Changes in the Immunomodulatory Properties of Adipose Stromal Cells Due to Hemarthrosis After Knee Injury

NCT ID: NCT05687331

Last Updated: 2023-01-18

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

Total Enrollment

20 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-04-05

Study Completion Date

2024-04-01

Brief Summary

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The goal of this observational study is to gain insight in the natural course of pro-inflammatory factors and hemarthrosis in patients older than 18 with a recent knee trauma. The main question\[s\] it aims to answer are:

* What is the natural course of pro-inflammatory factors and hemarthrosis in knee trauma?
* What are the effects of inflammation and hemarthrosis on the anti-inflammatory potential of ASC's in order to better determine eligible patients and circumstances for ASC's therapy?

Participants will:

* undergo blood withdrawal
* undergo knee arthrocentesis for synovial fluid sample collection
* physical examination
* fill out a questionnaire on knee complaints

Detailed Description

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Recent studies have found an amelioration of post-traumatic osteoarthritis by the use of adipose-derived stromal cells (ASC's) in an experimental animal model. This amelioration was only seen under inflammatory conditions. The presence of hemarthrosis has not been taken into account in the before mentioned animal model, and might have cytotoxic effects on ASC's and aggravate the inflammatory response. The objective of this study is to gain insight in the natural course of pro-inflammatory factors and hemarthrosis and its effects on the anti-inflammatory potential of ASC's in order to better determine eligible patients and circumstances for ASC's therapy.

Therefore the investigators designed a pilot study with exploratory analyses in and with synovial fluid in a longitudinal cohort.

Our study population will consist of 20 patients, older than 18 years, who sustained a recent knee trauma and are presented to the emergency department.The investigators will gather synovial fluid and blood samples for laboratory analysis perform and physical examination and provide questionnaires for clinical follow-up.

The main study endpoint are the anti-inflammatory capacities of ASC's in synovial fluid that contains blood as a result of hemarthrosis after knee injury.

Conditions

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Post-Traumatic Osteoarthritis of Knee Knee Injuries Hemarthrosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients with hemarthrosis

10 patients that sustained a knee trauma and have hemarthrosis during knee arthrocentesis (red color of the synovial fluid)

knee arthrocentesis

Intervention Type PROCEDURE

arthrocentesis of the knee joint to gather a synovial fluid sample

venipuncture

Intervention Type PROCEDURE

Peripheral venipuncture to gather a blood sample

MRI-scan

Intervention Type DIAGNOSTIC_TEST

MRI-scan of the knee

Physical examination

Intervention Type DIAGNOSTIC_TEST

Physical examination of the injured knee

KOOS questionnaire

Intervention Type OTHER

KOOS questionnaire of the injured knee

Patients without hemarthrosis

10 patients that sustained a knee trauma and do not have hemarthrosis during knee arthrocentesis (yellow color of the synovial fluid)

knee arthrocentesis

Intervention Type PROCEDURE

arthrocentesis of the knee joint to gather a synovial fluid sample

venipuncture

Intervention Type PROCEDURE

Peripheral venipuncture to gather a blood sample

MRI-scan

Intervention Type DIAGNOSTIC_TEST

MRI-scan of the knee

Physical examination

Intervention Type DIAGNOSTIC_TEST

Physical examination of the injured knee

KOOS questionnaire

Intervention Type OTHER

KOOS questionnaire of the injured knee

Interventions

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knee arthrocentesis

arthrocentesis of the knee joint to gather a synovial fluid sample

Intervention Type PROCEDURE

venipuncture

Peripheral venipuncture to gather a blood sample

Intervention Type PROCEDURE

MRI-scan

MRI-scan of the knee

Intervention Type DIAGNOSTIC_TEST

Physical examination

Physical examination of the injured knee

Intervention Type DIAGNOSTIC_TEST

KOOS questionnaire

KOOS questionnaire of the injured knee

Intervention Type OTHER

Other Intervention Names

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blood draw

Eligibility Criteria

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Inclusion Criteria

* Recently suffered an injury of the index knee (rotational or hyperextension)
* A swollen joint
* Inability to mobilise

Exclusion Criteria

* Patients with an active inflammatory or infectious comorbid disease (including rheumatic diseases)
* Patients using systemic immunosuppressant medication
* Patients with a contra-indication for undergoing a MRI-scan (non-compatible implants or claustrophobia for example)
* Patients with knee prosthesis
* Patients with coagulation disorders
* Patients with a history of a cruciate ligament or meniscal injury of the index knee
* Patients with a tibiofemoral fracture of the index knee due to current distortion
* In case the inclusion of the required amount of patient is reached in one the patient groups, additional patients belonging in the same patient group will not be included in the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Radboud University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Radboud umc

Nijmegen, Gelderland, Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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Bob Evers, Drs/Msc

Role: CONTACT

06-29630837

Rogier Thurlings, Dr/PhD

Role: CONTACT

0629652920

Facility Contacts

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Bob Evers, Drs/Msc

Role: primary

0629630837

Rogier Thurlings, Dr/PhD

Role: backup

0629652920

References

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Riordan EA, Little C, Hunter D. Pathogenesis of post-traumatic OA with a view to intervention. Best Pract Res Clin Rheumatol. 2014 Feb;28(1):17-30. doi: 10.1016/j.berh.2014.02.001.

