Autologous Adult Adipose-Derived Regenerative Cell Injection Into Chronic Partial-Thickness Rotator Cuff Tears
Rotator Cuff Tear, Rotator Cuff Tendinitis
About this trial
This is an interventional treatment trial for Rotator Cuff Tear focused on measuring rotator cuff tear, adipose-derived regenerative cells, adipose-derived stem cells, partial rotator cuff tears, corticosteroid
Eligibility Criteria
Inclusion Criteria:
- Males and females 30-75 years of age (inclusive).
- Subjects have a minimum of three (3) months of clinical symptoms consistent with a partial-thickness rotator cuff tear including but not limited to pain, muscle weakness, or limited active range of motion (AROM).
- Subjects have > 70% passive range of motion (PROM) of the index shoulder.
- Subjects have a baseline VAS - Pain score of ≥ 30 mm.
- Subjects have a partial-thickness rotator cuff tear, defined as ≥25% partial-thickness tear of the supraspinatus tendon on a 1.5 Tesla (1.5T) or a 3 Tesla (3T) MRI within the last 3 months, as determined by the Investigator.
- Subjects can give appropriate consent.
Exclusion Criteria:
- Age < 30 or > 75.
- Subject has an insufficient amount of subcutaneous tissue to allow recovery of 100 milliliters (mL) of adipose tissue.
- Subjects who have received a corticosteroid injection in the index subacromial bursa within the last 3 months.
- Subjects who have received more than one (1) previous corticosteroid injections or any biologic treatment in the index subacromial bursa within the past 6 months.
- Subjects with severe arthrosis of the glenohumeral or acromioclavicular joint.
- Subjects with a full-thickness tear of the rotator cuff.
Subjects who have undergone major surgery on the affected shoulder meeting one of the following criteria:
- Performed as treatment for (or required manipulation of) the rotator cuff. Examples include, but are not limited to, subacromial decompression, rotator cuff repair, SLAP repair, arthroplasty and fracture fixation with implants that involve or penetrate the rotator cuff; OR
- Performed using implants that interfere with MR visualization and/or evaluation of the supraspinatus tendon (e.g., biceps tenodesis); OR
- Performed in/on the glenohumeral joint, subacromial space, or acromioclavicular joint within the last 3 years (e.g. soft tissue Bankart repairs performed >3 years ago may still qualify).
NOTE: This exclusion criterion does not apply to minor soft tissue procedures with short recovery periods that do not involve musculoskeletal structures (e.g., lipoma excision).
- Subjects who were diagnosed with or treated for adhesive capsulitis of the index shoulder within the last 5 years.
- Subjects with current cervical radiculopathy impacting the index shoulder.
- Subjects who require the use of index arm for ambulation or mobilization via wheelchair, walker, crutches or cane.
- Subjects with any contraindication to MRI scan according to MRI guidelines, or who are unwilling to undergo MRI procedures.
- Subjects whose pain behavior or pain medication usage is, in the opinion of the Investigator, out of proportion to the underlying clinical condition or could interfere with the study- required assessments.
- Subjects with a history of systemic malignant neoplasms within the last 5 years.
- Subjects with biopsy-proven, malignant or local neoplasm within the last 6 months or any history of local neoplasm at the site of administration (on the affected arm), excluding basal cell carcinoma.
- Subject is receiving immunosuppressant therapy or has a known immunologic or severe autoimmune disease that requires chronic systemic immunosuppressive or immunomodulatory therapy (e.g., human immunodeficiency virus, systemic lupus erythematosus, rheumatoid arthritis, etc.). [Note: Topical or inhaled corticosteroids are permitted.]
- Subject is on an active regimen of chemotherapy or radiation- based treatment.
- Subjects with an allergy to sodium citrate or any "caine" type of local anesthetic.
- Subject is pregnant or breastfeeding or plans to become pregnant in the next 12 months.
- Subjects with clinically significant abnormal Lab tests (i.e. basic metabolic panel (BMP) or equivalent (e.g. CHEM-7), complete blood count (CBC), Liver function tests (LFTs), and prothrombin time/international normalized ratio (PT/INR)) as interpreted by the Investigator.
21. Subjects with a history of a bleeding diathesis or coagulopathy
22. Subject is, in the opinion of the Investigator, unable to comply with the requirements of the study protocol or is unsuitable for the study for any reason. Examples include the inability of the subject to complete patient-reported outcome instruments (PROs) and the inability of the Investigator to perform the injection procedure properly because of anatomic limitations of the subject.
23. Subject is currently participating in another clinical trial that has not yet completed its primary endpoint. (Noninterventional observational studies are not exclusionary.)
24. Subject 1) is a litigant in a civil suit that could affect the subject's ability to complete the study related activities or 2) is a defendant in a criminal case or 3) has an active workman's compensation case in progress.
25. Subject is part of a vulnerable population who, in the judgment of the Investigator, is unable to give informed consent for reasons of incapacity, immaturity, adverse personal. circumstances or lack of autonomy. This may include: individuals with a mental disability, persons in nursing homes, children, impoverished persons, persons in emergency situations, homeless persons, nomads, refugees, and those incapable of giving informed consent. Vulnerable populations also may include members of a group with a hierarchical structure such as university students, subordinate hospital and laboratory personnel, employees of the Sponsor, members of the armed forces, and persons kept in detention.
26. Uncooperative subjects or those with neurological/psychiatric disorders who are incapable of following directions or who are predictably unwilling to return for follow-up examinations.
Sites / Locations
- Arizona Research Center
- Biosolutions Clinical Research Center
- Lotus Clinical Research, LLC
- Sports and Orthopedic Center
- Universal Axon Clinical Research
- Shrock Clinical Research
- Andrews Institute for Orthopaedics and Sports Medicine
- Georgia Institute for Clinical Research
- Tulane University School of Medicine
- University of Michigan
- Sanford Medical Center
- Sanford Orthopedic Clinic/Research
- HD Research
- Texas Plastic Surgery
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Adipose Derived Regenerative Cells
Corticosteroid
Adipose-derived regenerative cell injection into the area of the supraspinatus tendon tear
Subjects in the active control arm will receive a corticosteroid injection into the subacromial space using ultrasound (US) guidance.