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Arthrocentesis vs Observation Study for Acute ACL Tears (ASPIRATE)

4 novembre 2026 mis à jour par: 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.

Aperçu de l'étude

Statut

Recrutement

Les conditions

Intervention / Traitement

Description détaillée

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.

Type d'étude

Interventionnel

Inscription (Estimé)

54

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

Lieux d'étude

    • Ohio
      • Columbus, Ohio, États-Unis, 43230
        • Recrutement
        • Jameson Crane Sports Medicine Institute
        • Contact:
        • Chercheur principal:
          • Jelle van der List, MD, PhD
      • Dublin, Ohio, États-Unis, 43016
        • Recrutement
        • Ohio State Outpatient Care Dublin
        • Contact:
        • Chercheur principal:
          • Jelle van der List, MD, PhD

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

15 ans à 40 ans (Enfant, Adulte)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

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

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: 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.

Aucune intervention: No Aspiration

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

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Quadriceps peak strength
Délai: 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

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Quadriceps atrophy
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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)
Délai: 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
Délai: 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
Délai: 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
Délai: 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

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Les enquêteurs

  • Directeur d'études: Jelle van der List, MD, PhD, Ohio State University

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

1 août 2026

Achèvement primaire (Estimé)

31 décembre 2028

Achèvement de l'étude (Estimé)

31 décembre 2029

Dates d'inscription aux études

Première soumission

3 septembre 2026

Première soumission répondant aux critères de contrôle qualité

4 novembre 2026

Première publication (Réel)

10 novembre 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

10 novembre 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

4 novembre 2026

Dernière vérification

1 novembre 2026

Plus d'information

Termes liés à cette étude

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • STUDY20252711

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

NON

Description du régime IPD

IPD will not be shared.

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .