Episealer® Knee System IDE Clinical Study

Running, not enrolling · Not applicable

Conditions studied: Degenerative Lesion of Articular Cartilage of Knee

In brief

The study is a randomized, prospective, multicenter, controlled clinical trial of the Episealer Knee System. The Episealer Knee System is intended for subjects with up to two focal femoral knee chondral or osteochondral lesion that is causing pain and/or disability and requires surgical treatment.

Key facts

Study ID

NCT04000659

Run by

Episurf Medical Inc.

People needed

13

Starts

2020-06-18

Expected to finish

2028-06-01

Last updated by the study team

2024-07-30

Who can join

Age: 30 and older, up to 70. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Be ≥ 30 years and ≤ 70 years.
• Have up to 2 symptomatic femoral chondral or osteochondral defects in the index knee on the medial or lateral femoral condyles or the knee trochlea area, which are:
• ICRS Grade 2, 3 or Grade 4
• Each suitable for treatment with 1 Episealer device NOTE: Additional femoral cartilage lesions which, in the opinion of the investigator, are asymptomatic and free from underlying bone lesions (e.g., bone edema) will not be treated.
• Have focal articular defect(s) each with a cartilage lesion area ≥ 1.5 cm2 and ≤ 7.0 cm2.
• Subjects with up to two defects ≥ 1.5 cm2 and ≤ 4.0 cm2, that are surrounded by adequate circumferential cartilage as determined by the investigator, will be randomized.
• Subjects with at least one defect > 4.0 cm2 and ≤ 7.0 cm2, with adequate bony support as determined by the investigator, will not be randomized, and will receive the Episealer device.
• Have screening scores that meet the following criteria:
• Visual Analog Scale (VAS) pain score of the index knee of ≥ 40 mm
• KOOS Overall Score of ≤ 60
• Have experienced knee pain symptoms and undergone prior non-surgical management (e.g., physical therapy, bracing, HA injections) for at least 4 weeks prior to being considered for the study.
• Be able to give voluntary, written informed consent to participate and have signed an Informed Consent Form specific to this study.
• Be willing and able to comply with all study procedures including all pre-operative, post-operative, and rehabilitation requirements.
• If female and of child-bearing potential, must have a negative pregnancy test prior to the surgical procedure and no intention of becoming pregnant in the next 24 months.

You may not qualify if…

• Pre-Operative Exclusion Criteria
• Subjects who meet any of the following pre-operative screening criteria will be excluded from participation in this study:
• Have a Body Mass Index (BMI) greater than 37 kg/m2.
• Have an ICRS Grade 3 or 4 tibial lesion of any size, or an ICRS Grade 4 patella lesion/fissure ≥ 2.0 mm in width in the index knee.
• Have malalignment of >8 degrees varus or valgus in the index knee based on standard AP x-rays.
• Have deficits in flexion or extension of >10 degrees in the index knee as compared to the contralateral knee.
• Have an existing prosthesis in the index knee compartment or opposing joint surface.
• Have joint instability in the index knee due to soft tissue or muscular insufficiency.
• Have a vascular insufficiency at the lesion site that will impair successful microfracture (e.g., avascular necrosis/osteonecrosis, osteochondritis dissecans). (NOTE: This exclusion will not apply to patients with lesions between 4.0-7.0 cm2 who will not undergo randomization and will be treated in the Episealer-only arm).
• Have inadequate bone stock underlying the lesion site, in the opinion of the investigator.
• Have any condition, therapy, or medication that may impair bone healing or prevent adequate implant fixation (e.g., osteoporosis).
• Have a diagnosis of a concomitant knee injury, which in the opinion of the investigator, may confound assessment of the index knee.
• Have any meniscus tears or defects that require resection of more than 1/3 of the meniscus in the compartment to be treated (i.e., medial meniscus when medial femoral compartment is being treated; lateral meniscus when lateral femoral compartment is being treated).
• Have a contralateral knee with symptomatic cartilage, meniscal, or ligamentous lesions; generalized osteoarthritis, or any condition that requires surgery, which in the opinion of the investigator, may confound assessment of the index knee, or any condition that requires surgery.
• Have any condition that is unrelated to the index knee and significantly impairs walking ability (e.g., spinal stenosis, sciatica).
• Have undergone previous treatment with autograft or allograft transfer, synthetic plugs, or microfracture in the index knee within 6 months of screening. (NOTE: Subjects who have undergone debridement at any point in the past are not excluded).
• Have a loss of joint space on standing radiographs (Kellgren-Lawrence Grade ≥3) in the index knee.
• Have an active systemic infection, or an active local infection in or near the index knee, or a previous history of joint infection.
• Have a history of rheumatoid arthritis.
• Have known allergies to any of the materials used in the implant (i.e., Cobalt-Chrome alloy and Titanium).
• Have a contraindication to MRI (e.g., implanted pacemaker, metallic cardiac valve(s), magnetic material such as surgical clips, stent, implanted electronic infusion pumps or any other condition that would prevent the subject from undergoing an MRI).
• Have a known immunodeficiency including subjects who are receiving or have received corticosteroids, immunosuppressants, immunostimulating agents or radiation therapy within 6 months prior to surgery.
• Are participating in another clinical investigation for which they received an investigational product (including, but not limited to, a drug or vaccine) within the last 60 days or report the intention 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 6 months.
• Have any mental or psychological disorder that would impair their ability to complete the study questionnaires.

Where it is running

• Physicians Research Group — Tempe, Arizona, United States
• Horizon Clinical Research — La Mesa, California, United States
• Ochsner Sports Medicine Institute — New Orleans, Louisiana, United States
• Hackensack University Medical Center — Hackensack, New Jersey, United States
• Plancher Orthopaedics & Sports Medicine — New York, New York, United States
• Ohio State University — Columbus, Ohio, United States
• Helios Clinical Research — Jackson, Tennessee, United States
• North Texas Medical Research Institute — Dallas, Texas, United States
• QEII Health Sciences Center — Halifax, Nova Scotia, Canada
• Universitatsmedizin Berlin Charite — Berlin, Germany
• Orthocentrum Hamburg — Hamburg, Germany
• University Hospital Coventry and Warwickshire NHS Trust — Coventry, England, United Kingdom
• University Hospital Southampton NHS Foundation Trust — Southampton, SO16 6YD, United Kingdom

Full record on ClinicalTrials.gov

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