Evaluation of rGH Therapy to Prevent Muscle Atrophy in Patients With ACL Tears
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ClinicalTrials.gov Identifier: NCT02420353 |
Recruitment Status :
Completed
First Posted : April 17, 2015
Results First Posted : January 6, 2020
Last Update Posted : January 6, 2020
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Condition or disease | Intervention/treatment | Phase |
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Rupture of Anterior Cruciate Ligament | Drug: Somatropin Drug: Placebo | Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 20 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Triple (Participant, Care Provider, Investigator) |
Primary Purpose: | Treatment |
Official Title: | Evaluation of Recombinant Growth Hormone Therapy to Prevent Muscle Atrophy in Patients With Anterior Cruciate Ligament Tears |
Actual Study Start Date : | May 2015 |
Actual Primary Completion Date : | October 2018 |
Actual Study Completion Date : | October 2018 |

Arm | Intervention/treatment |
---|---|
Active Comparator: Somatropin
Somatropin of rDNA origin
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Drug: Somatropin
GH dose will be calculated by nomogram estimation of body surface area, and will be administered via subcutaneous injection in the abdominal area twice per day (BID) at a dose of 0.5mg GH per body surface area (BSA) in m2 (0.5mg/m2). Patients will begin GH treatment one week prior to surgery and will continue through 5 weeks after surgery. On the day of surgery, patients will not take GH, but otherwise patients will take GH every day over this 6 week period. |
Placebo Comparator: Placebo
A placebo vehicle that contains somatropin diluent but no active hormone.
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Drug: Placebo
A placebo diluent that will be administered via subcutaneous injection in the abdominal area twice per day (BID) at a dose of the equivalent concentration of 0.5mg GH per body surface area (BSA) in m2 (0.5mg/m2). Patients will begin treatment one week prior to surgery and will continue through 5 weeks after surgery. On the day of surgery, patients will not take medication, but otherwise patients will take medication every day over this 6 week period. |
- Normative Isokinetic Knee Extension Strength, Measured in Newton Meters (Nm) at 26 Weeks Post-op [ Time Frame: at 26 wks post-op ]Isokinetic knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isokinetic measurements were performed at a speed of 60º/sec from a range of 0º to 90º of knee flexion. Normalized values were calculated by dividing the value from the injured limb by the value from the contralateral, uninjured leg prior to surgery. For each measurement, the highest force from a series of 5 repetitions was used.
- Normative Isokinetic Extension (Nm) at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]Isokinetic knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isokinetic measurements were performed at a speed of 60º/sec from a range of 0º to 90º of knee flexion. Normalized values were calculated by dividing the value from the injured limb by the value from the contralateral, uninjured leg prior to surgery. For each measurement, the highest force from a series of 5 repetitions was used.
- Normative Isokinetic Flexion (Nm) at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]Isokinetic knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isokinetic measurements were performed at a speed of 60º/sec from a range of 0º to 90º of knee flexion. Normalized values were calculated by dividing the value from the injured limb by the value from the contralateral, uninjured leg prior to surgery. For each measurement, the highest force from a series of 5 repetitions was used.
- Normative Isokinetic Flexion (Nm) at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]Isokinetic knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isokinetic measurements were performed at a speed of 60º/sec from a range of 0º to 90º of knee flexion. Normalized values were calculated by dividing the value from the injured limb by the value from the contralateral, uninjured leg prior to surgery. For each measurement, the highest force from a series of 5 repetitions was used.
- Normative Isometric Extension (Nm) at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]Isometric knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isometric measurements were performed at 45º of knee flexion. Normalized values were calculated by dividing the value from the injured limb by the value from the contralateral, uninjured leg prior to surgery. For each measurement, the highest force from a series of 5 repetitions was used.
- Normative Isometric Extension (Nm) at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]Isometric knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isometric measurements were performed at 45º of knee flexion. Normalized values were calculated by dividing the value from the injured limb by the value from the contralateral, uninjured leg prior to surgery. For each measurement, the highest force from a series of 5 repetitions was used.
- Normative Isometric Flexion (Nm) at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]Isometric knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isometric measurements were performed at 45º of knee flexion. Normalized values were calculated by dividing the value from the injured limb by the value from the contralateral, uninjured leg prior to surgery. For each measurement, the highest force from a series of 5 repetitions was used.
