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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04840147
Registration number
NCT04840147
Ethics application status
Date submitted
23/03/2021
Date registered
9/04/2021
Titles & IDs
Public title
A Comparison of JointRep® and Microfracture in Repair of Cartilage Lesions on the Femoral Condyle or Trochlea,
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Scientific title
A Randomized, Controlled, Comparative, Single-blinded, Multi-center Study Evaluating JointRep® and Microfracture in Repair of Focal Articular Cartilage Lesions on the Femoral Condyle or Trochlea, The JMAC Trial.
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Secondary ID [1]
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JR001PMAUS01-2020
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Universal Trial Number (UTN)
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Trial acronym
JMAC
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chondral Defect
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Articular Cartilage Defect
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Articular Cartilage Disorder of Knee
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Condition category
Condition code
Musculoskeletal
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Other muscular and skeletal disorders
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Injuries and Accidents
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Fractures
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Devices - JointRep®
Treatment: Surgery - Microfracture
Experimental: Intervention - JointRep® plus microfracture
Other: Control - Microfracture alone
Treatment: Devices: JointRep®
JointRep® is a medical device based on a thermogel polymer (Chitosan) for the treatment of chondral lesions, which consists of an injectable aqueous composition that forms a solid and sticky hydrogel in situ within cartilage defect(s). JointRep® is composed of an injectable thermo-gelling aqueous composition. It is used in conjunction with a Bone Marrow Stimulation type of procedure like Microfracture.
Treatment: Surgery: Microfracture
Microfracture is a bone marrow stimulation type of procedure where after debridement of the damaged chondral tissue within the lesion, obtention of stable vertical margins and curettage of the entire calcified layer, multiple holes are created with a variety of instruments (awls, picks, microdills, nanofracture) to establish a communication with the subchondral bone to create a blood clot to elicit the natural healing process
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Intervention code [1]
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Treatment: Devices
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Intervention code [2]
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Treatment: Surgery
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Lesion fill.
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Assessment method [1]
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Percentage of lesion fill measured by 3D quantitative Magnetic Resonance Imaging (qMRI).
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Timepoint [1]
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24-months post procedure.
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Secondary outcome [1]
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Visual Analogue Scale.
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Assessment method [1]
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Pain score in treated knee using the visual analogue scale from 0(no pain) to 10 (worst pain imaginable) .
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Timepoint [1]
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Baseline and then at 3-months, 6-months, 12-months and 24-months post procedure.
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Secondary outcome [2]
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T2 scores.
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Assessment method [2]
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Difference in quantitative T2 scores between investigational subjects and control subjects measured by qMRI.
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Timepoint [2]
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12 and 24-months post procedure.
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Secondary outcome [3]
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Treatment failure.
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Assessment method [3]
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Proportion of subjects who do not experience a treatment failure and achieve =80% lesion fill (success rate).
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Timepoint [3]
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24-months post procedure.
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Secondary outcome [4]
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Knee Injury and Osteoarthritis Outcome Score (KOOS).
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Assessment method [4]
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Knee Injury and Osteoarthritis Outcome Score (pain, function, symptoms, sports/recreation and quality of life). 100 indicates no problems and 0 indicates extreme problems.
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Timepoint [4]
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6 and 12 and 24-months post procedure.
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Secondary outcome [5]
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Tegner Activity Scale
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Assessment method [5]
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Tegner activity scale provides a level of activity and is scored between 0 and 10. Level 0 is the worst activity level and Level 10 is the best activity level.
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Timepoint [5]
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6 and 12 and 24-months post procedure.
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Secondary outcome [6]
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Magnetic Resonance Observation of Cartilage Repair Tissue 2.0 (MOCART-2) score.
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Assessment method [6]
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MOCART-2 score ranges form 0 (worst outcome) to 100 (best outcome) .
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Timepoint [6]
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6 and 12 and 24-months post procedure.
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Secondary outcome [7]
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Euro Quality of Life-5D (EQ-5D) instrument for measuring quality of life.
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Assessment method [7]
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EuroQol-5D (EQ-5D) instrument for measuring quality of life has two parts. The first assesses health in five parts (mobility, self-care, usual activity, pain/discomfort, anxiety depression) with each scored form 1 (best outcome) to 5 (worst outcome). The second part consists of a visual analogue scale rating perceived health form 0 (the worst imaginable health) to 100 (the best imaginable health).
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Timepoint [7]
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6 and 12 and 24-months post procedure.
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Secondary outcome [8]
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Safety as Adverse Events related to the procedure
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Assessment method [8]
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Evaluation of adverse events.
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Timepoint [8]
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Baseline to 24-months post procedure.
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Eligibility
Key inclusion criteria
* Be between 18-65 years old
* Have one or two focal articular cartilage lesion(s) (ICRS Grade 3 or 4A) on the femoral condyles or trochlea of the index knee; patellar tracking must be normal if the index lesion(s) is on the trochlea. Individually, a lesion can be between 1-7cm2. If more than one lesion is present, the sum of the two lesions should not exceed 10cm2.
* Within 6 months prior to treatment, have a Magnetic Resonance Imaging (MRI) or arthroscopic confirmation of lesion(s) in the index knee.
* For patients older than 40 y.o, to have a radiological Kellgren and Lawrence (K&L) grading from a standing knee radiograph taken less than 6 months previously, Grade 1 or
* If not, an actual test will be performed as part of the visit 1 procedures.
