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Rupture of Anterior Cruciate LigamentMARSNCT00625885

Multicenter ACL Revision Study (MARS)

An observational study of Rupture of Anterior Cruciate Ligament, run by Vanderbilt University Medical Center at 49 sites in 2 countries.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The purpose of this study is to determine the effects of modifiable risk factors on patient-reported quality of life, physical activity levels, and risk of early osteoarthritis following revision anterior cruciate ligament (ACL) reconstruction. Read more about this study

Who is it for?
Ages 12 to 65 years
Conditions the study is for
Rupture of Anterior Cruciate Ligament
How many people
1,234 participants
Where
49 sitesin 2 countries
Study dates
26 Mar 2006to 31 Aug 2030
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 12 to 65 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: All ACL-deficient candidates scheduled for a revision ACL reconstruction at one of the participating MARS sites.

Who may be able to join

  • All ACL-deficient candidates presenting to the clinic, between the ages of 12† and 65, scheduled to have a revision ACL reconstruction by a participating (MARS Study) surgeon.
  • All participants must have undergone a primary ACL reconstruction in the past and are currently identified as having experienced failure of their primary ACL reconstruction, as defined by either MRI, knee laxity (KT > 5mm), a positive pivot shift or Lachman's, functional instability, and/or by arthroscopic confirmation.
  • All ACL-deficient patients seeking a revision ACL reconstruction that have either partial (Grade I or II) and/or complete (Grade III) simultaneous ligamentous injuries to the collateral ligaments (MCL or LCL) and/or the posterior cruciate ligament (PCL) will also be included.
  • Non-operative treatment of patients with ACLR failure are also eligible to participate.
  • The following graft types will be the only ones accepted for inclusion:
  • any autograft
Show all 10Show fewer
  • Fresh-frozen allografts from a single donor source (Musculoskeletal Transplant Foundation (MTF); Edison, NJ). These grafts should consist of either:
  • bone-patellar tendon-bone
  • tibialis anterior/posterior
  • achilles tendon

Who cannot join

  • Patients presenting with prior infection, arthrofibrosis, or regional pain syndrome.
  • Subjects will be excluded if their allograft source does not come from MTF.
  • Patients unwilling or unable to complete their repeat questionnaire two years after their initial visit.

Trial locations and contacts

49 sites in 2 countries.

49 sites in 2 countries

United States47 sites
  • University of Michigan

    Ann Arbor, Michigan, 48106

  • Orthopaedic Associates of Aspen and Glenwood

    Aspen, Colorado, 81611

  • Intermountain Orthopaedics

    Boise, Idaho, 83703

  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts, 02215

  • University of Colorado

    Boulder, Colorado, 80304

  • Bridger Orthopaedic and Sports Medicine

    Bozeman, Montana, 59715

  • University of Buffalo

    Buffalo, New York, 14214

  • University of Vermont College of Medicine

    Burlington, Vermont, 05405

  • University of North Carolina Medical Center

    Chapel Hill, North Carolina, 27599

  • Perry Orthopaedics and Sports Med (Carolinas Healthcare System)

    Charlotte, North Carolina, 28211

  • Rush University Medical Center

    Chicago, Illinois, 60612

  • Cleveland Clinic

    Cleveland, Ohio, 44195

  • The Ohio State University

    Columbus, Ohio, 43221

  • UHZ Sports Medicine Institute

    Coral Gables, Florida, 33146

  • W.B. Carroll Memorial Clinic

    Dallas, Texas, 75204

  • Duke University

    Durham, North Carolina, 27710

  • Slocum Research and Education Foundation

    Eugene, Oregon, 97401

  • Connecticut Children's Medical Center

    Farmington, Connecticut, 06032

  • University of Connecticut Health Center

    Farmington, Connecticut, 06034

  • Cheaspeake Orthopaedics and Sports Medicine Center

    Glen Burnie, Maryland, 21061

  • New Hamphsire Knee Center

    Holderness, New Hampshire, 03217

  • Methodist Sports Medicine Center

    Indianapolis, Indiana, 46280

  • University of Iowa

    Iowa City, Iowa, 52242

  • Southeastern Orthopaedics / Knoxville Orthopaedic Clinic

    Knoxville, Tennessee, 37909

  • Scripps Memorial Hospital (OrthoCal Healthcare)

    La Jolla, California, 92123

  • National Sports Medicine Institute

    Lansdowne Town Center, Virginia, 20176

  • University of California - Los Angeles (UCLA)

    Los Angeles, California, 90095

  • Vanderbilt University

    Nashville, Tennessee, 37232

  • Robert Wood Johnson Medical School

    New Brunswick, New Jersey, 08901

  • NYU School of Medicine

    New York, New York, 10016

  • Hospital for Special Surgery

    New York, New York, 10021

  • Manhattan Orthopaedics, P.C.