- Normative Isometric Flexion (Nm) at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]Isometric knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isometric measurements were performed at 45º of knee flexion. Normalized values were calculated by dividing the value from the injured limb by the value from the contralateral, uninjured leg prior to surgery. For each measurement, the highest force from a series of 5 repetitions was used.
- Absolute Isokinetic Extension (Nm) at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]Absolute Isokinetic knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isokinetic measurements were performed at a speed of 60º/sec from a range of 0º to 90º of knee flexion. For each measurement, the highest force from a series of 5 repetitions was used.
- Absolute Isokinetic Extension (Nm) at 26 wk Post-op [ Time Frame: at 26 wk post-op ]Absolute Isokinetic knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isokinetic measurements were performed at a speed of 60º/sec from a range of 0º to 90º of knee flexion. Strength values were calculated by comparing the affected limb of each subject across study group. For each measurement, the highest force from a series of 5 repetitions was used.
- Absolute Isokinetic Flexion (Nm) at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]Absolute Isokinetic knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isokinetic measurements were performed at a speed of 60º/sec from a range of 0º to 90º of knee flexion. For each measurement, the highest force from a series of 5 repetitions was used.
- Absolute Isokinetic Flexion (Nm) at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]Absolute Isokinetic knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isokinetic measurements were performed at a speed of 60º/sec from a range of 0º to 90º of knee flexion. Strength values were calculated by comparing the affected limb of each subject across study group. For each measurement, the highest force from a series of 5 repetitions was used.
- Absolute Isometric Extension (Nm) at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]Isometric knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isometric measurements were performed at 45º of knee flexion. For each measurement, the highest force from a series of 5 repetitions was used.
- Absolute Isometric Extension (Nm) at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]Absolute Isometric knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isometric measurements were performed at 45º of knee flexion. Strength values were calculated by comparing the affected limb of each subject across study group. For each measurement, the highest force from a series of 5 repetitions was used.
- Absolute Isometric Flexion (Nm) at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]Isometric knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isometric measurements were performed at 45º of knee flexion. For each measurement, the highest force from a series of 5 repetitions was used.
- Absolute Isometric Flexion (Nm) at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]Absolute Isometric knee flexion and extension strength measurements were obtained in a System 3 dynamometer (BioDex, Shirley, New York). Isometric measurements were performed at 45º of knee flexion. Strength values were calculated by comparing the affected limb of each subject across study group. For each measurement, the highest force from a series of 5 repetitions was used.
- VR12 Health Survey: Physical Health Summary Measure Score at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]The VR-12 includes 12 questions that do not give an overall score but yield a physical and mental component score. PCS and MCS summary scores are standardized using a t-score transformation and normalized to the U.S. population of a score of 50 and a standard deviation of 10. Higher PCS and MCS scores indicate better health. Medical Expenditure Panel Survey (MEPS) collected between 2000 and 2002 standard norms range as followed PCS maximum: 72.11; minimum: 0.59.
- VR12 Health Survey: Physical Health Summary Measure Score at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]The VR-12 includes 12 questions that do not give an overall score but yield a physical and mental component score. PCS and MCS summary scores are standardized using a t-score transformation and normalized to the U.S. population of a score of 50 and a standard deviation of 10. Higher PCS and MCS scores indicate better health. Medical Expenditure Panel Survey (MEPS) collected between 2000 and 2002 standard norms range as followed PCS maximum: 72.11; minimum: 0.59.
- VR12 Health Survey: Mental Health Summary Measure Score at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]The VR-12 includes 12 questions that do not give an overall score but yield a physical and mental component score. PCS and MCS summary scores are standardized using a t-score transformation and normalized to the U.S. population of a score of 50 and a standard deviation of 10. Higher PCS and MCS scores indicate better health. Medical Expenditure Panel Survey (MEPS) collected between 2000 and 2002 standard norms range as followed MCS Maximum: 76.09; Minimum: -2.47.