* Have a clinically stable knee, with no ligament deficiencies (<5mm side-to-side difference on Lachman and varus/valgus stress testing & Grade 0 or 1 on Pivot shift test) and the meniscal rims are intact (a maximum of 50% resection is allowed)
* Be able to give voluntary, written informed consent to participate and have signed an Informed Consent Form specific to this study
* VAS pain great than or equal to 4 in the last week.
* Be willing and able to comply with all study procedures including all preoperative, post-operative and rehabilitation requirements
* If female and of child-bearing potential, must report double-barrier, contraceptive use (e.g. use of birth-control pill and condom) for at least 2 months prior to treatment and in the 12 months following treatment.
* If female and of child-bearing potential, have a negative pregnancy test prior to the surgical procedure and no intention of becoming pregnant in the 12 months following treatment.
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Minimum age
18
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Maximum age
65
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Have a Body Mass Index (BMI) >35kg/m2
* Have more than two lesions (ICRS grade 3 or 4A) on any surface in the index knee
* Have "kissing" or opposing lesion(s) (ICRS grade 3 or 4A) of the condyle, tibia or patella in the index knee; additional linear lesions which bear Grade 3 or 4 characteristics may be acceptable if they are determined by the Investigator to be incidental, not clinically relevant, and consistent with the subject demographic
* Have malalignment of >5 degrees varus or valgus in the index knee based on standard AP x-rays requiring an osteotomy
* Have had any surgical treatment for cartilage repair in the index knee within 1 year prior to treatment
* Have had intra-articular injections within 3 months in the index knee
* Have a diagnosis of a concomitant knee injury which may confound assessment of the index knee (e.g., important meniscal injury)
* Have significant pain emanating from other lower body joints in the ipsilateral (hip, ankle) or contralateral (hip, knee, ankle) limb.
* Have known allergies to shellfish
* Have a known history of crystalloid or inflammatory arthropathy
* Have any condition that is unrelated to the index knee and significantly impairs walking ability (e.g., spinal stenosis, sciatica)
* Have advanced musculoskeletal disease
* Have active coagulation disorders
* Are currently using antibiotics
* Are participating concurrently in another clinical investigation, or have participated in a clinical investigation within the last 90 days, or intend to participate in another clinical investigation during the course of the study
* Are currently abusing drugs or alcohol or have a history of the same within the last 12 months
* Have any mental or psychological disorder that would impair their ability to complete the study questionnaires
* Are currently breastfeeding or planning to breastfeed any time during the course of the study
* Are currently a prisoner
* Have significant comorbidities or conditions associated with high-risk for surgical or anesthetic survival (e.g., renal failure, peripheral vascular disease, unstable cardiac disease, poorly controlled diabetes, immunosuppression, etc.)
* Have any medical condition or other circumstances, in the judgment of the investigator, that might interfere with the ability to return for follow-up visits, including any systemic illness, neuromuscular, neurosensory, or musculoskeletal deficiency that would render the subject unable to perform appropriate post-operative rehabilitation
* Have any condition which, in the judgment of the Investigator, would preclude adequate evaluation of the device's safety and performance
Intra-operative
Subjects who meet any of the following intra-operative screening criteria will be excluded from participation in this study:
* Have lesion(s) in the index knee that are not contained (intact shoulders) and/or exceed 7 cm² in total size after debridement for a single lesion and 10cm2 for more than one lesion, if within the same condyle or the trochlea. If only a single lesion suitable to be included is identified, it might be between 1-7cm2.
* Minor concomitant procedures are allowed such as, but not limited to:
1. Removal of loose bodies
2. Plica excision
3. Minor synovial removing
4. Minor chondroplasty (debridement)
5. Lysis of adhesions
6. Meniscal trimming/suturing which respects the exclusion criteria.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
22/09/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/12/2025
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Actual
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Sample size
Target
185
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,QLD,VIC
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Recruitment hospital [1]
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Canberra Orthopaedics and Sports Medicine - Deakin
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Recruitment hospital [2]
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Sydney Knee Specialists - Kogarah
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Recruitment hospital [3]
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Lingard Private Hospital - Newcastle
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Recruitment hospital [4]
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Orthosports - Randwick
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Recruitment hospital [5]
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Cairns Orthopaedic Clinic - Parramatta Park
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Recruitment hospital [6]
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North Queensland Knee - Pimlico
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Recruitment hospital [7]
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Melbourne Orthopedic Group - Melbourne
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Recruitment postcode(s) [1]
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- Deakin
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Recruitment postcode(s) [2]
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- Kogarah
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Recruitment postcode(s) [3]
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- Newcastle
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Recruitment postcode(s) [4]
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- Randwick
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Recruitment postcode(s) [5]
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- Parramatta Park
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Recruitment postcode(s) [6]
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- Pimlico
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Recruitment postcode(s) [7]
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- Melbourne
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Recruitment outside Australia
Country [1]
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Canada
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State/province [1]
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Nova Scotia
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Oligo Medic Pty Ltd
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Address
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Country
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Other collaborator category [1]
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Commercial sector/industry
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Name [1]
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Mobius Medical Pty Ltd.
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
The aim of the study is to compare whether JointRep® plus microfracture is more effective than microfracture alone when treating symptomatic focal articular cartilage lesions in the knee (femoral condyles or trochlea).
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Trial website
https://clinicaltrials.gov/study/NCT04840147
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Bruce Caldwell, MBBS, FRACS
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Address
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Lingard Private Hospital
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Matthias Schurhoff, MD
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Address
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Country
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Phone
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+13054919070
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04840147