Early Viscosupplementation After Partial Meniscectomy: a Randomized Controlled Trial

NCT ID: NCT02629380

Last Updated: 2017-09-13

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

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-12-31

Study Completion Date

2016-05-31

Brief Summary

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The rational of intra-articular viscosupplementation is based on both the biological and mechanical properties of HA, which exerts positive effects on the modulation of the entire joint environment.

The aim of the present double blind controlled study was to evaluate the effects in terms of pain control and functional recovery provided by a single intra-operative injection of HA performed at the end of arthroscopic partial meniscectomy.

Patients included in this trial were randomized in two treatment groups: the first one received a single injection of HA (Hymovis 24 mg/3ml, Fidia Farmaceutici Spa, Padova, Italy) at the end of the arthroscopic meniscectomy, whereas the second group was treated by surgery alone.

All patients were evaluated basally, at 15, 30, 60, and 180 days after surgery by the following evaluation tools: IKDC (International Knee Documentation Committee) subjective, VAS (Visual Analogue Score) for pain, EQ-VAS for general Health Status, KOOS (Knee Injury and Osteoarthritis Outcome Score) and Tegner score. Furthermore, during the basal evaluation and at each follow-up visit up to 2 months, active and passive Range of Motion (ROM) of both the operated and contralateral knee were documented; also in addition, the trans-patellar circumference of both knees was registered to assess the trend of knee swelling over time.

Detailed Description

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Conditions

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Meniscus Lesion

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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Hyaluronic acid group

Single injection of 3 ml HA (Hymovis, Fidia Farmaceutici SpA, Padova, Italy) at the end of the arthroscopic meniscectomy

Group Type EXPERIMENTAL

hyaluronic acid

Intervention Type BIOLOGICAL

A single injection of 3 ml hyaluronic acid to be performed under arthroscopic view at the end of meniscectomy

meniscectomy alone

Arthroscopic meniscectomy alone

Group Type OTHER

meniscectomy alone

Intervention Type PROCEDURE

The patients randomized in this group will receive arthroscopic meniscectomy alone

Interventions

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hyaluronic acid

A single injection of 3 ml hyaluronic acid to be performed under arthroscopic view at the end of meniscectomy

Intervention Type BIOLOGICAL

meniscectomy alone

The patients randomized in this group will receive arthroscopic meniscectomy alone

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. chronic symptomatic meniscal tears requiring partial resection;
2. healthy contra-lateral knee (i.e. no pain or functional limitation in the contra-lateral joint);

Exclusion Criteria

1. previous surgery on the index knee;
2. other concurrent articular lesion requiring surgical treatment (e.g.: cartilage or ligament injuries);
3. history of knee infectious arthritis;
4. concurrent rheumatic, metabolic or severe systemic disease;
5. Body Mass Index (BMI) \> 30;
6. known hypersensibility or allergy to/towards HA ;
7. alcohol or other substances abuse/excess.
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Istituto Ortopedico Rizzoli

OTHER

Sponsor Role lead

Responsible Party

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Federica Balboni

BScD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Elizaveta Kon, MD

Role: PRINCIPAL_INVESTIGATOR

II Clinic and Nano-biotechnology Lab, Rizzoli Orthopedic Institute, Bologna, Italy

Locations

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II Orthopaedic Clinic, Rizzoli Orthopaedic Institute

Bologna, Emilia-Romagna, Italy

Site Status

Countries

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Italy

References

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Edouard P, Rannou F, Coudeyre E. Animal evidence for hyaluronic acid efficacy in knee trauma injuries. Review of animal-model studies. Phys Ther Sport. 2013 May;14(2):116-23. doi: 10.1016/j.ptsp.2013.02.001. Epub 2013 Mar 16.

Reference Type BACKGROUND
PMID: 23506791 (View on PubMed)

Freymann U, Endres M, Goldmann U, Sittinger M, Kaps C. Toward scaffold-based meniscus repair: effect of human serum, hyaluronic acid and TGF-ss3 on cell recruitment and re-differentiation. Osteoarthritis Cartilage. 2013 May;21(5):773-81. doi: 10.1016/j.joca.2013.02.655. Epub 2013 Mar 5.

Reference Type BACKGROUND
PMID: 23473977 (View on PubMed)

Thein R, Haviv B, Kidron A, Bronak S. Intra-articular injection of hyaluronic acid following arthroscopic partial meniscectomy of the knee. Orthopedics. 2010 Oct 11;33(10):724. doi: 10.3928/01477447-20100826-11.

Reference Type BACKGROUND
PMID: 20954664 (View on PubMed)

Tan GK, Dinnes DL, Butler LN, Cooper-White JJ. Interactions between meniscal cells and a self assembled biomimetic surface composed of hyaluronic acid, chitosan and meniscal extracellular matrix molecules. Biomaterials. 2010 Aug;31(23):6104-18. doi: 10.1016/j.biomaterials.2010.04.018. Epub 2010 May 14.

Reference Type BACKGROUND
PMID: 20471080 (View on PubMed)

Westrich G, Schaefer S, Walcott-Sapp S, Lyman S. Randomized prospective evaluation of adjuvant hyaluronic acid therapy administered after knee arthroscopy. Am J Orthop (Belle Mead NJ). 2009 Dec;38(12):612-6.

Reference Type BACKGROUND
PMID: 20145786 (View on PubMed)

Waddell DD, Bert JM. The use of hyaluronan after arthroscopic surgery of the knee. Arthroscopy. 2010 Jan;26(1):105-11. doi: 10.1016/j.arthro.2009.05.009. Epub 2009 Nov 25.

Reference Type BACKGROUND
PMID: 20117634 (View on PubMed)

Cake M, Read R, Edwards S, Smith MM, Burkhardt D, Little C, Ghosh P. Changes in gait after bilateral meniscectomy in sheep: effect of two hyaluronan preparations. J Orthop Sci. 2008 Nov;13(6):514-23. doi: 10.1007/s00776-008-1279-6. Epub 2008 Dec 17.

Reference Type BACKGROUND
PMID: 19089539 (View on PubMed)

Mathies B. Effects of Viscoseal, a synovial fluid substitute, on recovery after arthroscopic partial meniscectomy and joint lavage. Knee Surg Sports Traumatol Arthrosc. 2006 Jan;14(1):32-9. doi: 10.1007/s00167-005-0625-x. Epub 2005 May 26.

Reference Type BACKGROUND
PMID: 15918064 (View on PubMed)

Filardo G, Di Matteo B, Tentoni F, Cavicchioli A, Di Martino A, Lo Presti M, Iacono F, Kon E, Marcacci M. No Effects of Early Viscosupplementation After Arthroscopic Partial Meniscectomy: A Randomized Controlled Trial. Am J Sports Med. 2016 Dec;44(12):3119-3125. doi: 10.1177/0363546516660070. Epub 2016 Aug 15.

Reference Type DERIVED
PMID: 27528611 (View on PubMed)

Other Identifiers

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Rizzoli HA-MEN

Identifier Type: -

Identifier Source: org_study_id

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