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Arthrocentesis vs Observation Study for Acute ACL Tears (ASPIRATE)

4. november 2026 opdateret af: Jelle van der List, MD PhD MBA, Ohio State University

Arthrocentesis Study for Perioperative Intervention on Reducing Arthritis and Trauma-related Effects

The ASPIRATE trial is a randomized controlled trial evaluating the effects of pre- and post-operative knee joint aspiration in patients with an ACL injury. The study aims to determine if removing knee joint fluid can mitigate the increasing inflammation after surgery, reduce quadriceps atrophy, improve short-term pain, enhance functional recovery, and lower long-term rates of post-traumatic knee osteoarthritis.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

While Anterior Cruciate Ligament Reconstruction (ACLR) successfully restores joint stability, patients still face challenges regarding long-term osteoarthritis and lower rates of returning to sports. Traumatic hemarthrosis-the buildup of blood in the joint following an injury and surgery-acts as a toxic agent that triggers cartilage degeneration. Furthermore, it causes arthrogenic muscle inhibition (AMI), which leads to quadriceps muscle shrinkage and abnormal walking patterns. This cycle is often referred to as the "second-hit phenomenon". While draining fluid from the knee (arthrocentesis) before surgery is common, performing repeat drainages after surgery to remove built-up blood is experimental. This study evaluates whether this low-cost, widely available procedure can safely interrupt that destructive cycle.

The main objective of this trial is to intervene in the hemarthrosis process to prevent or reduce the incidence of AMI and cartilage breakdown through pre- and post-operative joint drainage. Secondary objectives include assessing whether the procedure leads to less quadriceps muscle shrinkage, improves short-term pain, enhances leg strength at 3 and 6 months, accelerates return-to-sport rates, and reduces joint wear at a 1-year follow-up.

Eligible participants include individuals aged 15 to 40 years who experienced their injury 30 days or less prior, have a confirmed ACL tear, and have chosen to undergo ACLR using either a quadriceps tendon or bone-patellar tendon-bone autograft. Key exclusion criteria include previous knee or ACL surgery on the same leg, a cortisone injection within the previous 3 months, major multi-ligament repairs done at the same time (such as the MCL, PCL, or PLC), advanced osteoarthritis, pregnancy, or an inability to speak English fluently.

All participants will undergo standard ACLR surgery using their own tissue graft. Clinical assessments are conducted from baseline through 1 year, tracking patient surveys on knee pain, activity levels, and psychological readiness at baseline, 1 week, 2 weeks, 6 weeks, 3 months, 6 months, and 1 year. Physical and imaging steps include measuring thigh circumference with a tape measure at every visit, performing leg strength tests on a special machine at 3 and 6 months, and taking standing knee X-rays with a specialized framing device at the 1-year mark to evaluate joint health.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

54

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

    • Ohio
      • Columbus, Ohio, Forenede Stater, 43230
        • Rekruttering
        • Jameson Crane Sports Medicine Institute
        • Kontakt:
        • Ledende efterforsker:
          • Jelle van der List, MD, PhD
      • Dublin, Ohio, Forenede Stater, 43016
        • Rekruttering
        • Ohio State Outpatient Care Dublin
        • Kontakt:
        • Ledende efterforsker:
          • Jelle van der List, MD, PhD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

15 år til 40 år (Barn, Voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  1. Age 15 -40
  2. Time from injury to aspiration ≤30 days
  3. Patient with a confirmed ACL tear and have elected to have an ACL reconstruction using a quadriceps tendon (QT) or bone-patellar tendon-bone (BPTB) autograft tendon

Exclusion Criteria:

  1. Fear of needles or rejection of arthrocentesis
  2. Previous knee or ACL surgery on the affected knee
  3. Previous cortisone injection in the affected knee within the previous 3 months
  4. Concomitant procedures that involve repair or reconstruction of the medial collateral ligament (MCL), posterolateral corner (PLC) or posterior cruciate ligament reconstruction (PCL)
  5. Osteoarthritis Kellgren-Lawrence grade ≥3.
  6. Cartilage procedures beyond microfracture or chondroplasty
  7. Planned osteotomies or meniscus allograft transplantation (MAT)
  8. Muscular, vascular or neurological diseases that influence rehabilitation or surgery
  9. Current use of prednisone or cytostatic medication
  10. Obesity with a BMI ≥45
  11. Daily smoking
  12. History of illicit drug or alcohol abuse
  13. History of prior infection in knee
  14. History of chemotherapy treatment
  15. History of sickle cell disease
  16. Pregnancy during injury or surgery
  17. No mastery of the English language

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Aspiration

Each subject that is randomized to this arm will receive a knee aspiration both before and after ACL surgery.

