Single and Double Bundle ACL Reconstructions, in Term of Cartilage Damage Due to Remaining Instability After Surgery.

NCT ID: NCT04626999

Last Updated: 2020-11-13

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

52 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-01-08

Study Completion Date

2021-06-30

Brief Summary

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The prevalence of ACL (Anterior Cruciate Ligament) ruptures is relatively high, primarily due to sports and military training injuries. With the advancements of ACL reconstruction therapies, there exist two ways to reconstruct ACL: single-bundle ACL reconstruction (SBACLR) and double-bundle ACL reconstruction (DBACLR). Previous research studies claimed that DBACLR techniques are superior to that of SBACLR, while others stated no notable differences between the two. The variables assessed in previous studies are findings related to the clinical instabilities of the knees (both subjective nor objectives views) and standard radiology examination, such as Xray or MRI. Knee instabilities are the primary goal of ACL reconstructions. Hence this study focuses on finding the dissimilarities between the two previously mentioned techniques by observing the early consequences (subclinically) of knee instabilities towards cartilage damage. The dissimilarities assessments utilize biomolecular tests (ELISA) of cartilage oligomeric matrix protein (COMP) on synovial joint fluid of the knee and knee joint cartilage examination using MRI T2 mapping. Furthermore, there will be a stability (biomechanical) check of the knee joint in the form of a Lachman test, a pivot shift test, and a Rolimeter.

This study requires around 47-52 subjects divided into two operation techniques of SBACLR and DBACLR. To evaluate the results from COMP, MRI T2 mapping, Lachman test, pivot shift test, and Rolimeter, this study is divided into three timeframes: before an operation, three months after post-operation, and six months post-operations. The differences between the test variables are then used as an indicator to assess the cartilage conditions from two operation techniques: SBACLR and DBACLR. Subsequently, the study also examines the possible correlation of each of the resulting variables.

Detailed Description

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This study utilizes a single-blind randomized clinical trial to evaluate whether the DBACL reconstruction surgery is more suitable than SBACL reconstruction in the subclinical aspect of cartilage damage through a biomolecular examination from the synovial joint fluid COMP and MRI T2 mapping.

This study's estimated time is between two to three years ranging from January 2018 until the end of June 2021.

The samples are randomly divided into two groups: the SBACLR group and the DBACLR group. The sample size for each group was 26 subjects. For the subjects, the accepted inclusion criteria were male, age 18-40 years, total primary AC rupture, injury time 1-12 months, willingness to attend the study, and signed informed consent.

Exclusion criteria include subjects having other ligament injuries in the knee, history of rheumatoid arthritis, severe osteoarthritis Kellgren-Lawrence grading\> 2, Body Mass Index (BMI) ≥ 25, fracture around the knee joint or osteochondral avulsion, history of injury with either or both semitendinosus or gracilis muscle, patellofemoral instability, contraindication of anesthesia, and partial ACL rupture.

Drop Out criteria includes: subjects not returning to control, undergoing treatment outside the program, not complying with study protocols, re-injury to the studied knee causing ligament, meniscus or cartilage injury, and postoperative knee infection.

Prospective subjects have been diagnosed with the total loss of ACL and meet the research criteria are explained about the aims and objectives of the study and sign a consent form to participate in the study.

Each subject was assigned to one of the study groups through a simple randomization method: the SBACL reconstruction surgery action group or the DBACL reconstruction surgery action group.

All subjects were examined the Lachman test, pivot test, Rolimeter measurement, MRI T2 mapping, and knee joint fluid for ELISA examination of sfCOMP (synovial fluid COMP) at the time before surgery, the third month, and the sixth month postoperatively.

Conditions

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Anterior Cruciate Ligament Rupture Knee Instability Cartilage Damage

Keywords

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knee instability anterior cruciate ligament rupture cartilage damage Single Bundle ACL Reconstruction Double Bundle ACL Reconstruction COMP (Cartilage Oligomeric Matrix Protein) MRI T2 Mapping

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Synovial fluid COMP

Knee joint fluid is aspirated for ELISA COMP examination

Group Type ACTIVE_COMPARATOR

Single Bundle ACL Reconstruction

Intervention Type PROCEDURE

Arthroscopy Single Bundle ACL Reconstruction is a procedure to reconstruct the ACL using one bundle.

