Study of Autologous Conditioned Serum After Anterior Cruciate Ligament Reconstructive Surgery

NCT ID: NCT01037738

Last Updated: 2009-12-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

62 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-05-31

Study Completion Date

2009-01-31

Brief Summary

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Abstract

Background

Pro-inflammatory cytokines play a pivotal role in osteoarthritis, as well as in bone tunnel widening after ACL reconstructive surgery. A new treatment option is to administer autologous conditioned serum (ACS) containing endogenous anti-inflammatory cytokines including IL-1Ra and growth factors (IGF-1, PDGF and TGF-ß1, among others) in the liquid blood phase.

Objective The purpose of this trial was to establish whether the osteoclastic effect could be affected by intra-articular application of ACS, thus resulting in a potential decrease of knee laxity and leading to a better postoperative outcome.

Methods In a prospective, randomized, double-blinded, placebo-controlled trial with two parallel groups, 62 patients were treated. Bone tunnel width was measured by CT scans, while clinical efficacy was assessed by patient-administered outcome instruments (WOMAC, IKDC 2000) up to one year following the ACL reconstruction in patients receiving either ACS (Group A) or placebo (Group B). The investigators compared the levels and dynamics of IL-1b concentrations in the synovial liquid and examined the correlation between the levels of IL-1b at three different post-operative points.

Level of evidence Therapeutic study, Level 1 (randomized controlled trial \[significant differences and narrow confidence intervals\])

Detailed Description

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Conditions

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Joint Instability

Keywords

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ACL reconstruction autologous conditioned serum Orthokine osteoarthritis interleukin receptor antagonist growth factors WOMAC IKDC

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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ACS - Orthokin

Autologous conditioned serum (ACS) - Orthokin containing endogenous anti-inflammatory cytokines including IL-1Ra and growth factors (IGF-1, PDGF and TGF-ß1, among others) in the liquid blood phase.

Group Type ACTIVE_COMPARATOR

ACL reconstructive surgery and ACS/ Orthokin application

Intervention Type PROCEDURE

ACL reconstructive surgery and ACS/ Orthokin or Placebo intraarticular application on Day 0,1,6 and 10 postoperatively, regarding the Arm

Placebo

Physiologic solution

Group Type PLACEBO_COMPARATOR

ACL reconstructive surgery and ACS/ Orthokin application

Intervention Type PROCEDURE

ACL reconstructive surgery and ACS/ Orthokin or Placebo intraarticular application on Day 0,1,6 and 10 postoperatively, regarding the Arm

Interventions

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ACL reconstructive surgery and ACS/ Orthokin application

ACL reconstructive surgery and ACS/ Orthokin or Placebo intraarticular application on Day 0,1,6 and 10 postoperatively, regarding the Arm

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

Eligible patients were:

* older than 18 years
* prior to each surgery, traumatic ACL rupture was determined on the basis of a clinical examination and confirmed by exploratory and therapeutic arthroscopic surgery in accordance with good surgical practice
* the same preoperative diagnosis of isolated ACL rupture
* a knee axis deviation up to 5°; knee osteoarthritis up to grade 1 according to the AO
* knee chondral lesion up to grade 2 (Outerbridge classification).

Exclusion Criteria

* poor general health as judged by the orthopedic surgeon
* Concomitant painful or disabling disease of the spine, hips, or lower limbs that would interfere with evaluation of the afflicted knee
* Any clinically significant or symptomatic vascular or neurological disorder; crystalline, inflammatory and infectious arthropathies
* Infections
* Osteomyelitis
* Alcohol/drug abuse
* Known coagulopathy
* Corticosteroid or anti-coagulant usage, and morbid obesity.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Croatian Institute of Health Insurance

UNKNOWN

Sponsor Role collaborator

University of Zagreb

OTHER

Sponsor Role lead

Responsible Party

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University Clinic for Traumatology, Draskoviceva 19, 10000 Zagreb, Croatia

Locations

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Medical School, University of Zagreb

Zagreb, , Croatia

Site Status

Countries

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Croatia

References

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References 1. Harris NL, Indelicato PA, Bloomberg MS, Meister K, Wheeler DL. Radiographic and histologic analysis of the tibial tunnel after allograft anterior cruciate ligament reconstruction in goats. American Journal of Sports Medicine 30 (3):368-73,2002. 2. Hoher J, Moller HD, Fu FH. Bone tunnel enlargement after anterior cruciate ligament reconstruction: fact or fiction? Knee Surgery, Sports Traumatology and Arthroscopy 6 (4):231-40,1998. 3. Hsu CJ, Hsu HC, Jim YF. A radiological study after anterior cruciate ligament reconstruction. Journal of Chinese Medical Association 66(3):160-5,2003. 4. Nakayama Y, Shirai Y, Narita T, Mori A. Enlargement of bone tunnels after anterior cruciate ligament reconstruction. Nippon Ika Daigaku Zasshi 65(5):377-81,1998. 5. Topliss C, Webb J. An audit of tunnel position in anterior cruciate ligament reconstruction. Knee 8(1):59-63,2001.

Reference Type BACKGROUND

Other Identifiers

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REC LCA 2B

Identifier Type: -

Identifier Source: org_study_id