Anterior Cruciate Ligament InjuriesPhase 4NCT06311513
Concentrated Bone Marrow Aspirate in Revision ACL Reconstruction
A Phase 4 study testing Concentrated Bone Marrow Aspirate Injection and Revision Anterior Cruciate Ligament Reconstruction in people with Anterior Cruciate Ligament Injuries and Post-Traumatic Osteoarthritis of Knee, run by Hospital for Special Surgery, New York at 2 sites in United States.
Trial summary
The goal of this pilot randomized clinical trial is to look into the efficacy of concentrated bone marrow aspirate (cBMA) in improving post traumatic osteoarthritis (PTOA) symptoms in patients undergoing revision anterior cruciate ligament reconstruction surgery. Read more about this study
- Who is it for?
- Ages 18 to 55 years
- Conditions the study is for
- Anterior Cruciate Ligament Injuries, Post-Traumatic Osteoarthritis of Knee, Bone Marrow Aspirate Concentrate
- What is being tested?
- Concentrated Bone Marrow Aspirate Injection and Revision Anterior Cruciate Ligament Reconstruction
- Type of treatment
- Injection or infusion, Surgery or procedure
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 40 participants
- Where
- 2 sitesUnited States
- Study dates
- 22 Jan 2024to Dec 2028
- Phase
- Phase 4
- 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 18 to 55 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Males and Females
- Age 18 to 55
- Previous unilateral ACLR (Anterior Cruciate Ligament Reconstruction) within the last 5 years, and identified as having experienced failure of the primary ACLR
- Scheduled to have a revision ACLR surgery, with any graft type (including patellar tendon, hamstring, quad or allograft)
- Able to complete all study procedures and participate in a standardized physical therapy program
Who cannot join
- History of inflammatory arthritis or joint sepsis
- Prior or concurrent total or sub-total meniscectomy
- Prior or present avascular necrosis of the index knee
- Oral or intra-articular corticosteroid injection within 3 months
- Hyaluronic acid or PRP (Platelet-Rich Plasma) injection within 6 months
- Use of duloxetine, doxycycline, indomethacin, glucosamine and/or chondroitin (ongoing or within 2 months)
- Any clinical or laboratory abnormality greater than grade 3 CTCAE, which in the view of the investigator, will compromise the participant's safety.
- Planned arthroplasty in the index knee
Trial locations and contacts
2 sites in 1 country. Contact the study team or a site near you to ask about taking part.
United States2 sites, 2 recruiting
- Recruiting
Emory Orthopaedics & Spine Center
Atlanta, Georgia, 30097
- Recruiting
Hospital for Special Surgery
New York, New York, 10021
Daniel de la Huerta, MD, 212-606-1000 ext. 2603159, delahuertamezad@hss.edu
Miguel Otero, Ph.D.
About this study
Official title: Multi-Center Pilot Study to Evaluate Concentrated Bone Marrow Aspirate (cBMA) as a Treatment to Modify Post-Traumatic Osteoarthritis (PTOA) Following Revision Anterior Cruciate Ligament Reconstruction (ACLR)
The goal of this pilot randomized clinical trial is to look into the efficacy of concentrated bone marrow aspirate (cBMA) in improving post traumatic osteoarthritis (PTOA) symptoms in patients undergoing revision anterior cruciate ligament reconstruction surgery. The main questions it aims to answer are whether clinical outcomes, such as pain, are improved in patients who get cBMA with surgery, if there is a change in circulating markers of inflammation and what part of the cellular and molecular composition of cBMA may explain its effects.
Read the detailed description
Anterior cruciate ligament reconstruction (ACLR) surgery is considered a relatively safe and effective procedure, however, up to 18% of grafts will fail and require revision surgery. Some studies have shown that these patients may be at increased risk of worse clinical outcomes, including fast progression toward post-traumatic osteoarthritis (PTOA). This is likely in part due to the inflammatory environment created within the joint. Concentrated bone marrow aspirate (cBMA) is a regenerative medicine therapy that contains soluble factors and connective tissue progenitor cells which may have immunomodulatory and pro-regenerative potential. The use of this therapy in conjunction with standard of care surgical treatment may help reduce the inflammatory microenvironment inside the joint, therefore modifying the conditions that might lead to developing long term complications such as PTOA.