    New York, New York, 10021

  • The Rothman Institute / Thomas Jefferson University

    Philadelphia, Pennsylvania, 19085

  • University of Pennsylvania

    Philadelphia, Pennsylvania, 19104

  • Booth, Bartolozzi, Balderston Orthopaedics

    Philadelphia, Pennsylvania, 19107

  • Orthopaedic and Fracture Clinic

    Portland, Oregon, 97225

  • Princeton Orthopaedic Associates

    Princeton, New Jersey, 08540

  • Inland Orthopaedics/Washington State University

    Pullman, Washington, 99163

  • Town Center Orthopaedic Associates

    Reston, Virginia, 20190

  • Mayo Clinic

    Rochester, Minnesota, 55905

  • Regions Hospital (Health Partners Research Foundation)

    Saint Paul, Minnesota, 55101

  • San Antonio Orthopaedic Group

    San Antonio, Texas, 78216

  • University of California - San Francisco

    San Francisco, California, 94143

  • Orthopaedic Institute

    Sioux Falls, South Dakota, 57115

  • Washington University at St. Louis

    St Louis, Missouri, 63141

  • Commonwealth Orthopaedics and Rehabilitation

    Vienna, Virginia, 22181

  • Keller Army Community Hospital - USMA

    West Point, New York, 10996

Other trials in United States

Canada2 sites
  • Fowler Kennedy Sports Medicine Clinic/Univ. of Western Ontario

    London, Ontario

  • Royal Columbian Hospital (FraserHealth)

    New Westminster, British Columbia, V3L3W7

Other trials in Canada

About this study

The purpose of this study is to determine the effects of modifiable risk factors on patient-reported quality of life, physical activity levels, and risk of early osteoarthritis following revision anterior cruciate ligament (ACL) reconstruction.

The investigators hypothesize that modifiable variables exist at the time of revision ACL reconstruction (e.g., cause of failure, current graft source and type, surgical exposure, and femoral and tibial tunnel position) which will be predictors of patient-reported outcomes.

Read the detailed description

Injury to the anterior cruciate ligament (ACL) results in a threat to an active lifestyle and exposes the patient to risk of osteoarthritis. ACL reconstruction is typically chosen by individuals to allow a return to their previous work and sports activities. The results of primary ACL reconstruction have in general been good at restoring functional stability. Primary ACL reconstruction has a graft failure rate ranging from approximately 2%-8%. Consensus amongst surgeons and low-level evidence (retrospective case series) indicate a worse outcome following revision ACL reconstruction compared to primary reconstruction. The typical surgeon performs less than 10 revision ACL reconstructions per year. Thus, the ability of any single surgeon or small group of surgeons to accumulate enough cases to effectively analyze predictors for worse outcome is impossible.

With this in mind, the Multi-Center ACL Revision Study (MARS) group was established as a multi-center surgeon group to perform a prospective longitudinal cohort analysis of revision ACL reconstruction. This is a mixed group of academic and private practice physicians and has been supported and endorsed by the American Orthopedic Society for Sports Medicine (AOSSM).

This study focuses on the predictors for ACL revision outcome at 2, 6,10 and 20 years following a patient's revision ACL reconstruction. This will be accomplished by three Specific Aims. Specific Aim 1 will determine the independent predictors of patient-reported quality of life, utilizing a general (SF-36) and knee-specific (Knee Injury and Osteoarthritis Outcome Score - KOOS) validated outcome instrument. Specific Aim 2 will determine the independent predictors of sports function utilizing three validated outcome instruments (the Marx activity level, International Knee Documentation Committee Subjective form - IKDC, and the KOOS sports and recreation subscale). Specific Aim 3 will identify those independent modifiable predictors measured at the time of the revision ACL reconstruction associated with symptoms of knee osteoarthritis at up to 20 years post-surgery. Symptoms will be quantified using the validated survey instrument the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Once the predictors for these worse outcomes are identified, surgeons can be educated in potential modifiable variables to improve the outcome.

Keywords
Anterior Cruciate Ligament/injuries, Anterior Cruciate Ligament/surgery, Knee injuries/surgery, Outcomes research, Prospective Studies
Medical subject headings
Anterior Cruciate Ligament Injuries, Knee Injuries

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Graft re-rupture

    Measured: 2, 6, 10, and 20 years after revision ACL surgery

Secondary outcomes (1)
  1. Patient based outcome measures

    Activity level (as measured by the Marx activity scale). Sports function (as measured by the KOOS and IKDC). Pain and swelling (as measured by the WOMAC).

