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NCT Number: NCT06040957

Bone Marrow Versus Adipose Tissue as a Cell Source for Infiltrative Treatment of Knee Osteoarthritis

The MAST-GR study is a randomized controlled interventional trial with parallel treatment arms and 1:1 allocation

The primary objective of the study is to compare the safety and efficacy of a single intra-articular infiltration of Bone marrow aspirate concentrate (BMAC) with one of minimally manipulated adipose tissue (MM-AT) so as to determine the most effective cellular product in treating patients with knee osteoarthritis (OA).

The secondary objective is to demonstrate whether intra-articular infiltration of BMAC or MM-AT can induce disease-modifying effects in knee OA by imaging and biological assessments on peripheral blood.

The tertiary objective of the study is to identify factors that influence the clinical response to treatment (baseline characteristics of patients, biological characteristics of the treated knee, characteristics of cellular products, BMAC and MM-AT).

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Key information

Conditions

Knee Osteoarthritis Arthritis Joint Diseases Musculoskeletal Diseases Osteoarthritis Osteoarthritis, Knee Rheumatic Diseases

Age range

40 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Istituto Ortopedico Rizzoli

Bologna, 40136, Italy

Location status: Recruiting

Location contact

Alessandro Di Martino, MD

SUB_INVESTIGATOR

Angelo Boffa, MD

SUB_INVESTIGATOR

Deyanira Contartese, PhD

SUB_INVESTIGATOR

Francesca Veronesi, PhD

SUB_INVESTIGATOR

Gianluca Giavaresi, MD

SUB_INVESTIGATOR

Iacopo Romandini, MD

SUB_INVESTIGATOR

Luca Andriolo, MD

CONTACT

[email protected]

6366567 ext. 051

Marco Franceschini, MD

SUB_INVESTIGATOR

Marco Miceli, MD

SUB_INVESTIGATOR

Melania Maglio, PhD

SUB_INVESTIGATOR

Paolo Spinnato, MD

SUB_INVESTIGATOR

Roberta Licciardi, MSc

CONTACT

[email protected]

6366567 ext. 051

Silvia Brogini, PhD

SUB_INVESTIGATOR

Stefano Zaffagnini, MD

SUB_INVESTIGATOR

Veronica Borsari, PhD

SUB_INVESTIGATOR

Viviana Costa, PhD

SUB_INVESTIGATOR

About this study

Patients with symptomatic unilateral knee OA will be included in a randomized controlled Trial (RCT), in which one group of patients will be treated with 1 intra-articular infiltration of BMAC, and one group will be treated with 1 intra-articular infiltration of MM-AT. A total of 204 patients will be included and will undergo infiltrative treatment after collecting informed consent for study participation and master data. Patients will be clinically evaluated at 0-2-6-12 months follow-up. Possible disease-modifying effects of the two cell products will be investigated by analysis on peripheral blood at 0-2-6-12 months follow-up and by evaluation of radiographic and magnetic resonance imaging (MRI) at 0 and 12 months follow-up. In addition, characterization of the portion of BMAC and MM-AT remaining from treatment will be carried out, as well as baseline assessment of peripheral blood on all patients, and synovial fluid and synovial membrane, where possible, to analyze their influence on clinical outcome.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Patients with symptomatic unilateral knee OA with:

  • Men or women aged 40 to 75 years;
  • Signs and symptoms of OA with a clinical history of gonalgia or swelling for at least 6 months;
  • Radiographic signs of OA (Kellgren-Lawrence grade 1-4);
  • No benefit after at least 4 months of conservative treatment;
  • Ability and consent of patients to actively participate in clinical and radiological (rx and MRI) follow-up;
  • Signing of informed consent.

Exclusion criteria

  • Patients unable to express consent;
  • Patients aged < to 40 and > to 75 years;
  • Patients with axial deviations > 5°;
  • Patients who have suffered trauma or undergone intra-articular infiltration of other substance in the previous 6 months;
  • Patients who have undergone knee surgery in the previous 12 months;
  • Patients with concomitant knee injuries causing joint pain or swelling (-focal full-thickness osteochondral defects, acute meniscal injuries);
  • Patients with malignant neoplasms;
  • Patients with uncompensated systemic diseases (rheumatic diseases, metabolic disorders such as diabetes and thyroid diseases);
  • Patients with infectious diseases;
  • Patients with histories of alcohol or drug abuse;
  • Patients who are pregnant;
  • Patients with allergies to anesthetics used in the procedure.

