorbidities, including type 2 diabetes mellitus and, when present, active Wagner grade 2-4 diabetic foot ulcers. These clinical characteristics will be recorded for observational analyses and do not define separate study groups.

Exclusion Criteria

  • Critical limb ischemia without revascularization options or hemodynamic instability.
  • Active systemic infection or sepsis at the time of enrollment.
  • End-stage renal disease requiring dialysis.
  • Current use of high-dose systemic corticosteroids or other immunosuppressive drugs.
  • Current or recent malignancy within the last 5 years, except adequately treated non-melanoma skin cancer.
  • Significant cognitive impairment or psychiatric condition that, in the opinion of the investigator, precludes informed consent or adherence to study procedures.
  • Pregnancy or breastfeeding.

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

Cohorts and Interventions

Group / Cohort
Foot/Ankle Surgery Cohort
Adults undergoing clinically indicated foot or ankle surgery at a university hospital in Brazil, with or without comorbidities, including type 2 diabetes mellitus and, when present, active Wagner grade 2-4 diabetic foot ulcers. Blood samples and calcaneal bone marrow aspirate will be collected for systemic laboratory tests and mesenchymal stem cell functional assays.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clonogenic capacity of calcaneal bone marrow mesenchymal stem cells (CFU-F)
Time Frame: Up to 14 days after bone marrow aspirate collection.
Number of colony-forming unit fibroblasts (CFU-F) per milliliter of calcaneal bone marrow aspirate, quantified in primary culture under standardized conditions.
Up to 14 days after bone marrow aspirate collection.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Osteogenic and adipogenic differentiation of mesenchymal stem cells
Time Frame: Up to 28 days after bone marrow aspirate collection.
Osteogenic and adipogenic differentiation capacity of calcaneal bone marrow mesenchymal stem cells, assessed by alkaline phosphatase activity and semi-quantitative scoring of Alizarin Red and Oil Red O staining.
Up to 28 days after bone marrow aspirate collection.

Collaborators and Investigators

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

Sponsor

Universidade Sao Francisco

Investigators

  • Principal Investigator: Vanessa Bertolucci, PhD Candidate, Universidade Sao Francisco

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.

Helpful Links

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 (Estimated)

September 20, 2026

Primary Completion (Estimated)

July 1, 2028

Study Completion (Estimated)

June 1, 2029

Study Registration Dates

First Submitted

August 30, 2026

First Submitted That Met QC Criteria

August 30, 2026

First Posted (Actual)

September 3, 2026

Study Record Updates

Last Update Posted (Actual)

September 3, 2026

Last Update Submitted That Met QC Criteria

August 30, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • USF-IQF-BMA-DFU-001

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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