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Arthrocentesis vs Observation Study for Acute ACL Tears (ASPIRATE)

4. November 2026 aktualisiert von: 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.

Studienübersicht

Status

Rekrutierung

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

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.

Studientyp

Interventionell

Einschreibung (Geschätzt)

54

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studienorte

    • Ohio
      • Columbus, Ohio, Vereinigte Staaten, 43230
        • Rekrutierung
        • Jameson Crane Sports Medicine Institute
        • Kontakt:
        • Hauptermittler:
          • Jelle van der List, MD, PhD
      • Dublin, Ohio, Vereinigte Staaten, 43016
        • Rekrutierung
        • Ohio State Outpatient Care Dublin
        • Kontakt:
        • Hauptermittler:
          • Jelle van der List, MD, PhD

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

15 Jahre bis 40 Jahre (Kind, Erwachsene)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

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

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: 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.

Kein Eingriff: No Aspiration

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

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Quadriceps peak strength
Zeitfenster: 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

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Quadriceps atrophy
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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)
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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
Zeitfenster: 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

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Ermittler

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

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

1. August 2026

Primärer Abschluss (Geschätzt)

31. Dezember 2028

Studienabschluss (Geschätzt)

31. Dezember 2029

Studienanmeldedaten

Zuerst eingereicht

3. September 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

4. November 2026

Zuerst gepostet (Tatsächlich)

10. November 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

10. November 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

4. November 2026

Zuletzt verifiziert

1. November 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • STUDY20252711

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

NEIN

Beschreibung des IPD-Plans

IPD will not be shared.

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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