Treatment and study plan

Bone marrow aspirate concentrate injection

Biological

single intra-articular injection of Bone Marrow aspirate concentrate derived from the patient's iliac crest

intra-articular injection of Minimally manipulated adipose tissue

Biological

single intra-articular injection of Minimally manipulated adipose tissue derived from the patient's abdominal adipose tissue

Primary outcomes

  1. Western Ontario and McMaster University Osteoarthritis index (WOMAC) - Pain subscale

    Time frame: 6 months follow-up

    It is a pathology-specific questionnaire used for the assessment of referred pain at the knee joint level in patients with OA

Secondary outcomes

  1. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)

    Time frame: baseline, 2 months, 6 months, 12 months follow-up

    It's a standardized and widely used questionnaire to assess the condition of patients with osteoarthritis of the knee and includes assessment of pain, stiffness, and physical function of the joints. It can be administered to the patient.

    It measures 5 items for pain (range 0-20), two for stiffness (range 0-8), and 17 for functional limitation (range 0-68) that mainly relate to activities of daily living (e.g., getting up from a sitting position, bending over, going up and down stairs etc.); The score is then normalized on a 0-100 scale. Higher values indicate a worse outcome

  2. Knee Injury and Osteoarthritis Outcome Score (KOOS)

    Time frame: baseline, 2 months, 6 months, 12 months follow-up

    This is a subjective, knee-specific rating scale that is considered one of the most reliable assessment tools in the evaluation of knee pathology. The questionnaire examines the following categories: symptoms, stiffness, pain, daily activities, sports and quality of life

  3. Visual Analogue Scale (VAS)

    Time frame: baseline, 2 months, 6 months, 12 months follow-up

    Visual analog scale consisting of a straight line segment (10 cm length), the ends of which correspond to "no pain" (0) and "the strongest pain imaginable" (10).

  4. EuroQol Visual Analogue Scale (EQ-VAS)

    Time frame: baseline, 2 months, 6 months, 12 months follow-up

    EQ-VAS is a visual analog scale that has a range of scores from 0 (worst imaginable health condition) to 100 (best imaginable health condition).

  5. Tegner Activity Level Scale

    Time frame: baseline, 2 months, 6 months, 12 months follow-up

    Tegner Activity Level Scale is a questionnaire to find out the patient's level of physical activity.All patients will indicate the type of sporting activity performed and its frequency.

  6. Objective parameters- Range of Motion

    Time frame: baseline, 2 months, 6 months, 12 months follow-up

    Evaluation of the Range of Motion for comparative analysis.

  7. Objective parameters - Circumferences

    Time frame: baseline, 2 months, 6 months, 12 months follow-up

    Bilateral trans- and supra- patellar circumferences measurement for comparative analysis

  8. Patient Acceptable Symptom State (PASS)

    Time frame: baseline, 2 months, 6 months, 12 months follow-up

    A tool to assess patient satisfaction in consideration of their current degree of pain, function, and daily activity. Patients can express if their state of health will be satisfying, answering "yes" or "no.

  9. Minimally Clinical Important Difference (MCID)

    Time frame: baseline, 2 months, 6 months, 12 months follow-up

    The patient should indicate the degree of perceived improvement after the infiltrative procedure.

  10. Expectations about the effectiveness of the treatment

    Time frame: baseline

    The patient should indicate at baseline what clinical benefits he or she expects from the treatment according to the question, "What benefits do you expect to get as a result of the treatment you will undergo?" the patient can choose from one of the following items:Full recovery, Definitely better, Much better, Slightly better,No change

  11. Kellgren-Lawrence score

    Time frame: baseline, 12 months follow-up

    The Kellgren Lawrence scale classifies knee OA into 4 grades of subsequent greater severity, the parameters used being reduced joint space and the presence of osteophytes

  12. 3 Tesla Nuclear Magnetic Resonance Imaging (3T MRI)

    Time frame: baseline, 12 months follow-up

    Sequences such as T2-weighted FSE, FS-3D SPGR, and T2 Mapping will be used to assess cartilage thickness and signal, the presence of cysts and subchondral edema, joint profile, the presence of osteophytes and their size, the status of the menisci, both medial and lateral, and the status of the synovium.

  13. Analysis of circulating micro RNAs

    Time frame: baseline, 2 months, 6 months, 12 months follow-up

    miRNAs, involved in OA progression, will be identified and quantified, including miR675-5p, miR-31-5p and miR-33a-5p

Study contacts

Contact information is provided by the study sponsor or research team.

Luca Andriolo, MD

CONTACT

[email protected]

6366567 ext. 051

Roberta Licciardi, MSc

CONTACT

[email protected]

6366567 ext. 051

Sponsors and collaborators

Lead sponsor

Istituto Ortopedico Rizzoli

Other

Registry information

Official study title

Bone Marrow vs Adipose Tissue as a Cell Source for Infiltrative Treatment of Knee Osteoarthritis: Randomized Clinical Trial

Important dates

Study start
2024
Primary completion
2027
Study completion
2027
First posted
Sep 18, 2023
Registry last updated
Feb 20, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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