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Comparing Meniscal Repair Biologic Augmentation: Marrow Venting Procedure Versus PRP (MVP Trial)

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The University of Chicago

Status

Enrolling

Conditions

Meniscal Tear

Treatments

Other: Platelet Rich Plasma (PRP)
Other: Bone marrow venting procedure (BMVP)

Study type

Interventional

Funder types

Other

Identifiers

NCT04775004
IRB20-1394

Details and patient eligibility

About

There are no current or past RCT comparing biologic augments for meniscal repair. There is good data supporting both the use of BMVP of the intercondylar notch and intra-articular PRP injections for augmentation of meniscal repair. However, the effectiveness of these augmentation methods with respect to each other has never been investigated. The knowledge gained will allow us to potentially influence and adapt protocols to treat this particular patient population. Additionally, resources available at our institution provide a supportive framework with which to maintain contact with patients after hospital discharge. These key factors will allow us to perform a robust analysis of this population, to include outcomes measures of function as well as meniscal repair failure and reoperation rate.

The proposed interventional aim to compare meniscal repair augmentation methods is novel, as the direct comparison of these outcome measures has not been previously described. Because of the known benefit of biologic augmentation of meniscal repair, the investigators hypothesize that the repair failure rate for both cohorts will be lower than the reported repair failure rate for isolated tears without biologic augmentation; the investigators also hypothesize that BMVP of the intercondylar notch will clinically be significantly better than intra-articular PRP injection. The basis behind this hypothesis is in vivo evidence as well as a small RCT supporting the use of BMVP as augmentation for meniscal repair procedures.

Enrollment

146 estimated patients

Sex

All

Ages

16+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria

  1. Age 16 or older

  2. Medial, lateral, vertical longitudinal, oblique, or radial meniscal tear

  3. Complex tears may be included at the discretion of the site investigator if patient has one of tear patterns listed in inclusion criteria 2 as the most predominant finding

  4. No other concomitant procedure unless one of the following:

    • Chondroplasty
    • Synovectomy
    • Loose body removal
    • "Contralateral" menisectomy (i.e. medial meniscus repair with a lateral menisectomy or lateral meniscus repair with a medial menisectomy) would be permitted for inclusion
    • Any other procedure that does not include drilling, requires prior approval of the study sponsor for each procedure

Exclusion Criteria

  1. Patients requiring cartilage restorative or repair procedures (i.e. OCD fixation, micro-fracture repair, or others)
  2. Patients with meniscus root tears
  3. Patients undergoing repair for horizontal cleavage tears
  4. Kellgren-Lawrence scale 3>
  5. Patients undergoing lateral release
  6. Ipsilateral chondral lesion with Outerbridge classification of 3-4
  7. Use of prednisone or other steroids, any immunosuppressant, or chemotherapy 1-week before surgery or expected use within six weeks after surgery
  8. Cortisone use within the six weeks prior to surgery
  9. Utilizing worker's compensation at the time of screening
  10. Any previous ligament surgery on the index limb. Any previous meniscal surgery on the index meniscus.
  11. Concomitant ligamentous insufficiency
  12. Inflammatory rheumatic disease or other rheumatic disease
  13. Immune compromised patients (hepatitis, HIV, etc.)
  14. Any nicotine based products within the three months prior to surgery (including cigarettes, cigars, vaping, nicotaine patch, etc)
  15. History of distal femur, proximal tibia, or patellar fracture that was treated operatively
  16. Non English-speaking patients

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

146 participants in 2 patient groups

Bone marrow venting procedure (BMVP)
Active Comparator group
Description:
Subjects randomized in the OR to undergo BMVP surgical augmentation
Treatment:
Other: Bone marrow venting procedure (BMVP)
Platelet rich plasma (PRP)
Active Comparator group
Description:
Subjects randomized in the OR to undergo PRP surgical augmentation
Treatment:
Other: Platelet Rich Plasma (PRP)

Trial contacts and locations

3

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Central trial contact

Justin Bell

Data sourced from clinicaltrials.gov

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