- VR12 Health Survey: Mental Health Summary Measure Score at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]The VR-12 includes 12 questions that do not give an overall score but yield a physical and mental component score. PCS and MCS summary scores are standardized using a t-score transformation and normalized to the U.S. population of a score of 50 and a standard deviation of 10. Higher PCS and MCS scores indicate better health. Medical Expenditure Panel Survey (MEPS) collected between 2000 and 2002 standard norms range as followed MCS Maximum: 76.09; Minimum: -2.47.
- International Knee Document Committee (IKDC) at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]The IKDC percentage score is a subjective patients reported outcome measure (PROM) that scores a participants over all score. The PROM looks at 3 categories: symptoms, sports activity, and knee function. Scores range from 0 to 100, the final score given is interpreted as a measure of function with higher scores representing higher levels of function.
- International Knee Documentation Committee (IKDC) up to 26 wk Post-op [ Time Frame: up to 26 wk post-op ]The IKDC percentage score is a subjective patients reported outcome measure (PROM) that scores a participants over all score. The PROM looks at 3 categories: symptoms, sports activity, and knee function. Scores range from 0 to 100, the final score given is interpreted as a measure of function with higher scores representing higher levels of function.
- The Knee Injury and Osteoarthritis Outcome Score (KOOS): Patient Reported Outcome Measure: ADL at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]
KOOS Function in daily living (ADL) (17 items). A Likert scale is used and all items have five possible answer options scored from 0 (No Problems) to 4 (Extreme Problems) and each of the five scores is calculated as the sum of the items included. An aggregate total score is not calculated since it is regarded desirable to analyze and interpret the five dimensions separately.
Maximum score 100% / Minimum score 0%. Scores are transformed to a 0-100 scale, with zero representing extreme knee problems and 100 representing no knee problems as is common in orthopaedic assessment scales and generic measures
- KOOS Patient Reported Outcome Measure: ADL at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]
KOOS Function in daily living (ADL) (17 items). A Likert scale is used and all items have five possible answer options scored from 0 (No Problems) to 4 (Extreme Problems) and each of the five scores is calculated as the sum of the items included. An aggregate total score is not calculated since it is regarded desirable to analyze and interpret the five dimensions separately.
Maximum score 100% / Minimum score 0%. Scores are transformed to a 0-100 scale, with zero representing extreme knee problems and 100 representing no knee problems as is common in orthopaedic assessment scales and generic measures
- KOOS Patient Reported Outcome Measure: Pain at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]
KOOS Pain (9 items) A Likert scale is used and all items have five possible answer options scored from 0 (No Problems) to 4 (Extreme Problems) and each of the five scores is calculated as the sum of the items included. An aggregate total score is not calculated since it is regarded desirable to analyze and interpret the five dimensions separately.
Maximum score 100% / Minimum score 0%. Scores are transformed to a 0-100 scale, with zero representing extreme knee problems and 100 representing no knee problems as is common in orthopaedic assessment scales and generic measures
- KOOS Patient Reported Outcome Measure: Pain at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]
KOOS Pain (9 items) A Likert scale is used and all items have five possible answer options scored from 0 (No Problems) to 4 (Extreme Problems) and each of the five scores is calculated as the sum of the items included. An aggregate total score is not calculated since it is regarded desirable to analyze and interpret the five dimensions separately.
Maximum score 100% / Minimum score 0%. Scores are transformed to a 0-100 scale, with zero representing extreme knee problems and 100 representing no knee problems as is common in orthopaedic assessment scales and generic measures
- KOOS Patient Reported Outcome Measure: Quality of Life at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]
KOOS Quality of Life (QoL) (4 items) A Likert scale is used and all items have five possible answer options scored from 0 (No Problems) to 4 (Extreme Problems) and each of the five scores is calculated as the sum of the items included. An aggregate total score is not calculated since it is regarded desirable to analyze and interpret the five dimensions separately.
Maximum score 100% / Minimum score 0%. Scores are transformed to a 0-100 scale, with zero representing extreme knee problems and 100 representing no knee problems as is common in orthopaedic assessment scales and generic measures
- KOOS Patient Reported Outcome Measure: Quality of Life at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]
KOOS Quality of Life (QoL) (4 items) A Likert scale is used and all items have five possible answer options scored from 0 (No Problems) to 4 (Extreme Problems) and each of the five scores is calculated as the sum of the items included. An aggregate total score is not calculated since it is regarded desirable to analyze and interpret the five dimensions separately.
