ClinicalTrials.gg
Active, not recruitingNCT02659215FastTRACKUpdated Apr 15, 2026

HyaloFAST Trial for Repair of Articular Cartilage in the Knee

An interventional study of Hyalofast and Microfracture in Defect of Articular Cartilage, sponsored by Anika Therapeutics, Inc.. Active, not recruiting at 48 sites in 9 countries. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-04-15.

Sponsored by Anika Therapeutics, Inc. · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
200
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
All
01

Study summary

The purpose of this study is to evaluate the safety and efficacy of Hyalofast® scaffold with bone marrow aspirate concentrate (BMAC) compared to microfracture in the treatment of symptomatic cartilage defects of the knee.

Read the detailed description
  • Prospective, randomized, active treatment-controlled, evaluator-blinded (radiologist reviewer and physician evaluator) multicenter study (up to 40 sites in the US and EU).
  • All subjects that meet preoperative screening eligibility criteria will be randomized to treatment with Hyalofast® with BMAC or Microfracture.
  • Hyalofast® is a sterile, biodegradable non-woven pad (2 x 2 cm or 5 x 5 cm) that is composed of HYAFF-11®, a benzyl ester of hyaluronic acid. Hyalofast® acts as a biodegradable support for the autologous bone marrow aspirate concentrate. Hyalofast® is soft and conformable and can easily be cut to fit the lesion size.
  • Autologous bone marrow is harvested from the subject intraoperatively during the Index Procedure. Approximately 60 mL of bone marrow will be aspirated from the subject's iliac crest using the SmartPrep 2 Bone Marrow Processing Pack. The cellular rich portion will be concentrated via the SmartPrep BMAC 2 Centrifuge System at point-of-care to provide 7 mL of bone marrow aspirate concentrate (BMAC). 1 - 2 mLs will be used for post-procedure testing of total nucleated cells, cell viability, and sterility.
  • Hyalofast® with BMAC is implanted during either a standard knee arthroscopy or min-arthrotomy depending upon surgeon preferences and intra-operative findings. The lesion to be treated will be debrided to a stable cartilage margin. The defect will be sized and Hyalofast® will be cut to fit the lesion area. If necessary, more than one Hyalofast® pad can be overlapped to cover the lesion. 2 mL of BMAC will be loaded per Hyalofast® scaffold and then implanted to cover the defect. Hyalofast® with BMAC readily adheres to the site of application, but, if necessary, can be secured to the defect margins with an FDA-approved fibrin glue.
  • All subjects will be assessed at intervals post-procedure (1 month, 3 months, 6 months, 12 months, 24 months, and 36 months).
  • Subjects will be required to follow a strict pre-specified post-surgery rehabilitation protocol specific to the defect location.
  • Measures to assess effectiveness will be conducted at follow-ups, with the primary effectiveness endpoint assessment done at the 24 month timepoint.
  • Evaluators doing efficacy assessments of the subject and administering subject-reported outcome instruments will be blinded to the treatment.
  • Safety will be assessed by the collection of adverse events at all timepoints.
  • Magnetic Resonance Imaging (MRI) will be conducted at Screening, 1 month, 12 months, 24 months, and 36 months. Evaluation of the MRIs, including the Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score, will be done by blinded radiologist reviewers. The one month MRI will be used as the baseline MRI for evaluation of treatment effectiveness.
02

