Neocartilage Implant to Treat Cartilage Lesions of the Knee

Phase 3

Terminated

• Conditions: Articular Cartilage Disorder; Degeneration; Articular Cartilage; Defect of Articular Cartilage; Chronic Cartilage Injury; Acute Cartilage Injury
• Interventions: Biological: Neocartilage Implant/DeNovo® ET (Engineered Tissue Graft); Other: Microfracture

• Registration Number: NCT01400607
• Lead Sponsor: ISTO Technologies, Inc.

Brief Summary

ISTO Technologies, Inc. is proposing a clinical study with 225 subjects, to establish the safety and efficacy of the Neocartilage Implant for the treatment of ICRS Grade 3 and 4 articular cartilage lesions of the knee compared to microfracture treatment.

Detailed Description

In the United States alone, more than 500,000 cartilage lesions per year require some treatment to reduce pain, restore joint mobility, and prevent further damage caused by the progression of osteoarthritis. The lack of effective cartilage repair approaches or products for restoration of defective articular cartilage to its native, hyaline morphology only continues to exacerbate the incidence of osteoarthritis as these initial defects enlarge and degrade over a 10 to 20 year period. The repair of cartilage, especially in the knee, remains a formidable clinical challenge. Regenerative medicine approaches to cartilage repair have only begun to be explored as possible options and there is a clear trend toward biological solutions for the repair and regeneration of damaged or diseased articular cartilage. The study was designed to compare how well the Neocartilage Implant works against the microfracture therapy, a widely used and accepted cartilage repair therapy. Data to be collected include Pain and Function in Daily Living scores, symptoms, Function in Sports and Recreation, and Knee Related Quality of Life. Additionally, MRI and X-rays will be collected to evaluate the cartilage repair progress. These assessments will be used through the five years of post-operative follow-up.

Study Timeline

• Study Start: 2011-07
• Study First Submitted: 2011-07-20
• Study First Submitted QC: 2011-07-21
• Study First Posted: 2011-07-22
• Status Verified: 2016-09
• Last Update Submitted: 2017-08-29
• Last Update Posted: 2017-08-31
• Primary Completion: 2020-09
• Study Completion: 2020-09

Recruitment & Eligibility

• Status: TERMINATED
• Sex: All
• Target Recruitment: 14

Inclusion Criteria

Generally, the following inclusion criteria must be met, however, this is not a complete list.

• Male or Female between the ages of 18 and 60
• (1) or (2) articular cartilage lesions of the distal femur ranging in no more than 5 cm2 each
• Ipsilateral knee compartment has intact menisci (or meniscectomized remnant with > 5mm wide rim) and stable ligaments in the affected knee
• 3 months out from initiation of conservative non-surgical management (e.g.hyaluronic acid injection, activity modification) or previous minimal surgical intervention (e.g., arthroscopic lavage, debridement) or 12 months out from marrow stimulation for this condition

Exclusion Criteria

Generally, if a potential participant meets any of the following criterions, they will not be eligible for this study. Additionally, more criteria will be evaluated to confirm eligibility as this list is not a complete list of criteria.

• Osteoarthritis
• Rheumatoid arthritis
• History of septic or reactive arthritis
• Gout or a history of gout or pseudo-gout in the affected knee
• Osteochondritis dissecans or osteochondral lesions of the knee with bone loss > 6mm deep
• Bipolar articular cartilage involvement (or kissing lesions) of the ipsilateral compartment (i.e., > than ICRS Grade 2 on the opposing articular surface)
• Associated damage to the underlying subchondral bone requiring an osteochondral graft
• Is pregnant or breast-feeding
• Has a BMI > 35 (kg/m2)
• Has prior total meniscectomy of either knee
• Has received, within the past three months, intra-articular hyaluronic acid therapy, or steroid therapy
• Has more than two clinically relevant chondral lesion(s) on the index knee

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Neocartilage Implant	Neocartilage Implant/DeNovo® ET (Engineered Tissue Graft)	Neocartilage Implant surgically implanted and affixed to subchondral bone using commercial fibrin during mini-open knee arthrotomy.
Microfracture	Microfracture	Standard of care cartilage repair technique.

Primary Outcome Measures

Name	Time	Method
Knee Injury and Osteoarthritis Outcomes Scores (KOOS)	36 months	Knee Injury and Osteoarthritis Outcomes Scores (KOOS) Pain and Function in Daily Living (ADL) subscales.

Secondary Outcome Measures

Name	Time	Method
IKDC Knee Examination	Baseline, 6 week, 6, 12, 18, 24 months and annually through 5 years
Subject reported questionnaires	Baseline, 6 week, 6, 12, 18, 24 months and annually through 5 years	Various questionnaires are required to be completed by the subject before and after treatment throughout the study.

Trial Locations

Locations (9)

Cleveland Clinic; 🇺🇸 Cleveland, Ohio, United States

Kerlan Jobe Orthopaedic Clinic; 🇺🇸 Los Angeles, California, United States

The Ohio State University Sports Medicine Center; 🇺🇸 Columbus, Ohio, United States

Rush University Medical Center; 🇺🇸 Chicago, Illinois, United States

Hospital for Special Surgery -Sports Medicine and Shoulder Service; 🇺🇸 New York, New York, United States

Santa Monica Orthopaedic & Sports Medicine Group; 🇺🇸 Santa Monica, California, United States

The Hawkins Foundation; 🇺🇸 Greenville, South Carolina, United States

Insall Scott Kelly Institute for Orthopaedics & Sports Medicine; 🇺🇸 New York, New York, United States

The Methodist Hospital Research Institute; 🇺🇸 Houston, Texas, United States