Safety and Efficacy Study of HYTOP® in the Treatment of Focal Chondral Defects.

TRB Chemedica

Status

Completed

Conditions

Focal Chondral Defect in Femoro-tibial Compartment of the Knee Joint

Treatments

Device: HYTOP®

Study type

Interventional

Funder types

Industry

Identifiers

NCT01791062

CAREKT-DE-2011-12

Details and patient eligibility

About

The two-layer bioresorbable HYTOP® matrix consists of an upper layer of highly purified porcine splint-skin which contains natural pores, and a lower layer of highly purified collagen fleece containing hyaluronan (HA).

In this study, the medical device will be used and evaluated in a one-step procedure combining microfracturing with surgical implantation of HYTOP®. HYTOP® will support haemostasis in the articular cartilage defect, act as a support for cell growth and as a three-dimensional scaffold for cell differentiation. HYTOP® will protect the underlying tissue after cartilage debridement and/or microfracturing of the subchondral bone.

The primary working hypothesis is that HYTOP® is safe and suitable as a cell-free matrix to support haemostasis, as a cover for the cartilage lesion and eventually to enhance cartilage regeneration in a one-step surgical procedure.

Enrollment

2 patients

Sex

All

Ages

18 to 50 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Male and female patients between 18 and 50 years of age.
Good general health condition.
Signed written informed consent.
General anaesthesia is justifiable for the patient from the medical point of view.
Focal chondral defects involving the femorotibial compartment of the knee joint localised in only one compartment and not larger than the size of one HYTOP® patch.
Isolated one-sided chondral lesion.
Cartilage defect classified as Outerbridge grade 3 or 4.
Chondral lesions not exceeding through the subchondral bone (intact subchondral bone).
Nearly intact chondral structure surrounding the defect, specifically Outerbridge grade 2 or less.
Corresponding joint area classified with maximum Outerbridge grade 2.
Clinical symptoms in the target joint (pain on walking 100 m of more than 4 on an 11-point numerical scale or swelling or locking or 'giving way').
Ensured compliance of subjects over the whole study period.

Exclusion criteria

Treatment with any investigational product within 4 weeks prior to study entry.
Patients with known hypersensitivity to the constituents of the product or any component or procedure used in the study.
Patients with previous treatment of the study relevant defect site.
Cartilage lesion is not intact shouldered, has bipolar or corresponding involvement or bipolar 'kissing' lesions.
Necessity of cartilage repair treatment at bilateral joints.
Patients with meniscus lesions, total or partial (more than 1/3 of total volume) resected meniscus, limited joint mobility, varus/valgus joint malalignment of more than 5 degrees or insufficient ligament support.
Inflammatory joint diseases (e.g. rheumatoid arthritis, Bechterew disease, chondromatosis).
Infection at study relevant site.
Osteoarthritis, arthrofibrosis or haematopoetic related diseases.
Study relevant metabolic disease, adipositas (BMI equal to or greater 30 kilogram per square meter).
Study relevant neoplastic, neurological or mental illness.
Study relevant autoimmune disease.
Patients with elevated risk of bleeding.
Recent history of drug and/or alcohol abuse (within the last 6 months).
Pregnant or lactating females.
Participants of childbearing age (pre-menopausal) who do not accept the use of methods of birth control with pearl index more than 1% (e.g. oral contraceptives, vaginal ring, hormone-releasing intrauterine device (IUD), implants, depot syringes, hormone patch, double barrier method, tubal ligation, vasectomised partner,...) during the treatment period and the first 12 weeks of follow-up period.
Subjects unable to understand informed consent or having a high probability of non compliance to the study procedures and/or non completion of the study according to investigator's judgement (e.g. illiteracy, insufficient knowledge of local language).
Subjects not capable of contracting and of understanding the nature, risks, significance and implications of the clinical investigation and unable to form a rational intention in the light of these facts.
Low probability of compliance with after-care rehabilitation scheme.
Forbidden concomitant treatment affecting the evaluation of study parameters (e.g. oral intake of chondroitin sulfate, glucosamine, piascledine, other i.a. treatments like depot corticosteroids or arthroscopic procedures).