The investigators hypothesize that cBMA treatment at the time of revision ACLR may improve clinical outcomes at 1 year after surgery and reduce the risk of developing PTOA-associated symptoms.
Participants will be randomized to either get a cBMA injection (investigational arm) at the time of surgery or a placebo incision (control arm). Biological specimens (blood, urine, synovial fluid), imaging data, functional tests and patient reported clinical outcomes will be measured at different time points during the study, for up to two years after the surgery. This will allow the investigators to evaluate the effect of cBMA in clinical outcomes. Biological specimens will be analyzed using molecular biology techniques to determine their composition, including the concentration of cells and other inflammatory markers.
- Conditions
- Anterior Cruciate Ligament Injuries, Post-Traumatic Osteoarthritis of Knee, Bone Marrow Aspirate Concentrate, ACL Injury
- Being tested
- Concentrated Bone Marrow Aspirate Injection, Sham Incision, Revision Anterior Cruciate Ligament Reconstruction
- Keywords
- Regenerative Medicine, Orthobiologics, Concentrated Bone Marrow Aspirate, Revision ACLR
- Medical subject headings
- Anterior Cruciate Ligament Injuries
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Concentrated Bone Marrow Aspirate InjectionBiological
Also called cBMA, BMAC, Bone Marrow Aspirate Concentrate
Intraoperatively, bone marrow will be harvested from the iliac crest with a commercial kit, it will then be prepared via centrifugation and an injection of the resulting concentrated product (cBMA) will be administered in the operative knee. cBMA is an autologous biologic product.
Sham IncisionProcedure or surgery
A 2 mm sham incision will be made in the anatomical site where bone marrow would be harvested.
Revision Anterior Cruciate Ligament ReconstructionProcedure or surgery
Also called Revision ACLR
This is the standard-of-care surgical procedure.
| Study group | Role | What they receive |
|---|---|---|
| Investigational Arm | Experimental | Patients undergoing revision anterior cruciate ligament reconstruction surgery will get an intraoperative injection of concentrated bone marrow aspirate (cBMA). Receives: Biological: Concentrated Bone Marrow Aspirate Injection; Procedure: Revision Anterior Cruciate Ligament Reconstruction |
| Control Arm | Sham comparator | Patients undergoing revision anterior cruciate ligament reconstruction surgery will get a sham incision in lieu of bone marrow harvesting. Receives: Procedure: Sham Incision; Procedure: Revision Anterior Cruciate Ligament Reconstruction |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change from baseline in patient reported knee pain
The primary outcome measured for this study will be postoperative knee pain. This will be achieved using the Knee Injury and Osteoarthritis Outcome Score (KOOS) standardized questionnaire, which will be electronically delivered to participants at baseline and at 6-weeks, 6-months, 12-months and 24-months postoperatively. This questionnaire measures 42 items in a Likert scale for 5 different dimensions: pain, other symptoms, activities of daily living, function in sports and recreation and knee-related quality of life. The questionnaire is scored as a percentage from 0 to 100, with 0 representing extreme knee problems and 100 indicating no knee related symptoms, and therefore better outcomes.
Measured: Baseline, 6 weeks, 6 months, 12 months and 24 months post-operative
Secondary outcomes (4)
Expression of local inflammatory biomarkers
Synovial fluid collected before and 6 weeks after surgery will be analyzed using ELISA panels, looking for expression and concentration of markers of inflammation (e.g. IL-1β, TNFα) and matrix remodeling (COMP, CTXII)
Measured: Baseline and 6 weeks post-operative
Concentration of circulating inflammatory biomarkers
Biological samples (urine and blood) will be collected intraoperatively, and at 6-weeks and 12-months post-operatively. Samples will be processed and analyzed using ELISA panels, looking for the circulating concentration of markers of inflammation (e.g. IL-1β, TNFα) and matrix remodeling (COMP, CTXII).
Measured: Baseline, 6 weeks and 12 months post-operative
Change from baseline in cartilage morphology
Proton density weighted fast-spin-echo images will be acquired to assess cartilage morphology preoperatively and at 12 months post-operatively. Findings will be scored using the MRI Osteoarthritis Knee Score (MOAKS), which establishes criteria for assessing lesion grade (from 0 - best to 3 - worst) in fourteen distinct subregions.
