Meniscal Tears
Conditions
Keywords
Cartilage Repair, Cartilage Grafting, Meniscus Repair, Meniscus Trimming, Ligament Reconstruction, Cartilage Smoothing, Nanoscope, Nanoscopic Diagnostic Arthroscopy, Knee Joint
Brief summary
The goal of this clinical trial is to look at how well different surgeries heal over time in patients that have previously undergone arthroscopic knee interventions. These procedures may include cartilage repair or grafting, meniscus repair or trimming, ligament reconstruction, cartilage smoothing, and treatments such as amniotic tissue or platelet rich plasma (PRP). Using a very small camera called a nanoarthroscope, doctors will take a "second look" inside the knee after surgery to see how it has healed. These findings will be compared to patient-reported outcomes, such as pain and function scores, as well as images taken during the original surgery. The goal is to determine whether this second look provides useful information that can help guide recovery and future care.
Detailed description
The purpose of this study is to examine the healing potential and mid to long term outcomes of various orthopaedic surgical interventions within the knee joint through a novel modality, bedside nanoarthroscopy. These interventions include but are not limited to: autocartilage grafting, biocartilage grafting, meniscus repair, partial meniscectomy, ligament reconstruction, chondroplasty, as well as amnion placement and platelet rich plasma injection. The "second look" nanoscopic outcomes will be compared to the gold standard patient reported outcome measures as well as time of surgery arthroscopic images. The individuals recruited for the study will participate in one single clinic visit which will entail a nanoscopic evaluation of their knee. Patients will be asked to fill out a standardized battery of validated patient reported outcome measure surveys and will be consented to undergo a "nanoscopic second look" into their knee joint using a nanoscope in the clinic setting. This procedure involves inserting a nanoscopic camera into the knee joint for diagnostic purposes. The nanoscope is no larger than an 18-gauge needle which is routinely used in clinic and hospital settings to deliver injections and perform arthrocentesis. For the patients who agree to participate, the following information will be collected from them and from chart review. Injury, procedure performed, date of procedure, and time since procedure. Key images from preoperative MRI will also be accessed along with arthroscopic images from the time of surgery. Nanoscopic images and patient reported outcome measures as described above will also be collected and secured. Using a comparison of key slices of preoperative MRI, time of surgery arthroscopic images, and nanoscopic second look images, a percentage of healing will be estimated and recorded. This number will then be compared against scores on the patient reported outcome surveys. This will be repeated for all patients enrolled in the study and statistical analysis will be performed to determine if there is a correlation between patient reported outcome scores and percentage of healing at nanoscopic second look. Secondary outcomes will also be analyzed including success/failure of any biologic augmentation type procedures such as cartilage allograft or autograft and/or amniotic membrane use by comparing time of surgery images to nanoscopic second look images It will take approximately 2 years to enroll all study subjects and approximately 3 years to complete this study.
Interventions
PROCEDURENanoscopic Arthroscopy of the Knee
Participants who agree to participate will undergo a postoperative in-clinic nanoscopic arthroscopy of the knee at a routine follow-up visit. A small nanoscope will be inserted into the knee joint in a clinic setting to obtain images that will be used for comparison to the arthroscopic images taken from their surgery and preoperative MRI images. The estimated healing will then be recorded and compared with patient reported outcome survey scores.
Sponsors
Angelina Vera MD
Arthrex, Inc.
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 years and older who have undergone or are scheduled to undergo arthroscopic knee intervention. * Eligible procedures include meniscus repair, biocartilage procedures, and other arthroscopic biologic interventions of the knee * Ability to understand and provide informed consent * Agreement to undergo postoperative in-clinic second-look nanoscopic arthroscopy of the knee.
Exclusion criteria
* Refusal to undergo postoperative in-clinic second-look nanoscopic arthroscopy of the knee. * Inability to provide informed consent. * Individuals who are not yet adults (infants, children, teenagers). * Pregnant women * Prisoners
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Correlation between Estimated Percentage Meniscal Healing at Second Look Nanoscopic Arthroscopy and PROMIS Score. | From baseline (preoperative assessment) to the postoperative second-look nanoscopic arthroscopy visit (3 to 24 months after the index meniscal repair procedure). | The primary outcome measure is the correlation between estimated meniscal repair healing and change from baseline in PROMIS Physical Function T-Score. Meniscal healing will be assessed using postoperative second-look nanoscopic arthroscopy images obtained 3 to 24 months after the index procedure. The Principal Investigator or delegated trained investigator will visually estimate healing of the original repair site from 0% to 100%, where 0% indicates no observable healing and 100% indicates complete healing with continuous, stable tissue bridging. PROMIS Physical Function will be assessed using the PROMIS Bank v2.0 Physical Function CAT at baseline and at the postoperative nanoscopic visit. The relationship between estimated healing percentage and PROMIS Physical Function T-Score change will be assessed using Spearman's rank correlation coefficient. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Estimated Percentage Healing Based on Comparison of Preoperative MRI Intraoperative Arthroscopic Images and Postoperative Nanoscopic Images. | From the index procedure to postoperative second-look nanoscopic arthroscopy visit (3 to 24 months after the index procedure). | The secondary outcome measure is the estimated percentage of meniscal repair healing based on side-by-side review of intraoperative arthroscopic images and postoperative second-look nanoscopic arthroscopy images. Images will be reviewed by the Principal Investigator or delegated trained investigator using protocol-defined healing criteria. Healing will be visually estimated as the proportion of the original meniscal repair site demonstrating healing and recorded as a percentage from 0% to 100%, where 0% indicates no observable healing and 100% indicates complete healing. Healing percentage will be calculated at the postoperative second-look nanoscopic arthroscopy visit, occurring 3 to 24 months after the index procedure. |
Countries
United States
Contacts
CONTACTRobert J Panganiban
CONTACTRobert Bimbi, PhD
PRINCIPAL_INVESTIGATORAngelina Vera, MD, FAAOS, FAANA
University Medical Center of Southern Nevada
Outcome results
None listed