Maximum score 100% / Minimum score 0%. Scores are transformed to a 0-100 scale, with zero representing extreme knee problems and 100 representing no knee problems as is common in orthopaedic assessment scales and generic measures
- KOOS Patient Reported Outcome Measure: Sport and Recreation at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]
KOOS Sport and Recreation (Sport/Rec) (5 items) A Likert scale is used and all items have five possible answer options scored from 0 (No Problems) to 4 (Extreme Problems) and each of the five scores is calculated as the sum of the items included. An aggregate total score is not calculated since it is regarded desirable to analyze and interpret the five dimensions separately.
Maximum score 100% / Minimum score 0%. Scores are transformed to a 0-100 scale, with zero representing extreme knee problems and 100 representing no knee problems as is common in orthopaedic assessment scales and generic measures.
- KOOS Patient Reported Outcome Measure: Sports and Recreation at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]
KOOS Sport and Recreation (Sport/Rec) (5 items) A Likert scale is used and all items have five possible answer options scored from 0 (No Problems) to 4 (Extreme Problems) and each of the five scores is calculated as the sum of the items included. An aggregate total score is not calculated since it is regarded desirable to analyze and interpret the five dimensions separately.
Maximum score 100% / Minimum score 0%. Scores are transformed to a 0-100 scale, with zero representing extreme knee problems and 100 representing no knee problems as is common in orthopaedic assessment scales and generic measures.
- KOOS Patient Reported Outcome Measure: Symptoms at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]
KOOS Symptoms (7 items) A Likert scale is used and all items have five possible answer options scored from 0 (No Problems) to 4 (Extreme Problems) and each of the five scores is calculated as the sum of the items included. An aggregate total score is not calculated since it is regarded desirable to analyze and interpret the five dimensions separately.
Maximum score 100% / Minimum score 0%. Scores are transformed to a 0-100 scale, with zero representing extreme knee problems and 100 representing no knee problems as is common in orthopaedic assessment scales and generic measures
- KOOS Patient Reported Outcome Measure: Symptoms at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]
KOOS Symptoms (7 items) A Likert scale is used and all items have five possible answer options scored from 0 (No Problems) to 4 (Extreme Problems) and each of the five scores is calculated as the sum of the items included. An aggregate total score is not calculated since it is regarded desirable to analyze and interpret the five dimensions separately.
Maximum score 100% / Minimum score 0%. Scores are transformed to a 0-100 scale, with zero representing extreme knee problems and 100 representing no knee problems as is common in orthopaedic assessment scales and generic measures
- Absolute Quadriceps Volume (L) at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]Bilateral MRI scans were obtained at specific time points to assess the muscle volume of the quadriceps and hamstring muscle groups will be calculated using GE ImagePACS software (FDA cleared software which is the standard software used to read and analyze imaging studies in the UMHS).
- Absolute Quadricep Volume (L) at 26 Week Post-op [ Time Frame: at 26 week post-op ]Bilateral MRI scans were obtained at specific time points to assess the muscle volume of the quadriceps and hamstring muscle groups will be calculated using GE ImagePACS software (FDA cleared software which is the standard software used to read and analyze imaging studies in the UMHS).
- Absolute Hamstring Volume (L) at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]Bilateral MRI scans were obtained at specific time points to assess the muscle volume of the quadriceps and hamstring muscle groups will be calculated using GE ImagePACS software (FDA cleared software which is the standard software used to read and analyze imaging studies in the UMHS).
- Absolute Hamstring Volume (L) at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]Bilateral MRI scans were obtained at specific time points to assess the muscle volume of the quadriceps and hamstring muscle groups will be calculated using GE ImagePACS software (FDA cleared software which is the standard software used to read and analyze imaging studies in the UMHS).
- Normalized Quadriceps Volume (L) at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]Normalized volume relative to the pre-op measurements of the uninjured limb, used to assess the muscle volume of the quadriceps and hamstring muscle groups will be calculated using GE ImagePACS software (FDA cleared software which is the standard software used to read and analyze imaging studies in the UMHS).
- Normalized Quadriceps Volume (L) at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]Normalized volume relative to the pre-op measurements of the uninjured limb, used to assess the muscle volume of the quadriceps and hamstring muscle groups will be calculated using GE ImagePACS software (FDA cleared software which is the standard software used to read and analyze imaging studies in the UMHS).