Conditions studied

  • Defect of Articular Cartilage

Keywords

  • Hyaluronic Acid
  • Cartilage Repair
  • Knee
03

In context

Lead sponsor

Anika Therapeutics, Inc. is the lead sponsor of 17 studies on the registry; 1 is open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Patient is male or female, between 18 and 60 years of age
  2. Patient's (BMI) is \<35 kg/m2
  3. Patient has a symptomatic lesion of the femoral condyle (medial and/or lateral) or femoral trochlea that is between 1.5 - 6 cm2 on screening images confirmed by the independent radiologist
  4. The symptomatic lesion is classified as International Cartilage Repair Society (ICRS) grade 3 or 4
  5. Patient agrees to actively participate in a strict rehabilitation protocol and follow-up program
  6. Patient is using only nonsteroidal anti-inflammatory drugs or acetaminophen/paracetamol during the month before signing the form to treat knee pain
  7. Patient is willing and able to provide informed consent and comply with study requirements
  8. Patient, if woman of , must have a negative pregnancy test at Screening, cannot be lactating and is willing to use adequate for the first 12 months of the study after the last surgery
  9. Patient has ability to consistently rate knee pain and function as demonstrated by completion of total KOOS score
  10. Patient has a minimum of 45 out of 100 Visual Analogue Scale (VAS) score for index knee pain when remembering index knee pain when not on medication and when active
  11. Patient is willing to use other pain medication rather than Non-steroidal Anti-inflammatory Drugs (NSAIDS) for 6 months post-surgery (e.g. acetaminophen, or narcotic analgesics, if prescribed). Post-surgical use of aspirin for clot prevention is acceptable.
  12. Patient is willing to restrict pain medication after 6 months post-surgery to NSAIDs or acetaminophen/paracetamol only through the end of the trial
  13. Patient must have Hematocrit ≥ 28.0%; White Blood Cell count ≤ 14,000; Count ≥ 50,000; Creatinine ≤ 2.0 mg/dL; and (INR) ≤ 1.6

Exclusion criteria

Exclusion Criteria:

  1. Major concomitant cartilage lesions which require extensive surgical treatment. (Lesions such as minor loose bodies, small debris fragments, small cartilage fragments or prominent knee fat pad are allowed. These lesions may be treated with debridement).
  2. Presence of a kissing bipolar lesion that is apposed to the index lesion and is deeper than Grade 2 (ICRS classification) as determined by MRI. (Presence of a kissing (bipolar) lesion that is apposed to the index lesion and is deeper than Grade 2 and is discovered under arthroscopy are allowed). The non-index lesion, if indicated for treatment, should be treated with the study assigned treatment of the index lesion.
  3. Diagnosed advanced osteoarthritis as demonstrated by a Kellgren-Lawrence grade of 3 or 4 in the index knee
  4. Complex ligamentous instability of the index or contralateral knee. (Previous reconstructions of Anterior Cruciate Ligament (ACL) or Posterior Cruciate Ligament (PCL) are allowed, of either the index or contralateral knee, if instability is not present. Grade 1 ligamentous injury are allowed)
  5. Infections or skin diseases at target knee joint
  6. Osteochondritis dissecans (OCD)
  7. Patients requiring meniscal arrow or meniscal sutures
  8. Previous meniscal transplant in the index knee
  9. Patients with previous total or functional meniscectomy. (Patients with a previous partial meniscectomy and a meniscus that is considered biomechanically functional are allowed)
  10. Varus or valgus malalignment exceeding 10° in either knee
  11. Patient requiring concomitant surgical procedures at the time of Index Procedure such as osteotomies (e.g. high tibial valgus and/or patellar realignment osteotomy), bone subchondral perforation, ligament surgery, meniscal surgeries etc.
  12. Previous cartilage repair procedure (microfracture, Osteochondral autograft transplantation system (OATS) or Autologous Chondrocyte Implantation (ACI) with or without use of a scaffold (matrix) in the index knee
  13. Previous failed microfracture procedure in index knee. (Previous history of microfracture in the contralateral knee is allowed)
  14. Known (allergy) to hyaluronate
  15. (s) to microfracture surgery
  16. Hyaluronic acid intra-articular injections into the index knee within the last 90 days before signing
  17. therapy by systemic or intra-articular route within the last 60 days before informed consent or intramuscular or oral corticosteroids within the last 30 days before informed consent.
  18. Uncontrolled diabetes
  19. Any concomitant painful or disabling disease of the spine, hips, or lower limbs, including the contralateral knee, that would interfere with evaluation of the index knee
  20. Any or symptomatic vascular or neurologic disorder of the lower extremities
  21. Any evidence of the following diseases in the index knee: septic arthritis; inflammatory joint disease; gout; recurrent episodes of pseudogout; Paget disease of bone; ochronosis; acromegaly; hemochromatosis; Wilson disease; primary osteochondromatosis; heritable disorders; collagen gene mutations
  22. Rheumatoid arthritis or gouty arthritis
  23. Current diagnosis of osteomyelitis
  24. Any result from screening blood work (including complete blood count, (PT)/Partial Thromboplastin Time (PTT)/INR, liver function, and creatinine) that exceeds 1.5x the or is below 0.5x the lower limit of normal.
  25. Diagnosed musculoskeletal cancer or any diagnosed cancer, other than musculoskeletal if not on long term remission (e.g. at least 5 years or negative at last exam), except basal cell carcinoma
  26. Alcohol and drug (including medication) abuse
  27. Patients who are at higher risk for post-surgical bleeding (e.g., bleeding disorder; taking anticoagulants except low dose aspirin) or post-surgical infection (e.g., taking ; have a severe infection or a history of serious infection)
  28. Contraindications to MR imaging
  29. Patient is currently receiving workman's compensation or disability or is in litigation for workman's compensation or disability claims
  30. Participation in concurrent trials or in previous trial within 90 days of signing informed consent
Terms in these criteria, in plain language(13)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
200 participants (actual)

