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NCT Number: NCT05706909

The Use of Genex in the Management of Early-Stage Osteonecrosis of the Femoral Head

The purpose of this study is to assess the clinical and x-ray results of patients who are treated with core decompression of the hip and the injection of a bone marrow concentrate and the use of the Bone Graft Substitute Genex®.

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This study is active but is not currently recruiting participants.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Cleveland Clinic

Cleveland, Ohio, 44195, United States

About this study

Avascular necrosis (AVN) or osteonecrosis (ON) of the femoral head refers to a condition in bone metabolism when cells of the trabecular bone (porous bone found at the end of long bones like the femur) in the hip spontaneously die. Depending on the amount of femoral head involvement, parts of the surface, like the articular surface that do not have blood vessels may collapse as the disease advances. Although the exact common occurrence of AVN or ON is unknown, the incidence is estimated to be between 20,000 to 30,000 newly diagnosed patients each year in the US.

Core decompression of the hip is a minimally invasive surgical technique performed to manage symptoms in early stages (precollapse) of the condition. The procedure involves drilling holes into the femoral head to relieve pressure and create channels for new blood vessels to nourish the affected areas. Multiple adjuncts to core decompression, such as structural bone grafts, bone marrow concentrates, and bone proteins have been developed to accelerate the healing process in these patients. In recent years, considerable research activity has also been expanded to find new bone substitutes with osteoconductive properties (where bone grows on a surface) for the use in the treatment of surgically created defects.

Genex® Bone Graft Substitute is a catalyst for bone healing. It complements the body's natural healing processes and encourages normal bone structure to be restored at a steady rate. Over 12 months, the graft matrix is completely absorbed and replaced by bone. No foreign artifacts are left behind to impair structural integrity.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Subject is at least 18 years or older with osteonecrosis of the femoral head
  • Surgeon considers the patient appropriate for the core decompression procedure of the hip
  • Subject provides voluntarily signature on the IRB approved Informed Consent Form
  • Subject must be physically and mentally willing and able, in the Investigator's opinion at the time of enrollment, to be compliant with the protocol and complete the study protocol and follow ups

Exclusion criteria

  • Subject is pregnant at the time of surgery
  • Subject is incarcerated
  • Subject is not comfortable with speaking, reading and understanding questions and providing responses in an available language for the questionnaires provided for the study

Treatment and study plan

Genex with ABMC

Device

Core decompression, injection of autologous bone marrow concentrate and the use of genex® Bone graft Substitute as an adjunct associated with the decompression procedure

Primary outcomes

  1. Change from baseline X-ray result.

    Time frame: 6 weeks, 12 weeks, 6 months, 12 months post operatively

    Assessment of bone regeneration

  2. Change from baseline MRI result.

    Time frame: 12 months

    Assessment for no further collapse or progression of osteonecrosis

Secondary outcomes

  1. Numeric Pain Scale

    Time frame: Baseline, 6 weeks, 12 weeks, 6 months, 12 months

    To assess pain using the Numeric Pain Scale on a scale of 0-10 with 10 being the worst possible pain report and 0 being no pain

  2. Modified Harris Hip Score

    Time frame: Baseline, 6 weeks, 12 weeks, 6 months, 12 months

    To evaluate the success of the core decompression procedure using the Modified Harris Hip Score by adding up the assigned points for each question, divided by a maximum score of (91) x 100 to create a percentage. A higher score equals a higher level of physical function (100% = full function).

  3. Hip Outcome Score

    Time frame: Baseline, 6 weeks, 12 weeks, 6 months, 12 months

    To assess the outcome of the treatment intervention using the Hip Outcome Score with five possible responses, graded from 0 to 4 with 4 being no difficulty at all and 0 unable to do in regard to physical limitations.

  4. EQ-5D-5L Score

    Time frame: Baseline, 6 weeks, 12 weeks, 6 months, 12 months

    To assess aspects of mobility, self-care, usual activities, pain/discomfort and anxiety/depression using the EQ-5D-5L tool. The EQ-5D-5L descriptive system uses (1) 'not /no problems', (2) 'slight problems', (3) 'moderate problems', (4) 'severe problems', and (5) 'unable to' (mobility, self-care, usual activities), 'extreme' (pain/depression), or 'extremely' (anxiety/depression).

Sponsors and collaborators

Lead sponsor

The Cleveland Clinic

Other

Collaborators

  • Biocomposites Ltd

Registry information

Acronym: Genex

Important dates

Study start
2023
Primary completion
2026
Study completion
2027
First posted
Jan 31, 2023
Registry last updated
Apr 17, 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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