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CompletedNCT03462823ACLROCSUpdated Jul 7, 2026

Use of an Osteoconductive Scaffold in ACL-Reconstruction

An interventional study of Osteoconductive scaffold-hamstring tendon composite repair and Hamstring tendon-only repair in ACL - Anterior Cruciate Ligament Rupture, ACL and ACL Injury, sponsored by Sandro Fucentese. Completed at 1 site in Switzerland. Open to participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2026-07-07.

Sponsored by Sandro Fucentese · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
56
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
All
01

Study summary

Primary objective of the study is to evaluate efficacy of the surgical technique for ACL reconstruction using an osteoconductive scaffold, enlaced into the hamstring tendon autograft, compared to the traditional technique.

Read the detailed description

Reconstruction of the anterior cruciate ligament (ACL) using autograft tissue is currently recommended as the standard of care following an ACL tear or rupture, with the bone-tendon-bone (BTB) graft and hamstring tendon graft the most common. Although a BTB autograft is widely recognized to offer high mechanical performance and rapid graft healing, these advantages come at the cost of a longer surgery time and higher risk of severe patient discomfort at the graft harvest site. Use of a hamstring tendon autograft is less painful, but is generally slower to heal with higher risk of mechanical graft failure due to poor bone ingrowth. The aim of the current study is to augment graft-to-bone incorporation by use of an osteoconductive scaffold enlaced into the hamstring tendon autograft. This bovine derived composite bone substitute is inserted into the articular aperture of the femoral bone tunnel and should provide an osteoconductive / osteoinductive environment at a biomimetic attachment site leading to improved secondary graft-fixation and a reduced incidence of tunnel widening.

Primary objective of the study is to evaluate efficacy of the surgical technique for ACL reconstruction using an osteoconductive scaffold, enlaced into the hamstring tendon autograft, compared to the traditional technique.

Secondary objectives aim to assess the clinical outcome of the interventional treatment including patient subjective knee function and objective measures of knee stability.

02

Conditions studied

  • ACL - Anterior Cruciate Ligament Rupture
  • ACL
  • ACL Injury

Keywords

  • ACL Reconstruction
  • Osteoconductive Scaffold
  • Bone Tunnel Widening
03

Who can participate

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

Inclusion criteria

  • Acute unilateral complete tear of the ACL that occurred within 18 weeks before planned surgery and requires reconstruction of the
  • Informed consent as documented by signature

Exclusion criteria

Exclusion Criteria:

  • Prior ACL reconstruction or other surgical procedure on the affected knee.
  • Prior fracture of the affected leg.
  • Multi-ligament reconstruction.
  • Previous or current ACL injury on contra-lateral leg.
  • Medical condition or comorbidity that would interfere with study participation.
  • The patient is mentally compromised.
  • Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant.
  • Other clinically significant concomitant disease states (e.g. renal failure, hepatic dysfunction, cardiovascular disease, etc.).
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Participant)
Enrollment
56 participants (actual)

Study arms

  • Active comparator
    Control treatment

    ACL-reconstruction using hamstring autograft with hybrid fixation in accordance with in-house standard of care.

    Device: Hamstring tendon-only repair

  • Experimental
    Experimental treatment

    ACL-reconstruction using hamstring autograft with hybrid fixation combined with the osteoconductive device under study.

    Device: Osteoconductive scaffold-hamstring tendon composite repair

Interventions

  • DeviceOsteoconductive scaffold-hamstring tendon composite repair

    The device under study is a composite bone substitute composed of a natural mineral matrix of bovine origin, reinforced with biodegradable synthetic polymers and natural collagen derivatives of bovine origin (smartbone, IBI S.A., Switzerland).

  • DeviceHamstring tendon-only repair

    ACL-reconstruction using hamstring autograft with hybrid fixation in accordance with in-house standard of care.

05

What researchers measure

Primary outcomes

  1. Bone tunnel volume

    CT based relative change of the femoral bone tunnel volume from baseline to follow-up 1 and 2.

    Time frame: 0, 4.5, 12 months post surgery

Secondary outcomes

  1. IKDC Subjective Knee Evaluation Form

    International Knee Documentation Committee Subjective Knee Evaluation Form is designed to detect improvement or deterioration in symptoms, function and sports activities due to knee impairment for patients with a variety of knee conditions including ligament injuries. It is a patient-completed questionnaire available in multiple languages including German with an ordinal scoring system ranging from 0 (highest level of symptoms or lowest level of function) to 100 (no limitation with daily or sporting activities and the absence of symptoms).