Measured: Baseline, 12 months post-operative
Change from baseline in articular cartilage relative proteoglycan content and collagen fibril organization
Combined T1ρ-T2 quantitative MRI image acquisition protocol will help determine the changes in relative proteoglycan content and collagen fibril organization within the knee articular cartilage.
Measured: Baseline, 12 months postoperative
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Mar 2024
- Study start22 Jan 2024
- Primary completionDec 2027 (estimated)
- Study completionDec 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Anterior Cruciate Ligament InjuriesStudies of the same condition, open and under way.
- More trials run by Hospital for Special Surgery, New YorkThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- This is a single-blinded randomized controlled trial. Participants will be allocated to either: 1. Investigational arm (Revision ACLR + cBMA) 2. Control arm (Revision ACLR + Sham Incision)
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Hospital for Special Surgery, New York
- Sponsor type
- University, hospital or other
- Collaborators
- Emory University, Arthritis Foundation
- Responsible party
- Sponsor
- Investigators
- Miguel Otero, Ph.D., Principal investigator, Hospital for Special Surgery, New York
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06311513
- Sponsor's protocol ID
- 2023-1017
- Other IDs
- 1177535
- Status last verified
- Nov 2025
- First submitted
- 8 Mar 2024
- Last updated
- 20 Nov 2025
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- Yes
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 20 Nov 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Multi-Center Pilot Study to Evaluate Concentrated Bone Marrow Aspirate (cBMA) as a Treatment to Modify Post-Traumatic Osteoarthritis (PTOA) Following Revision Anterior Cruciate Ligament Reconstruction (ACLR)
- ClinicalTrials.gov ID
- NCT06311513
- Acronym / sponsor ID
- 2023-1017
- Conditions
- Anterior Cruciate Ligament Injuries, Post-Traumatic Osteoarthritis of Knee, Bone Marrow Aspirate Concentrate, ACL Injury
- Keywords
- Regenerative Medicine, Orthobiologics, Concentrated Bone Marrow Aspirate, Revision ACLR
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Hospital for Special Surgery, New YorkUniversity, hospital or other
- Collaborators
- Emory University, Arthritis Foundation
- Study start
- 22 Jan 2024 (actual)
- Primary completion
- Dec 2027 (estimated)
- Study completion
- Dec 2028 (estimated)
- First posted
- 15 Mar 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this pilot randomized clinical trial is to look into the efficacy of concentrated bone marrow aspirate (cBMA) in improving post traumatic osteoarthritis (PTOA) symptoms in patients undergoing revision anterior cruciate ligament reconstruction surgery. The main questions it aims to answer are whether clinical outcomes, such as pain, are improved in patients who get cBMA with surgery, if there is a change in circulating markers of inflammation and what part of the cellular and molecular composition of cBMA may explain its effects.
Detailed description
Anterior cruciate ligament reconstruction (ACLR) surgery is considered a relatively safe and effective procedure, however, up to 18% of grafts will fail and require revision surgery. Some studies have shown that these patients may be at increased risk of worse clinical outcomes, including fast progression toward post-traumatic osteoarthritis (PTOA). This is likely in part due to the inflammatory environment created within the joint. Concentrated bone marrow aspirate (cBMA) is a regenerative medicine therapy that contains soluble factors and connective tissue progenitor cells which may have immunomodulatory and pro-regenerative potential. The use of this therapy in conjunction with standard of care surgical treatment may help reduce the inflammatory microenvironment inside the joint, therefore modifying the conditions that might lead to developing long term complications such as PTOA.
The investigators hypothesize that cBMA treatment at the time of revision ACLR may improve clinical outcomes at 1 year after surgery and reduce the risk of developing PTOA-associated symptoms.