The procedure uses Hamstring (Gracillis muscle and Semitendinosus muscle) as a graft.

Double Bundle ACL Reconstruction

Intervention Type PROCEDURE

Arthroscopy Double Bundle ACL Reconstruction is a procedure to reconstruct the ACL using Two bundles (Double bundle).

The procedure uses Gracillis tendon as a Posterolateral bundle graft and Semitendinosus tendon as an Anteromedial bundle graft.

MRI T2 Mapping

Affected knee is subjected to an MRI T2 mapping examination to see the condition of cartilage

Group Type ACTIVE_COMPARATOR

Single Bundle ACL Reconstruction

Intervention Type PROCEDURE

Arthroscopy Single Bundle ACL Reconstruction is a procedure to reconstruct the ACL using one bundle.

The procedure uses Hamstring (Gracillis muscle and Semitendinosus muscle) as a graft.

Double Bundle ACL Reconstruction

Intervention Type PROCEDURE

Arthroscopy Double Bundle ACL Reconstruction is a procedure to reconstruct the ACL using Two bundles (Double bundle).

The procedure uses Gracillis tendon as a Posterolateral bundle graft and Semitendinosus tendon as an Anteromedial bundle graft.

Instability Examination

Lachmant Test, Pivot shift test and Rolimeter Measurement

Group Type ACTIVE_COMPARATOR

Single Bundle ACL Reconstruction

Intervention Type PROCEDURE

Arthroscopy Single Bundle ACL Reconstruction is a procedure to reconstruct the ACL using one bundle.

The procedure uses Hamstring (Gracillis muscle and Semitendinosus muscle) as a graft.

Double Bundle ACL Reconstruction

Intervention Type PROCEDURE

Arthroscopy Double Bundle ACL Reconstruction is a procedure to reconstruct the ACL using Two bundles (Double bundle).

The procedure uses Gracillis tendon as a Posterolateral bundle graft and Semitendinosus tendon as an Anteromedial bundle graft.

Interventions

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Single Bundle ACL Reconstruction

Arthroscopy Single Bundle ACL Reconstruction is a procedure to reconstruct the ACL using one bundle.

The procedure uses Hamstring (Gracillis muscle and Semitendinosus muscle) as a graft.

Intervention Type PROCEDURE

Double Bundle ACL Reconstruction

Arthroscopy Double Bundle ACL Reconstruction is a procedure to reconstruct the ACL using Two bundles (Double bundle).

The procedure uses Gracillis tendon as a Posterolateral bundle graft and Semitendinosus tendon as an Anteromedial bundle graft.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Male
* Age 18-40 years
* Total primary ACL rupture
* Injury time 1-12 months
* Willingness to attend the study
* Signed informed consent.

Exclusion Criteria

* Subjects having other ligament injuries in the knee
* History of rheumatoid arthritis
* Severe osteoarthritis Kellgren-Lawrence grading\> 2
* Body Mass Index (BMI) ≥ 25
* Fracture around the knee joint or osteochondral avulsion
* History of injury with either or both semitendinosus or gracilis muscle, patellofemoral instability, contraindication of anesthesia, and partial ACL rupture.
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Indonesia University

OTHER

Sponsor Role lead

Responsible Party

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Ismail Hadisoebroto Dilogo

Professor in Faculty of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bobby N Nelwan, MD

Role: PRINCIPAL_INVESTIGATOR

Fakultas Kedokteran Universitas Indonesia

Locations

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Fakultas Kedokteran Universitas Indonesia

Jakarta Pusat, DKI Jakarta, Indonesia

Site Status RECRUITING

Countries

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Indonesia

Central Contacts

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Bobby N Nelwan

Role: CONTACT

Phone: +62811898464

Email: [email protected]

Ismail H Dilogo, MD, PhD

Role: CONTACT

Email: [email protected]

Facility Contacts

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Bobby N Nelwan, MD

Role: primary

Aryo N Triyudanto, MD

Role: backup

Other Identifiers

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ISMBNNCARTRECON

Identifier Type: -

Identifier Source: org_study_id