Study arms

  • Experimental
    Hyalofast with BMAC

    A hyaluronan-based scaffold (Hyalofast®) is utilized together with autologous bone marrow aspirate concentrate (BMAC) in a one-step arthroscopic/mini-arthrotomic procedure.

    Device: Hyalofast

  • Active comparator
    Microfracture

    Microfracture is an arthroscopic surgical technique involving placement of microfracture penetrations within the cartilage defect to provide stem cells and growth factors from the bone marrow to aid cartilage repair.

    Procedure: Microfracture

Interventions

  • DeviceHyalofast

    Implantation of Hyalofast scaffold with autologous bone marrow aspirate concentrate via arthroscopy/mini-arthrotomy.

  • ProcedureMicrofracture

    Microfracture is a well-established arthroscopic surgical technique for cartilage repair which involves several systematic steps, including debridement to a stable cartilage margin, careful removal of the calcified cartilage layer, and homogeneous placement of microfracture penetrations within the cartilage defect, with resultant complete defect fill by a well-anchored clot

06

What researchers measure

Primary outcomes

  1. Superiority of Hyalofast with Bone Marrow Aspirate Concentrate (BMAC) vs. Microfracture for % Change in Knee injury and Osteoarthritis Outcome Score (KOOS) Pain Score

    Co-primary endpoint

    Time frame: 2 years post-surgery

  2. Superiority of Hyalofast with Bone Marrow Aspirate Concentrate (BMAC) vs. Microfracture for % Change in International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Score

    Co-Primary Endpoint

    Time frame: 2 years post-surgery

Secondary outcomes

  1. Superiority of Hyalofast® with autologous BMAC vs. Microfracture for change in MRI MOCART Score from baseline to two years post-surgery

    Time frame: 2 years post-surgery

  2. Superiority of Hyalofast® with autologous BMAC vs. Microfracture for change in Evaluator Global Assessment from baseline to two years post-surgery

    Time frame: 2 years post-surgery

  3. Superiority of Hyalofast® with autologous BMAC vs. Microfracture in change in individual KOOS subscales from baseline to two years post-surgery

    Time frame: 2 years post-surgery

  4. Superiority of Hyalofast® with autologous BMAC vs. Microfracture in change in IKDC Knee Examination Form domains from baseline to two years post-surgery

    Time frame: 2 years post-surgery

  5. The incidence, timing, severity, and relationship to treatment of all Adverse Events (AE), will be collected for all participants.

