Patellar Tendon Regeneration With Platelet-rich Plasma

NCT ID: NCT01111747

Last Updated: 2012-03-14

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

PHASE4

Total Enrollment

27 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-11-30

Study Completion Date

2010-12-31

Brief Summary

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The central third of the patellar tendon is used as a donor site for anterior cruciate ligament (ACL) reconstruction. After months or years the harvest site partially regenerates. The regeneration process is accomplished by biological mechanisms,including cells and proteins known as growth factors. The platelets are natural reservoirs of growth factors, and a platelet concentrate known as Platelet-Rich Plasma (PRP) has a three to five fold increase in growth factors. The hypothesis of the study is that the PRP can improve the regeneration of the patellar tendon.

The platelets are obtained from the patient's blood through a filtration system called apheresis, with the use of 250 milliliters of blood, with a sterile system. All the others components of blood (red cells, plasma, white cells) returns to the patient. The PRP is then applied in the harvest site on the patellar tendon, at the end of ACL reconstruction.

The patients are randomized in two groups, one with the use of PRP and the other group without PRP. This information for the patients will be granted just at the end of the research. After the surgery the rehabilitation protocol is the same for both groups. An isokinetic testing is done before the surgery and after six months. Questionnaires about the knee function are asked before the surgery and after six months. A magnetic resonance imaging is performed after six months to evaluate the tendon regeneration.

Detailed Description

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Conditions

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Knee Instability

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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PRP

In this group PRP will be used in the patellar tendon donor site.

Group Type EXPERIMENTAL

Platelet-rich plasma

Intervention Type PROCEDURE

Intra-operative use of platelet-rich plasma in the patellar tendon after harvesting its central third for ACL reconstruction.

Control

In this group PRP will not be aded to the patellar tendon donor site

Group Type SHAM_COMPARATOR

Control group

Intervention Type PROCEDURE

In this group PRP will not be added to the patellar tendon donor site at the end of ACL reconstruction.

Interventions

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Platelet-rich plasma

Intra-operative use of platelet-rich plasma in the patellar tendon after harvesting its central third for ACL reconstruction.

Intervention Type PROCEDURE

Control group

In this group PRP will not be added to the patellar tendon donor site at the end of ACL reconstruction.

Intervention Type PROCEDURE

Other Intervention Names

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PRP platelet gel platelet concentrate growth factors concentrate plasma rich in growth factors PRP platelet-rich plasma platelet gel platelet concentrate growth factors concentrate plasma rich in growth factors

Eligibility Criteria

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Inclusion Criteria

* indication of anterior cruciate ligament surgery with patellar ligament
* skeletal maturity

Exclusion Criteria

* other knee ligament injuries
* severe chondral lesions
* osteoarthritis
* non-compliance to the rehabilitation
* previous surgery in the affected knee
* reoperation during the time of the study for an unrelated condition
* infection
Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Instituto de Ortopedia e Traumatologia - HCFMUSP - São Paulo, Brazil

UNKNOWN

Sponsor Role collaborator

University of Sao Paulo General Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Adriano M Almeida, MD

Role: PRINCIPAL_INVESTIGATOR

Instituto de Ortopedia e Traumatologia - HCFMUSP - São Paulo, Brazil

Arnaldo J Hernandez, MD, PhD

Role: STUDY_DIRECTOR

Instituto de Ortopedia e Traumatologia - HCFMUSP - São Paulo, Brazil

References

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Kartus J, Movin T, Papadogiannakis N, Christensen LR, Lindahl S, Karlsson J. A radiographic and histologic evaluation of the patellar tendon after harvesting its central third. Am J Sports Med. 2000 Mar-Apr;28(2):218-26. doi: 10.1177/03635465000280021301.

Reference Type BACKGROUND
PMID: 10750999 (View on PubMed)

Meisterling RC, Wadsworth T, Ardill R, Griffiths H, Lane-Larsen CL. Morphologic changes in the human patellar tendon after bone-tendon-bone anterior cruciate ligament reconstruction. Clin Orthop Relat Res. 1993 Apr;(289):208-12.

Reference Type BACKGROUND
PMID: 8472418 (View on PubMed)

Svensson M, Kartus J, Ejerhed L, Lindahl S, Karlsson J. Does the patellar tendon normalize after harvesting its central third?: a prospective long-term MRI study. Am J Sports Med. 2004 Jan-Feb;32(1):34-8. doi: 10.1177/0363546503258935.

Reference Type BACKGROUND
PMID: 14754721 (View on PubMed)

Anaguchi Y, Yasuda K, Majima T, Tohyama H, Minami A, Hayashi K. The effect of transforming growth factor-beta on mechanical properties of the fibrous tissue regenerated in the patellar tendon after resecting the central portion. Clin Biomech (Bristol). 2005 Nov;20(9):959-65. doi: 10.1016/j.clinbiomech.2005.05.012.

Reference Type BACKGROUND
PMID: 16055249 (View on PubMed)

Anitua E, Andia I, Ardanza B, Nurden P, Nurden AT. Autologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost. 2004 Jan;91(1):4-15. doi: 10.1160/TH03-07-0440.

Reference Type BACKGROUND
PMID: 14691563 (View on PubMed)

Spindler KP, Nanney LB, Davidson JM. Proliferative responses to platelet-derived growth factor in young and old rat patellar tendon. Connect Tissue Res. 1995;31(2):171-7. doi: 10.3109/03008209509028405.

Reference Type BACKGROUND
PMID: 15612333 (View on PubMed)

Molloy T, Wang Y, Murrell G. The roles of growth factors in tendon and ligament healing. Sports Med. 2003;33(5):381-94. doi: 10.2165/00007256-200333050-00004.

Reference Type BACKGROUND
PMID: 12696985 (View on PubMed)

Aspenberg P. Stimulation of tendon repair: mechanical loading, GDFs and platelets. A mini-review. Int Orthop. 2007 Dec;31(6):783-9. doi: 10.1007/s00264-007-0398-6. Epub 2007 Jun 22.

Reference Type BACKGROUND
PMID: 17583812 (View on PubMed)

Rodeo SA, Potter HG, Kawamura S, Turner AS, Kim HJ, Atkinson BL. Biologic augmentation of rotator cuff tendon-healing with use of a mixture of osteoinductive growth factors. J Bone Joint Surg Am. 2007 Nov;89(11):2485-97. doi: 10.2106/JBJS.C.01627.

Reference Type BACKGROUND
PMID: 17974893 (View on PubMed)

Sanchez M, Anitua E, Azofra J, Andia I, Padilla S, Mujika I. Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices. Am J Sports Med. 2007 Feb;35(2):245-51. doi: 10.1177/0363546506294078. Epub 2006 Nov 12.

Reference Type BACKGROUND
PMID: 17099241 (View on PubMed)

Other Identifiers

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CaPPesqHCFMUSP 0162/2008

Identifier Type: OTHER

Identifier Source: secondary_id

0162/08

Identifier Type: -

Identifier Source: org_study_id

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