Study of Suture Repair of Torn Meniscus in the Knee
Tab Title Description
Describes the nature of a clinical study. Types include:
- Observational study — observes people and measures outcomes without affecting results.
- Interventional study (clinical trial) — studies new tests, treatments, drugs, surgical procedures or devices.
- Medical records research — uses historical information collected from medical records of large groups of people to study how diseases progress and which treatments and surgeries work best.
- Rochester, Minnesota: 14-006973
NCT ID: NCT02237001
Sponsor Protocol Number: CTX-CP001
About this study
Horizontal meniscus tears meeting specified criteria will be repaired by any commonly used suture technique. Subjects will be followed for 2 years to evaluate the effectiveness of the repair, by assessing the re-operation rate, and by assessing improvements in knee pain and knee function.
Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.
Screening Inclusion Criteria:
Subjects of either gender may be eligible for inclusion in the study only if they meet all of the following criteria:
- Able and willing to give informed consent by voluntarily providing written informed consent in accordance with governing Institutional Review Board
- 18 to 60 years of age, inclusive at the time of screening;
- History indicative of meniscal pathology (e.g., pain, mechanical symptoms described as locking, clicking or giving way);
- Physical exam consistent with meniscus tear (e.g., locked joint, joint line tenderness and/or pain on meniscal compression);
- If prior ligament reconstruction, the study knee is clinically stable;
- Preoperative MRI evidence within 6 months consistent with a horizontal/radial/oblique meniscus tear in the symptomatic compartment
Arthroscopy Inclusion Criteria:
Consented subjects may be included in the study only if, upon arthroscopic inspection, their meniscal study lesion meets all of the following criteria established by the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) (see Appendix 1):
- Zone location: circumferential location of tear includes locations within 10mm of the peripheral rim of the meniscus;
- Radial location: any location from anterior to posterior;
- Tear pattern: primarily horizontal or oblique in orientation (not to exceed 45 degrees from horizontal);
- Compartment: either lateral or medial, but not both;
- Opposite compartment meniscal tear (if present) limited to the central portion (i.e., Zone 3/"white zone");
- Tear amenable to repair with all suture-based techniques.
Screening Exclusion Criteria:
Subjects will be excluded from the study for any of the following reasons:
- Arthritis in the study knee (Kellgren-Lawrence Grade 3 or higher [See Appendix 4]);
- Body Mass Index (BMI) ≥35 kg/m2;
- Previous meniscal repair or meniscectomy of the study meniscus;
- Unstable knee;
- Malalignment (> 5 degrees) of the study knee, based on X-ray within 6 months requiring osteotomy and/or requiring correction;
- History of constitutional/systemic inflammatory/arthritic problem or pain condition, history of knee infection, vascular condition of legs, benign neoplasms of knee, hepatitis, HIV, drug/alcohol abuse, tobacco use, cancer;
- Expected to undergo any other primary treatment of the knee;
- Any concomitant painful or disabling disease, condition or post-procedure status of either lower extremity that would interfere with evaluation or rehabilitation of the study knee.
- Pregnant or planning to become pregnant in the next 2 years.
Arthroscopy Exclusion Criteria:
Subjects will be excluded from the study if their study meniscus lesion meets any of the following criteria at arthroscopy:
- Tear pattern: primarily vertical longitudinal in orientation;
- Partial meniscectomy of any portion of the study meniscus extends beyond the central portion (i.e., Zone 3/"white zone");
- Intact or partially intact meniscus tear that, in the opinion of the Investigator, does not require repair;
- Poor meniscal tissue quality such that it will not hold a suture;
- Any portion of the meniscus repair that, in the opinion of the Investigator, is best treated using an implant other than suture;
- Bicompartmental Zone 1/"red zone" and/or Zone 2/"red-white zone" meniscal tears;
- Performance of a significant concomitant procedure intended as a therapeutic intervention on the study knee;
- Arthritis in the surgical knee (International Cartilage Research Society [ICRS] Grade 3b or higher or Modified Outerbridge Grade III or higher)
Participating Mayo Clinic locations
Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.
|Mayo Clinic Location
Mayo Clinic principal investigator
Aaron Krych, M.D.
Closed for enrollment
Despite the well-documented advantages of meniscal repair over meniscectomy, horizontal cleavage tears (HCTs) are often not repaired. Reported reasons include difficulty performing the repair, potential suture failure due to mechanical stresses, and poor healing rates. In addition, many surgeons have the perception that debriding the tear until the superior and inferior laminae are stable results in a good clinical outcome. Furthermore, many of the tears occur in patients who are older than the generally accepted indicated age for repair and may also have a degenerative component, making them potentially less likely to benefit from repair. This review was performed to evaluate the published outcomes of HCT repairs and test the hypothesis that surgically repaired HCTs have an unacceptably low rate of success.
Read More on PubMed