    Time frame: 3 years post-surgery

07

Study locations

48 sites
  • Physicians Research Group
    Tempe, Arizona 85284, United States
  • Axis Clinical Trials
    Los Angeles, California 90036, United States
  • Kerlan-Jobe Orthopedic Clinic
    Los Angeles, California 90045, United States
  • BioSolutions Clinical Research Center
    San Diego, California 91942, United States
  • New Hope Research Development
    Tarzana, California 91356, United States
  • Orthopedic Foundation
    Stamford, Connecticut 06905, United States
  • Paramount Trials, LLC
    Miami, Florida 33016, United States
  • Suncoast Clinical Research
    New Port Richey, Florida 34652, United States
  • OrthoIllinois
    Rockford, Illinois 61107, United States
  • Bone and Joint Clinic of Baton Rouge
    Baton Rouge, Louisiana 70808, United States
  • Covington Orthopedic and Sports Medicine Institute
    Covington, Louisiana 70433, United States
  • Clinical Research Center of Nevada
    Las Vegas, Nevada 89121, United States
  • New York Presbyterian Hospital
    New York, New York 11355, United States
  • Ohio State University Wexner Medical Center
    Columbus, Ohio 43221, United States
  • Penn Medicine
    Philadelphia, Pennsylvania 19104, United States
  • Austin Ortho Biologics / Seton Medical Center Austin
    Austin, Texas 78705, United States
  • Baylor Scott & White
    Temple, Texas 76508, United States
  • Epic Medical Research
    Murray, Utah 84123, United States
  • University Hospital Tulln
    Tulln, Lower Austria 3430, Austria
  • Kepler University Clinic
    Linz, Upper Austria 4021, Austria
  • Krankenhaus der Barmherzigen Schwestern
    Ried, Upper Austria 4910, Austria
  • Medical University of Graz
    Graz, Austria
  • Universtitatsklinkik Krems
    Krems, 3500, Austria
  • Medical University of Vienna
    Vienna, 1090, Austria
  • Evangelisches Krankenhaus
    Vienna, 1180, Austria
  • Private Hospital Doebling
    Vienna, 1190, Austria
  • Ortopeedia Arstid AS
    Tallinn, 10138, Estonia
  • North Estonia Medical Center
    Tallinn, 13419, Estonia
  • Health Center of Downtown-Lipotvaros, Orthopedic Outpatient Clinic (Belvárosi-Lipótvárosi Egészségügyi Szolgálat Ortopeadia)
    Budapest, 1051, Hungary
  • Semmelweis Egyetem Orthopaedic Clinic (Ortopédiai Klinika)
    Budapest, 1113, Hungary
  • Uzsoki Hospital, Department of Traumatology
    Budapest, 1145, Hungary
  • Jutrix Medical Llc
    Budapest, 6000, Hungary
  • Menta Egeszsegkozpont Kft.
    Budapest, H-1115, Hungary
  • Magyar Honvedseg, Egeszseugyi Kozpont, Balesteti Sebeszeti Osztaly
    Budapest, Hungary
  • DE KK Ortopediai Klinika
    Debrecen, Hungary
  • Somogy Megyei Kaposi Mór Oktatókórház
    Kaposvár, Hungary
  • Kastelypark Klinka
    Tata, Hungary
  • Medistra Hospital
    Jakarta, Indonesia
  • Royal Progess Hospital
    Jakarta, Indonesia
  • Instituto Ortopedico Rizzoli
    Bologna, Italy
  • A.O. Universitaria San Martino Monoblocco
    Genova, 16132, Italy
  • University Federico II
    Naples, 80131, Italy
  • AB "Ortopedijos technika"
    Kaunas, LT-49476, Lithuania
  • Vilnius University Hospital Santaros klinikos
    Vilnius, LT-08661, Lithuania
  • Desarrollo Ético en Investigación Clínica S.C.
    Guadalajara, CP 44500, Mexico
  • Cruz Roja Mexicana (Hospital de Ortopedia de la Cruz Roja Mexicana)
    Mérida, CP 97166, Mexico
  • Hospital Universitario Dr. José Eleuterio González
    Monterrey, Mexico
  • De La Salle Medical and Health Sciences Institute
    Cavite, Philippines
08

References and documents

Publications

  • Shah SS, Lee S, Mithoefer K. Next-Generation Marrow Stimulation Technology for Cartilage Repair: Basic Science to Clinical Application. JBJS Rev. 2021 Jan 19;9(1):e20.00090. doi: 10.2106/JBJS.RVW.20.00090. PubMed 33512974 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Dec 2015 to primary completion in Mar 2025, 111 months.

How these figures are worked out, and which studies are left out of them.

Registered
Jan 14, 2016
First posted
Jan 20, 2016
StartActual
Dec 2015
Primary completionActual
Mar 20, 2025
CompletionEst.
Jun 30, 2026
Results delay requested
Jan 21, 2026
Last update
Apr 15, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Apr 15, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02659215
Lead sponsor
Anika Therapeutics, Inc.
Responsible party
Sponsor
First posted
Jan 20, 2016
Start date
Dec 2015
Primary completion
Mar 20, 2025
Completion
Jun 30, 2026 (estimated)
Last update
Apr 15, 2026

Study contacts

Alberto Gobbi, MD
principal investigator · OASI Bioresearch Foundation

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is active, not recruiting, as verified in Apr 2026. You cannot join it, but the record below documents what was studied.

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