Autologous Tenocyte Implantation in Patients With Chronic Achilles Tendinopathy (ATI)
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Purpose
This study is designed to compare the treatment of 2 groups in patients with Achilles tendinopathy: autologous tenocytes injection in combination with exercises versus saline injection in combination with exercises
| Condition | Intervention | Phase |
|---|---|---|
|
Tendinopathy Achilles Tendon Injury Achillodynia |
Other: Autologous Tenocyte Implantation Other: Saline |
Phase 2 Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | The Value of Autologous Tenocyte Implantation in Patients With Chronic Achilles Tendinopathy: a Double-blind Randomised Clinical Trial |
- VISA-A score [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]a validated instrument to detect the severity of symptoms in patients with Achilles tendinopathy
- Ultrasonographic tendon repair - Ultrasonographic Tissue Characterization (UTC) [ Time Frame: 24 weeks ] [ Designated as safety issue: No ]UTC provides quantitative information on tendon fiber alignment and the related ultra-structural integrity of the tendon tissue through a non-invasive approach and is used in several clinical trials in humans
| Estimated Enrollment: | 90 |
| Study Start Date: | April 2011 |
| Estimated Study Completion Date: | April 2013 |
| Estimated Primary Completion Date: | December 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Autologous Tenocyte Implantation
Ultrasound guided intratendinous ATI (autologous tenocyte implantation) injection with eccentric exercises
|
Other: Autologous Tenocyte Implantation
ultrasound guided intratendinous ATI (autologous tenocyte injection) with eccentric exercises
|
|
Placebo Comparator: Saline injection
Ultrasound guided intratendinous saline injection with eccentric exercises
|
Other: Saline
ultrasound guided intratendinous saline injection with eccentric exercises
|
Detailed Description:
Overuse injury of the Achilles tendon is a common entity. When the exact origin of tendon pain is unclear, the term tendinopathy is preferred. Most accepted treatment at this moment is an eccentric exercise programme, according to the Dutch guidelines. However, a recent systematic review on the effectiveness of eccentric exercises to treat lower extremity tendinoses concluded that it is unclear whether eccentric exercises are more effective than other forms of treatment. Recent studies described new treatment strategies in tendinopathies, such as the use autologous Tenocyte Implantation (ATI). This treatment option can participate actively in tissue repair processes on cell level. The only published clinical pilot study in tendon research reported 60% improvement in all scores after 6 months follow-up.
Eligibility| Ages Eligible for Study: | 18 Years to 55 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Pain on palpation 2-7 cm proximal from the tendon insertion ("midportion")
- Symptoms > 2 months
- Age 18-55 years
Exclusion Criteria:
- Clinical suspicion of insertional disorders , Achilles tendon rupture, plantar flexor tenosynovitis, sural nerve pathology, peroneal subluxation
- Condition of the Achilles tendon caused by medications such as quinolones and statins
- Known to have the following disorders: spondylarthropathy, gout, hyperlipidemia, rheumatoid arthritis and sarcoidosis.
- Antibiotics allergy (aminoglycoside group)
- A condition that prevents the patients from executing an active rehabilitation programme
- Patient has received an injection for this injury
- Patient has received surgical intervention for this injury
- Patient has already one site (left or right) included in this study
- Patient does not wish, for whatever reason, to undergo one of the two treatments
- Known pregnancy
- Nursing women
Contacts and Locations| Contact: S. de Jonge, MD | +31 107044626 | s.dejonge@erasmusmc.nl |
| Netherlands | |
| Sports medicine department Medical Center The Hague | Recruiting |
| Leidschendam, Zuid-Holland, Netherlands, 2262 BA | |
| Contact: J.L. Tol, PhD, MD +31 70 3574235 h.tol@mchaaglanden.nl | |
| Contact: A. Weir, MD +31 70 3574235 a.weir@mchaaglanden.nl | |
| Principal Investigator: J.L. Tol, PhD, MD | |
| Sub-Investigator: S. de Jonge, MD | |
| Principal Investigator: | J.A.N. Verhaar, Prof | Erasmus Medical Center |
| Principal Investigator: | J.L. Tol, PhD | Medical Center The Hague |
More Information
Publications:
| Responsible Party: | Orthopaedic Department, Erasmus Medical Center |
| ClinicalTrials.gov Identifier: | NCT01343836 History of Changes |
| Other Study ID Numbers: | METC10-102 |
| Study First Received: | April 27, 2011 |
| Last Updated: | April 27, 2011 |
| Health Authority: | Netherlands: Ministry of Health, Welfare and Sport |
Keywords provided by Erasmus Medical Center:
|
autologous tenocytes cell therapy eccentric exercises |
Additional relevant MeSH terms:
|
Tendon Injuries Tendinopathy Wounds and Injuries Muscular Diseases Musculoskeletal Diseases |
ClinicalTrials.gov processed this record on May 16, 2013