    Time frame: 0 and 42 days, 6 months, 1, 2 and 5 years post surgery

  2. Lysholm Knee Scoring Scale

    To evaluate outcomes of knee ligament surgery, particularly symptoms of instability. It has an ordinal scoring system ranging from 0 to 100 (No symptoms or disability). A validated German version will be used.

    Time frame: 0 and 42 days, 6 months, 1, 2 and 5 years post surgery

  3. Tegner Activity Scale

    The Tegner activity scale (TAS) is used to measure the change in physical activity from pre-injury to follow-up. Patient's activity is scored on a scale with 11 levels from level 0 (on sick leave/disability) to level 10 (participation in competitive sports such as soccer at a national or international elite level). Evaluated will be the difference in score from pre-injury (assessed at baseline visit) to follow-up.

    Time frame: 0 and 42 days, 6 months, 1, 2 and 5 years post surgery

  4. KT-1000 Arthrometer Test

    The KT-1000 Arthrometer Test measures anterior displacement of the tibial plateau on the femur at a specific force. Its output variable is defined as the difference in full millimeters between the tibial displacement of the ACL reconstructed knee and the normal contralateral side.

    Time frame: 0 and 42 days, 6 months, 1, 2 and 5 years post surgery

  5. Lachmann Test

    The Lachman test measures anterior displacement conducted manually by the clinician. It is graded as the difference from the normal contralateral side as 0 (\<3 mm), 1 (3 to 5 mm), or 2 (\>5 mm).

    Time frame: 0 and 42 days, 6 months, 1, 2 and 5 years post surgery

  6. Pivot shift test

    The pivot shift test assesses the combined tibio-femoral rotation and anterior tibial translation. The pathologic motion elicited is graded as a glide (grade 1), clunk (grade 2), or gross clunk with locking (grade 3). A normal finding is graded as zero. The outcome measure is calculated from the difference between affected (repaired) and intact knee.

    Time frame: 0 and 42 days, 6 months, 1, 2 and 5 years post surgery

  7. Bone tunnel width

    Bone tunnel width will additionally be assessed on plain radiograph. Standard posteroanterior radiographs of the knee in full extension will be used. Bone tunnel width will be assessed at the widest part of the femoral bone tunnel. Assessed will be the relative change in femoral bone tunnel width.

    Time frame: 0 and 42 days, 12 and 24 months post surgery

  8. Osteoconductive scaffold-bone integration

    For a quantitative analysis of Osteoconductive scaffold (OCS)-bone integration, the mineral density profile along a predefined line will be examined. A slice showing the central portion of the OCS in the axial plane will be selected. A straight line of 2 cm length will be drawn perpendicular to the long axis of the OCS using image analysis software (Mimics). The CT-values along this line will be recorded and evaluated in the following way. Since the CT-values change according to the bone mineral density, the profile along the line will have a minimum at the interface of the tunnel wall and the OCS and a maximum on the OCS. The difference in Hounsfield units from the cancellous bone in the tunnel wall and the OCS-bone interface will be used as a measure for the degree of osseous integration of the implant.

    Time frame: day 0, 4.5 and 12 months post surgery

Other outcomes

  1. Patient safety

    Any occurrence of intra-operative complications will be recorded on the case report forms. Post-operative (serious) adverse events will be recorded at each follow-up visit.

    Time frame: 0 and 42 days, 6 months, 1, 2 and 5 years post surgery

06

Study locations

1 site
  • Balgrist University Hospital
    Zurich, 8008, Switzerland
07

References and documents

Publications

  • Gotschi T, Hodel S, Kuhne N, Bachmann E, Li X, Zimmermann SM, Snedeker JG, Fucentese SF. Osteoconductive Scaffold Placed at the Femoral Tunnel Aperture in Hamstring Tendon ACL Reconstruction: A Randomized Controlled Trial. Orthop J Sports Med. 2023 Jun 5;11(6):23259671231174478. doi: 10.1177/23259671231174478. eCollection 2023 Jun. PubMed 37347015 ↗

Study documents

  • Protocol and statistical analysis plan · Jun 6, 2017

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03462823
Lead sponsor
Sandro Fucentese
Responsible party
Sandro Fucentese (Head of Knee Surgery, Balgrist University Hospital) — Sponsor-investigator
First posted
Mar 13, 2018
Start date
Apr 29, 2017
Primary completion
Jan 29, 2024
Completion
Apr 11, 2025
Last update
Jul 7, 2026

Study contacts

Sandro Fucentese
principal investigator · Head of Knee Surgery

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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