Reference Type BACKGROUND
PMID: 24792943 (View on PubMed)

Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med. 2007 Oct;35(10):1756-69. doi: 10.1177/0363546507307396. Epub 2007 Aug 29.

Reference Type BACKGROUND
PMID: 17761605 (View on PubMed)

Luc B, Gribble PA, Pietrosimone BG. Osteoarthritis prevalence following anterior cruciate ligament reconstruction: a systematic review and numbers-needed-to-treat analysis. J Athl Train. 2014 Nov-Dec;49(6):806-19. doi: 10.4085/1062-6050-49.3.35.

Reference Type BACKGROUND
PMID: 25232663 (View on PubMed)

Ayral X, Pickering EH, Woodworth TG, Mackillop N, Dougados M. Synovitis: a potential predictive factor of structural progression of medial tibiofemoral knee osteoarthritis -- results of a 1 year longitudinal arthroscopic study in 422 patients. Osteoarthritis Cartilage. 2005 May;13(5):361-7. doi: 10.1016/j.joca.2005.01.005.

Reference Type BACKGROUND
PMID: 15882559 (View on PubMed)

Pulles AE, Mastbergen SC, Schutgens RE, Lafeber FP, van Vulpen LF. Pathophysiology of hemophilic arthropathy and potential targets for therapy. Pharmacol Res. 2017 Jan;115:192-199. doi: 10.1016/j.phrs.2016.11.032. Epub 2016 Nov 24.

Reference Type BACKGROUND
PMID: 27890816 (View on PubMed)

Gupte C, St Mart JP. The acute swollen knee: diagnosis and management. J R Soc Med. 2013 Jul;106(7):259-68. doi: 10.1177/0141076813482831.

Reference Type BACKGROUND
PMID: 23821708 (View on PubMed)

Wang Y, Shimmin A, Ghosh P, Marks P, Linklater J, Connell D, Hall S, Skerrett D, Itescu S, Cicuttini FM. Safety, tolerability, clinical, and joint structural outcomes of a single intra-articular injection of allogeneic mesenchymal precursor cells in patients following anterior cruciate ligament reconstruction: a controlled double-blind randomised trial. Arthritis Res Ther. 2017 Aug 2;19(1):180. doi: 10.1186/s13075-017-1391-0.

Reference Type BACKGROUND
PMID: 28768528 (View on PubMed)

ter Huurne M, Schelbergen R, Blattes R, Blom A, de Munter W, Grevers LC, Jeanson J, Noel D, Casteilla L, Jorgensen C, van den Berg W, van Lent PL. Antiinflammatory and chondroprotective effects of intraarticular injection of adipose-derived stem cells in experimental osteoarthritis. Arthritis Rheum. 2012 Nov;64(11):3604-13. doi: 10.1002/art.34626.

Reference Type BACKGROUND
PMID: 22961401 (View on PubMed)

Schelbergen RF, van Dalen S, ter Huurne M, Roth J, Vogl T, Noel D, Jorgensen C, van den Berg WB, van de Loo FA, Blom AB, van Lent PL. Treatment efficacy of adipose-derived stem cells in experimental osteoarthritis is driven by high synovial activation and reflected by S100A8/A9 serum levels. Osteoarthritis Cartilage. 2014 Aug;22(8):1158-66. doi: 10.1016/j.joca.2014.05.022. Epub 2014 Jun 10.

Reference Type BACKGROUND
PMID: 24928317 (View on PubMed)

Pers YM, Rackwitz L, Ferreira R, Pullig O, Delfour C, Barry F, Sensebe L, Casteilla L, Fleury S, Bourin P, Noel D, Canovas F, Cyteval C, Lisignoli G, Schrauth J, Haddad D, Domergue S, Noeth U, Jorgensen C; ADIPOA Consortium. Adipose Mesenchymal Stromal Cell-Based Therapy for Severe Osteoarthritis of the Knee: A Phase I Dose-Escalation Trial. Stem Cells Transl Med. 2016 Jul;5(7):847-56. doi: 10.5966/sctm.2015-0245. Epub 2016 May 23.

Reference Type BACKGROUND
PMID: 27217345 (View on PubMed)

Other Identifiers

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NL77974.091.21

Identifier Type: -

Identifier Source: org_study_id

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