Trial Comparing BST-CarGel and Microfracture in Repair of Articular Cartilage Lesions in the Knee

NCT ID: NCT00314236

Last Updated: 2015-12-18

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-12-31

Study Completion Date

2011-05-31

Brief Summary

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This study will investigate whether the treatment of damaged cartilage in the knee with BST-CarGel will increase the amount and quality of cartilage repair tissue when compared with microfracture alone. Furthermore, the effect of BST-CarGel in decreasing cartilage related pain and improving cartilage-related function in the knee will be assessed.

Detailed Description

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Cartilage repair currently remains a problematic orthopedic concern with no effective solution. The development of new surgical techniques or therapies is critical in meeting this medical need.

This Canadian trial will be a pivotal protocol study, conducted as a randomized, controlled trial. A total of 80 subjects, 40 subjects in each of the two groups (BST-CarGel applied to a microfractured lesion or microfracture alone), will be enrolled in this study. The subjects and investigative medical staff will not be blinded to treatment due to the difference in surgical incision size. However, although the treatment will not be blinded, the primary effectiveness assessment will be blinded. The primary endpoint of this study will be cartilage repair at 12 months proved by demonstrating that BST-CarGel treatment effectively fills cartilage lesions with high quality cartilaginous tissue. The secondary endpoints will be pain, stiffness and function while other tertiary endpoints will include safety, quality-of-life (QOL), as well as macroscopic characterizations of tissue repair. The primary measure of this study will occur at 12 months, when imaging of repair tissue using magnetic resonance (MR) and associated analyses will compare tissue volume, quality and other anatomical variables. Radiographic evaluations will be blinded. Volunteer biopsies at 13 months may be obtained. Pain, stiffness, function and QOL will be assessed prior to treatment, and at 3, 6 and 12 months following treatment using self-administered validated scores (WOMAC and SF-36). In addition, subject safety will be assessed through a record of adverse events.

Conditions

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Knee Injuries

Keywords

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Cartilage repair Cartilage Knee Knee Pain Microfracture arthroscopy bone marrow stimulation Chondrogenesis Scaffold Chitosan A02.165.165 A10.165.382.332 G07.574.500.325.377.625.180 A10.165.382.400 Articular Cartilage Repair

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Microfracture with BST-CarGel

BST-CarGel applied to a Microfractured lesion in repair of focal articular cartilage lesions on the femoral condyle

Group Type EXPERIMENTAL

BST-CarGel with Microfracture

Intervention Type DEVICE

Microfracture performed with BST-CarGel added to the treated defect

Microfracture without BST-CarGel

Microfractured lesion in repair of focal articular cartilage lesions on the femoral condyle

Group Type ACTIVE_COMPARATOR

Microfracture without BST-CarGel

Intervention Type PROCEDURE

Microfracture performed without BST-CarGel added to the treated defect.

Interventions

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BST-CarGel with Microfracture

Microfracture performed with BST-CarGel added to the treated defect

Intervention Type DEVICE

Microfracture without BST-CarGel

Microfracture performed without BST-CarGel added to the treated defect.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Between 18 and 55 years of age
* Focal articular cartilage lesion on the medial femoral condyle
* Grade 3 or 4 acute (traumatic) or chronic (degenerative) lesion
* Stable knee

Exclusion Criteria

* Multiple lesions or kissing lesions
* Clinically relevant compartment malalignment (\> 5 degrees)
* Undergone ligament treatments in the affected knee within 2 years prior to trial
* Inflammatory arthropathy, such as rheumatoid arthritis, systemic lupus, or active gout
* Previous surgical cartilage treatments in the affected knee in the last 12 months
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Piramal Healthcare Canada Ltd

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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William Stanish, MD

Role: PRINCIPAL_INVESTIGATOR

Orthopaedic and Sport Medicine - Dalhousie University

Locations

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Sports Medicine Centre - University of Calgary

Calgary, Alberta, Canada

Site Status

New West Sports Medicine

New Westminster, British Columbia, Canada

Site Status

Hospital at UBC

Vancouver, British Columbia, Canada

Site Status

Pan Am Clinic

Winnipeg, Manitoba, Canada

Site Status

Orthopaedic and Sport Medicine Clinic of Nova Scotia

Halifax, Nova Scotia, Canada

Site Status

Entralogix Clinical Group Inc.

Newmarket, Ontario, Canada

Site Status

Sports Medicine Clinic - Carleton University

Ottawa, Ontario, Canada

Site Status

Sunnybrook Health Sciences Centre, Div. of Orthopaedic Surgery

Toronto, Ontario, Canada

Site Status

Hopital Charles LeMoyne

Greenfield Park, Quebec, Canada

Site Status

Hospital Sacré-Coeur de Montréal

Montreal, Quebec, Canada

Site Status

Centre Hospitalier Affilie Universitaire de Quebec et Hôpital Valcartier

Québec, Quebec, Canada

Site Status

Seoul National University Hospital

Seoul, , South Korea

Site Status

Kyung Hee University Medical Center

Seoul, , South Korea

Site Status

Hospital Clinic i Provincial de Barcelona

Barcelona, Barcelona, Spain

Site Status

Hospital Universitario Gregorio Maraňón

Madrid, Madrid, Spain

Site Status

Hospital La Paz

Madrid, Madrid, Spain

Site Status

FREMAP Centro de Prevención y Rehabilitación

Majadahonda, Madrid, Spain

Site Status

Hospital Begona de Gijon

Gijón, Principality of Asturias, Spain

Site Status

Countries

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Canada South Korea Spain

References

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Hoemann CD, Hurtig M, Rossomacha E, Sun J, Chevrier A, Shive MS, Buschmann MD. Chitosan-glycerol phosphate/blood implants improve hyaline cartilage repair in ovine microfracture defects. J Bone Joint Surg Am. 2005 Dec;87(12):2671-2686. doi: 10.2106/JBJS.D.02536.

Reference Type BACKGROUND
PMID: 16322617 (View on PubMed)

Chevrier A, Hoemann CD, Sun J, Buschmann MD. Chitosan-glycerol phosphate/blood implants increase cell recruitment, transient vascularization and subchondral bone remodeling in drilled cartilage defects. Osteoarthritis Cartilage. 2007 Mar;15(3):316-27. doi: 10.1016/j.joca.2006.08.007. Epub 2006 Sep 26.

Reference Type BACKGROUND
PMID: 17008111 (View on PubMed)

Hoemann CD, Sun J, McKee MD, Chevrier A, Rossomacha E, Rivard GE, Hurtig M, Buschmann MD. Chitosan-glycerol phosphate/blood implants elicit hyaline cartilage repair integrated with porous subchondral bone in microdrilled rabbit defects. Osteoarthritis Cartilage. 2007 Jan;15(1):78-89. doi: 10.1016/j.joca.2006.06.015. Epub 2006 Aug 8.

Reference Type BACKGROUND
PMID: 16895758 (View on PubMed)

Stanish WD, McCormack R, Forriol F, Mohtadi N, Pelet S, Desnoyers J, Restrepo A, Shive MS. Novel scaffold-based BST-CarGel treatment results in superior cartilage repair compared with microfracture in a randomized controlled trial. J Bone Joint Surg Am. 2013 Sep 18;95(18):1640-50. doi: 10.2106/JBJS.L.01345.

Reference Type RESULT
PMID: 24048551 (View on PubMed)

Other Identifiers

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CG-CIP01-P

Identifier Type: -

Identifier Source: org_study_id