- Normalized Hamstring Volume (L) at Pre-op (Baseline) [ Time Frame: at pre-op (baseline) ]Normalized volume relative to the pre-op measurements of the uninjured limb, used to assess the muscle volume of the quadriceps and hamstring muscle groups will be calculated using GE ImagePACS software (FDA cleared software which is the standard software used to read and analyze imaging studies in the UMHS).
- Normalized Hamstring Volume (L) at 26 Weeks Post-op [ Time Frame: at 26 weeks post-op ]Normalized volume relative to the pre-op measurements of the uninjured limb, used to assess the muscle volume of the quadriceps and hamstring muscle groups will be calculated using GE ImagePACS software (FDA cleared software which is the standard software used to read and analyze imaging studies in the UMHS).
- Insulin Like Growth Factor (IGF1) at -1 and 5 Weeks Post-op [ Time Frame: Area under the curve between -1 and 5 weeks post-op ]IGF1 was measured from serum using an IMMULITE 2000 system (Siemens).
- Myostatin at -1 and 5 Weeks Post-op [ Time Frame: Area under the curve between -1 and 5 weeks post-op ]Myostatin was measured from plasma using ELISAs (R&D Systems, Minneapolis, MN) following manufacturer recommendations.
- MMP3 at -1 and 5 Weeks Post-op [ Time Frame: Area under the curve between -1 and 5 weeks post-op ]Matrix metalloproteinase-3 (MMP3) was measured from serum using ELISAs (R&D Systems, Minneapolis, MN) following manufacturer recommendations.
- Hyaluronic Acid at -1 and 5 Weeks Post-op [ Time Frame: Area under the curve between -1 and 5 weeks post-op ]Hyaluronic acid was measured from plasma using ELISAs (R&D Systems, Minneapolis, MN) following manufacturer recommendations.

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Ages Eligible for Study: | 18 Years to 35 Years (Adult) |
Sexes Eligible for Study: | Male |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Males between the ages of 18 and 35
- Have acute unilateral complete ACL tears with or without bucket handle medial meniscus tears that occurred within the past 6 months
- Consent to undergo an ACL reconstruction by an orthopaedic surgeon using a patellar tendon or hamstring autograft
- Will be performing supervised post-operative rehabilitation at UMHS MedSport at Dominos Farms
Exclusion Criteria:
- Patients who are undergoing a revision ACL reconstruction
- Had a previous injury to the involved knee
- Have an allergy to recombinant GH
- Have a BMI<20 or >35
- Have a growth disorder of bones or connective tissue, type 1 diabetes mellitus, type 2 diabetes mellitus, or who have a history of carpal tunnel syndrome, trigger finger, myopathy, cancer, endocrine disorder, hypertension or rheumatologic disorder.
- Systolic blood pressure >140mm Hg or diastolic blood pressure >90mm Hg, or with resting heart rate >110 BPM or <40 BPM at screening.
- Additionally, because GH is currently listed as a banned substance by the World Anti-Doping Agency (WADA), National Collegiate Athletics Association (NCAA) and most professional sports agencies, we will exclude patients who are current collegiate, professional or elite athletes.

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02420353
United States, Michigan | |
University of Michigan | |
Ann Arbor, Michigan, United States, 48109 |
Principal Investigator: | Christopher L Mendias, PhD, ATC | University of Michigan |
Documents provided by Christopher Mendias, PhD, ATC, University of Michigan:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | Christopher Mendias, PhD, ATC, Associate Professor, University of Michigan |
ClinicalTrials.gov Identifier: | NCT02420353 |
Other Study ID Numbers: |
HUM00087702 IND Exemption 123189 ( Other Identifier: FDA ) |
First Posted: | April 17, 2015 Key Record Dates |
Results First Posted: | January 6, 2020 |
Last Update Posted: | January 6, 2020 |
Last Verified: | December 2019 |
muscle atrophy growth hormone ACL tear |
Muscular Atrophy Atrophy Rupture Pathological Conditions, Anatomical |
Wounds and Injuries Neuromuscular Manifestations Neurologic Manifestations Nervous System Diseases |