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Arthrocentesis vs Observation Study for Acute ACL Tears (ASPIRATE)

2026年11月4日 更新者: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.

調査の概要

状態

募集

条件

介入・治療

詳細な説明

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.

研究の種類

介入

入学 (推定)

54

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

    • Ohio
      • Columbus、Ohio、アメリカ、43230
        • 募集
        • Jameson Crane Sports Medicine Institute
        • コンタクト:
        • 主任研究者:
          • Jelle van der List, MD, PhD
      • Dublin、Ohio、アメリカ、43016
        • 募集
        • Ohio State Outpatient Care Dublin
        • コンタクト:
        • 主任研究者:
          • Jelle van der List, MD, PhD

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

15年~40年 (子、大人)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

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

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:なし(オープンラベル)

武器と介入

参加者グループ / アーム
介入・治療
実験的: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.

介入なし:No Aspiration

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

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Quadriceps peak strength
時間枠: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

二次結果の測定

結果測定
メジャーの説明
時間枠
Quadriceps atrophy
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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)
時間枠: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
時間枠: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
時間枠: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
時間枠: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

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

捜査官

  • スタディディレクター:Jelle van der List, MD, PhD、Ohio State University

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2026年8月1日

一次修了 (推定)

2028年12月31日

研究の完了 (推定)

2029年12月31日

試験登録日

最初に提出

2026年9月3日

QC基準を満たした最初の提出物

2026年11月4日

最初の投稿 (実際)

2026年11月10日

学習記録の更新

投稿された最後の更新 (実際)

2026年11月10日

QC基準を満たした最後の更新が送信されました

2026年11月4日

最終確認日

2026年11月1日

詳しくは

本研究に関する用語

追加の関連 MeSH 用語

その他の研究ID番号

  • STUDY20252711

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

IPD プランの説明

IPD will not be shared.

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米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

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