    Measured: 2, 6,10, and 20 years after revision ACL surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Feb 2008 (estimated)
  2. Study start26 Mar 2006
  3. Primary completion1 Jun 2030 (estimated)
  4. Study completion31 Aug 2030 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
1,234 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00625885
Sponsor's protocol ID
070110
Other IDs
R01AR060846
Acronym
MARS
Status last verified
Aug 2026
First submitted
19 Feb 2008
Last updated
24 Aug 2026
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • MARS Group; Vasavada K, Vasavada V, Moran J, Devana S, Lee C, Hame SL, Jazrawi LM, Sherman OH, Huston LJ, Haas AK, Allen CR, Cooper DE, DeBerardino TM, Spindler KP, Stuart MJ, Ned Amendola A, Annunziata CC, Arciero RA, Bach BR Jr, Baker CL 3rd, Bartolozzi AR, Baumgarten KM, Berg JH, Bernas GA, Brockmeier SF, Brophy RH, Bush-Joseph CA, Butler V JB, Carey JL, Carpenter JE, Cole BJ, Cooper JM, Cox CL, Creighton RA, David TS, Dunn WR, Flanigan DC, Frederick RW, Ganley TJ, Gatt CJ Jr, Gecha SR, Giffin JR, Hannafin JA, Lindsay Harris N Jr, Hechtman KS, Hershman EB, Hoellrich RG, Johnson DC, Johnson TS, Jones MH, Kaeding CC, Kamath GV, Klootwyk TE, Levy BA, Ma CB, Maiers GP 2nd, Marx RG, Matava MJ, Mathien GM, McAllister DR, McCarty EC, McCormack RG, Miller BS, Nissen CW, O'Neill DF, Owens BD, Parker RD, Purnell ML, Ramappa AJ, Rauh MA, Rettig AC, Sekiya JK, Shea KG, Slauterbeck JR, Smith MV, Spang JT, Svoboda SJ, Taft TN, Tenuta JJ, Tingstad EM, Vidal AF, Viskontas DG, White RA, Williams JS Jr, Wolcott ML, Wolf BR, Wright RW, York JJ. A Novel Machine Learning Model to Predict Revision ACL Reconstruction Failure in the MARS Cohort. Orthop J Sports Med. 2024 Nov 14;12(11):23259671241291920. doi: 10.1177/23259671241291920. eCollection 2024 Nov.

    PubMed 39555321
  • MARS Group; Cooper DE, Dunn WR, Huston LJ, Haas AK, Spindler KP, Allen CR, Anderson AF, DeBerardino TM, Lantz BBA, Mann B, Stuart MJ, Albright JP, Amendola AN, Andrish JT, Annunziata CC, Arciero RA, Bach BR Jr, Baker CL 3rd, Bartolozzi AR, Baumgarten KM, Bechler JR, Berg JH, Bernas GA, Brockmeier SF, Brophy RH, Bush-Joseph CA, Butler V JB, Campbell JD, Carey JL, Carpenter JE, Cole BJ, Cooper JM, Cox CL, Creighton RA, Dahm DL, David TS, Flanigan DC, Frederick RW, Ganley TJ, Garofoli EA, Gatt CJ Jr, Gecha SR, Giffin JR, Hame SL, Hannafin JA, Harner CD, Harris NL Jr, Hechtman KS, Hershman EB, Hoellrich RG, Hosea TM, Johnson DC, Johnson TS, Jones MH, Kaeding CC, Kamath GV, Klootwyk TE, Levy BA, Ma CB, Maiers GP 2nd, Marx RG, Matava MJ, Mathien GM, McAllister DR, McCarty EC, McCormack RG, Miller BS, Nissen CW, O'Neill DF, Owens BD, Parker RD, Purnell ML, Ramappa AJ, Rauh MA, Rettig AC, Sekiya JK, Shea KG, Sherman OH, Slauterbeck JR, Smith MV, Spang JT, Svoboda SJ, Taft TN, Tenuta JJ, Tingstad EM, Vidal AF, Viskontas DG, White RA, Williams JS Jr, Wolcott ML, Wolf BR, York JJ, Wright RW. Physiologic Preoperative Knee Hyperextension Is a Predictor of Failure in an Anterior Cruciate Ligament Revision Cohort: A Report From the MARS Group. Am J Sports Med. 2018 Oct;46(12):2836-2841. doi: 10.1177/0363546518777732. Epub 2018 Jun 8.

    PubMed 29882693
  • MARS Group. Meniscal and Articular Cartilage Predictors of Clinical Outcome After Revision Anterior Cruciate Ligament Reconstruction. Am J Sports Med. 2016 Jul;44(7):1671-9. doi: 10.1177/0363546516644218. Epub 2016 May 9.

    PubMed 27161867

Questions about this trial

What is this clinical trial studying?

An observational study of Rupture of Anterior Cruciate Ligament, run by Vanderbilt University Medical Center at 49 sites in 2 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 24 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 49 sites in United States, Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Graft re-rupture (time frame: 2, 6, 10, and 20 years after revision ACL surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00625885, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Aug 2026; AzTrials last refreshed its copy on 27 Oct 2026.

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