Participants will be randomized to either get a cBMA injection (investigational arm) at the time of surgery or a placebo incision (control arm). Biological specimens (blood, urine, synovial fluid), imaging data, functional tests and patient reported clinical outcomes will be measured at different time points during the study, for up to two years after the surgery. This will allow the investigators to evaluate the effect of cBMA in clinical outcomes. Biological specimens will be analyzed using molecular biology techniques to determine their composition, including the concentration of cells and other inflammatory markers.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
- Model description
- This is a single-blinded randomized controlled trial. Participants will be allocated to either: 1. Investigational arm (Revision ACLR + cBMA) 2. Control arm (Revision ACLR + Sham Incision)
| Arm | Type | Receives |
|---|---|---|
| Investigational Arm | Experimental | Biological: Concentrated Bone Marrow Aspirate Injection, Procedure: Revision Anterior Cruciate Ligament ReconstructionPatients undergoing revision anterior cruciate ligament reconstruction surgery will get an intraoperative injection of concentrated bone marrow aspirate (cBMA). |
| Control Arm | Sham comparator | Procedure: Sham Incision, Procedure: Revision Anterior Cruciate Ligament ReconstructionPatients undergoing revision anterior cruciate ligament reconstruction surgery will get a sham incision in lieu of bone marrow harvesting. |
Who may qualify
- Ages
- 18 to 55 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- Males and Females
- Age 18 to 55
- Previous unilateral ACLR (Anterior Cruciate Ligament Reconstruction) within the last 5 years, and identified as having experienced failure of the primary ACLR
- Scheduled to have a revision ACLR surgery, with any graft type (including patellar tendon, hamstring, quad or allograft)
- Able to complete all study procedures and participate in a standardized physical therapy program
Key exclusion criteria (8 listed)
- History of inflammatory arthritis or joint sepsis
- Prior or concurrent total or sub-total meniscectomy
- Prior or present avascular necrosis of the index knee
- Oral or intra-articular corticosteroid injection within 3 months
- Hyaluronic acid or PRP (Platelet-Rich Plasma) injection within 6 months
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Concentrated Bone Marrow Aspirate InjectionAlso: cBMA, BMAC, Bone Marrow Aspirate ConcentrateIntraoperatively, bone marrow will be harvested from the iliac crest with a commercial kit, it will then be prepared via centrifugation and an injection of the resulting concentrated product (cBMA) will be administered in the operative knee. cBMA is an autologous biologic product. | Biological | Investigational Arm |
| Sham IncisionA 2 mm sham incision will be made in the anatomical site where bone marrow would be harvested. | Procedure or surgery | Control Arm |
| Revision Anterior Cruciate Ligament ReconstructionAlso: Revision ACLRThis is the standard-of-care surgical procedure. | Procedure or surgery | Control Arm, Investigational Arm |
Primary outcome
Change from baseline in patient reported knee pain
Time frame: Baseline, 6 weeks, 6 months, 12 months and 24 months post-operative
The primary outcome measured for this study will be postoperative knee pain. This will be achieved using the Knee Injury and Osteoarthritis Outcome Score (KOOS) standardized questionnaire, which will be electronically delivered to participants at baseline and at 6-weeks, 6-months, 12-months and 24-months postoperatively. This questionnaire measures 42 items in a Likert scale for 5 different dimensions: pain, other symptoms, activities of daily living, function in sports and recreation and knee-related quality of life. The questionnaire is scored as a percentage from 0 to 100, with 0 representing extreme knee problems and 100 indicating no knee related symptoms, and therefore better outcomes.
4 secondary outcomes
Expression of local inflammatory biomarkers
Time frame: Baseline and 6 weeks post-operative
Concentration of circulating inflammatory biomarkers
Time frame: Baseline, 6 weeks and 12 months post-operative
Change from baseline in cartilage morphology
Time frame: Baseline, 12 months post-operative
Change from baseline in articular cartilage relative proteoglycan content and collagen fibril organization
Time frame: Baseline, 12 months postoperative
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Nov 2025.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Miguel Otero, Ph.D. principal investigator
Hospital for Special Surgery, New York
2 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Concentrated Bone Marrow Aspirate Injection and Revision Anterior Cruciate Ligament Reconstruction in people with Anterior Cruciate Ligament Injuries and Post-Traumatic Osteoarthritis of Knee, run by Hospital for Special Surgery, New York at 2 sites in United States.
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 5 inclusion and 8 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: looking for participants now, as of the sponsor's last update on 20 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 2 sites in United States. 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
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?
Contact Daniel de la Huerta, MD (917-260-3159, delahuertamezad@hss.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change from baseline in patient reported knee pain (time frame: Baseline, 6 weeks, 6 months, 12 months and 24 months post-operative). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 20 Nov 2025.