Aspiration is a minimally invasive medical procedure in which a sterile needle and syringe are inserted into the intra-articular space of the knee joint to extract excess synovial fluid that is built up around the knee space.

Ingen indgriben: No Aspiration

Each subject that is randomized to this arm will not receive an intervention and will only complete questionnaires.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Quadriceps peak strength
Tidsramme: 3 months and 6 months

The Biodex measurement physical device will be used to measure the isokinetic strength of the quadriceps muscle. The leg is brought from flexion to extension at 60 degrees per second and 300 degrees per second and the maximum force is measured for the quadriceps. This is compared to the contralateral side and expressed in the limb symmetry index (LSI) as the percentage of strength compared to the contralateral side. This is expressed N/m

3 months and 6 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Quadriceps atrophy
Tidsramme: 3 and 6 Months

The quadriceps circumference of the affected leg is measured in centimeters at 6 and 16 centimeters above the superior pole of the patella and compared to the contralateral side.

3 and 6 Months
Short-term Pain
Tidsramme: 1 week, 2 weeks, 6 weeks, 3 months, 6 months and 1 year

The overall pain in the knee is assessed using a visual analog scale (VAS) questionnaire that is standardized, and this is compared to the preoperative baseline score. The score ranges from 0 to 10 with 0 indicating no pain and 10 indicating worst pain imaginable

1 week, 2 weeks, 6 weeks, 3 months, 6 months and 1 year
Patient-reported outcome measures
Tidsramme: 1 week, 2 weeks, 6 weeks, 3 months, 6 months, 1 year

The questionnaire subjective International Knee Documentation Committee (IKDC) will be obtained. The score ranges from 0 to 100 with 100 having a normal score and 0 an abnormal score.

1 week, 2 weeks, 6 weeks, 3 months, 6 months, 1 year
Lysholm Score
Tidsramme: 1 week, 2 weeks, 6 weeks, 3 months, 6 months, 1 year

The questionnaire Lysholm Score will be obtained. The score ranges from 0 to 100 with 100 having a normal score and 0 an abnormal score.

1 week, 2 weeks, 6 weeks, 3 months, 6 months, 1 year
Forgotten Joint Score
Tidsramme: 1 week, 2 weeks, 6 weeks, 3 months, 6 months, 1 year

The questionnaire Forgotten Joint Score will be obtained. The score ranges from 0 to 100 with 100 having a normal score and 0 an abnormal score.

1 week, 2 weeks, 6 weeks, 3 months, 6 months, 1 year
Tegner activity score
Tidsramme: 1 week, 2 weeks, 6 weeks, 3 months, 6 months, 1 year

The questionnaire Tegner activity score will be obtained. The score ranges from 0 to 100 with 100 having a normal score and 0 an abnormal score.

1 week, 2 weeks, 6 weeks, 3 months, 6 months, 1 year
Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI)
Tidsramme: 1 week, 2 weeks, 6 weeks, 3 months, 6 months, 1 year

The questionnaire Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) will be obtained. The score ranges from 0 to 100 with 100 having a normal score and 0 an abnormal score.

1 week, 2 weeks, 6 weeks, 3 months, 6 months, 1 year
Return to Sports
Tidsramme: 3 months, 6 months and 1 year.

Return to sports will be assessed using questionnaires: when they return to sports (months after surgery), if they have reached preinjury level of performance (yes/no) and whether they are fully return to previous level (yes/no).

3 months, 6 months and 1 year.
Joint space narrowing on radiographs
Tidsramme: 1 year

Osteoarthritic changes at AP and Rosenberg views at 1 year of the medial and lateral compartment compared to preoperative radiographs measured in absolute millimeters at the narrowest area of the respective compartments

1 year
Osteoarthritis grade on radiographs
Tidsramme: 1 year

Osteoarthritic changes at AP and Rosenberg views at 1 year of the medial and lateral compartment compared to preoperative radiographs measured as Kellgren-Lawrence scale (scale from 0 to 4 with 0 indicating no signs of osteoarthritis and 4 indicating end-stage bone-on-bone osteoarthritis)

1 year

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Studieleder: Jelle van der List, MD, PhD, Ohio State University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. august 2026

Primær færdiggørelse (Anslået)

31. december 2028

Studieafslutning (Anslået)

31. december 2029

Datoer for studieregistrering

Først indsendt

3. september 2026

Først indsendt, der opfyldte QC-kriterier

4. november 2026

Først opslået (Faktiske)

10. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

10. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • STUDY20252711

Plan for individuelle deltagerdata (IPD)

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IPD-planbeskrivelse

IPD will not be shared.

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