Stromal Vascular Fraction (SVF) Cells for Non-Operative Treatment of Small Rotator Cuff Tears (SVF)
Primary Purpose
Rotator Cuff Tears
Status
Withdrawn
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Tisseel Injectable Product
Stromal Vascular Fraction Cells
Sponsored by
About this trial
This is an interventional treatment trial for Rotator Cuff Tears
Eligibility Criteria
Inclusion Criteria
- Male and female patients 30-65 years of age
- Symptomatic partial-thickness rotator cuff tears
- Suitable candidate for lipoaspiration and autologous adipose derived stem cell therapy as per physician.
Exclusion Criteria
- History of RC repair of affected shoulder, osteomyelitis or septic arthritis;
- Primary diagnosis of osteoarthritis, primary adhesive capsulitis;
- Full thickness rotator cuff tear
- RC tear of the subscapularis (SSc) or teres minor (TM), or a RC tear at the musculotendinous junction.
- Prescribed physical therapy or injection (of any nature) to shoulder prior to initial visit (within past 3 months);
- Clinically significant medical diseases that can impact tissue healing (i.e. Cardiovascular/peripheral vascular disease, diabetes, cancer, endocrine disease, hepatic disease (hepatitis), renal disease, autoimmune/inflammatory disease, HIV;
- Cervical spine radiculopathy;
- Current anticoagulation therapy (excluding Aspirin 81mg), immunosuppressant medication, narcotic use;
- Women of child bearing potential must test negative on standard urine pregnancy test and must agree to practice appropriate contraception for the first year of the study (i.e. oral contraceptive, barrier method, intrauterine device (IUD), intramuscular contraceptive);
- Subjects with abnormal hematology or serum chemistry lab results, outside of the normal range, as defined by the American Board of Internal Medicine (ABIM) Laboratory Test Reference Ranges, which are clinically significant, in the opinion of the investigator;
- BMI greater than 40 kg/m2;
- History of tobacco use within last 3 years;
- Subject has been diagnosed with any bleeding disorders, including but not limited to: hemophilia A or B, Von Willebrand Disease;
- Currently participating, or has participated in any other clinical trials within 6 months prior to the screening visit;
- Subjects has any significant medical condition, that in the option of the investigator, would make them unable to provide informed consent and/or interfere with their compliance of study requirements;
- Subject has a documented allergy to the anesthetic or any component of the injectable, including but not limited to: aprotinin.
- Subject has a contraindication for completing the MRI (i.e. pacemaker, aneurysm clip, metal fragments, etc that may become dislodged) or has problems with loud noises or claustrophobia.
Sites / Locations
- AdventHealth Orlando
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Experimental
Arm Label
Fibrin Glue
SVF cells and Fibrin Glue
Arm Description
Single 4 milliliter (mL) injection of 0.9% normal saline and fibrin glue solution
Nucleated adipose-derived cells loaded in a fibrin glue scaffold
Outcomes
Primary Outcome Measures
Primary Efficacy - MRI-measured healing rate in the rotator cuff tear
Healing rates between the treatment with stromal vascular fraction (SVF) cells and exercise program (EP) group will be compared to the sham and EP group.
Primary Safety - Incidence/Rates of adverse events (AEs) involving the affected joint
Both study-related AE assessments and the clinical record will be interrogated to determine if the subjects had any adverse events involving the affected joint. Incidence and rates of AEs between the treatment with stromal vascular fraction (SVF) cells and exercise program (EP) group will be compared to the sham and EP group.
Secondary Outcome Measures
Patient-reported measures Western Ontario Rotator Cuff (WORC) Index
WORC score - Compare clinical outcomes between treatment with stromal vascular fraction (SVF) cells and EP and sham injection and EP. The investigators expect the SVF-treated patients to improve by over 12% on the WORC at the final 2-yr follow-up.
Patient-reported measures Patient Reported Outcomes Measurement Information System (PROMIS)
PROMIS score - Compare clinical outcomes between treatment with stromal vascular fraction (SVF) cells and EP and sham injection and EP.expect the SVF-treated patients to improve by 10 points on the PROMIS at the final 2-yr follow-up.
Patient-reported measures Visual Analog Scale (VAS)
Pain VAS score - Compare clinical outcomes between treatment with stromal vascular fraction (SVF) cells and EP and sham injection and EP. expect the SVF-treated patients to improve by over 12% on the WORC, by 10 points on the PROMIS, and by 20% on the pain VAS by the final 2-yr follow-up. expect the SVF-treated patients to improve by 20% on the pain VAS at the final 2-yr follow-up.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05264922
Brief Title
Stromal Vascular Fraction (SVF) Cells for Non-Operative Treatment of Small Rotator Cuff Tears
Acronym
SVF
Official Title
Stromal Vascular Fraction (SVF) Cells for Non-Operative Treatment of Small Rotator Cuff Tears
Study Type
Interventional
2. Study Status
Record Verification Date
February 2023
Overall Recruitment Status
Withdrawn
Why Stopped
Study never started. PI left institution.
Study Start Date
January 9, 2022 (Actual)
Primary Completion Date
July 22, 2022 (Actual)
Study Completion Date
July 22, 2022 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AdventHealth
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The investigator's goal is to determine the effectiveness of stromal vascular fraction (SVF) cell injection to treat small rotator cuff tears without surgery.
Detailed Description
Small rotator cuff tendon tears are a hard task in shoulder care. They are often not operated on because research has not shown any increased benefit of surgery over physical therapy. The most common way to treat these tears is through physical therapy or steroid injections. However, the relief doesn't last very long. Recent studies have shown a lot of tears get worse over time. This happens because the physical therapy options can treat the pain and symptoms, but do not heal the actual tear.
Another non-surgical option for treating small tears is through adipose-derived stem cells. Adipose-derived stem cells are cells that are found in the fat in our bodies. The cells have shown promise in fixing tissues and may provide help to treat small rotator cuff tears. The investigators are studying a part of these fat cells known as the stromal vascular fraction (SVF). The SVF contains a number of cells that are able to become a variety of different cells. This is important because they may be able to turn into cells that may help heal the damaged rotator cuff tendons. These cells have been shown to improve results after rotator cuff surgery, but no research has used these cells to help small tears without surgery. The use of SVF is investigational. "Investigational" means that the drug being tested has not been approved for routine clinical use or for the use described in this study by the United States Food and Drug Administration (FDA). The FDA is allowing the use of this drug for research. The investigators goal is to determine the effectiveness of SVF cell injection to treat small rotator cuff tears without surgery.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Rotator Cuff Tears
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Subjects will be randomized 1:1 to SVF Cells & Fibrin Glue or Fibrin Glue alone.
Masking
ParticipantCare ProviderOutcomes Assessor
Masking Description
The provider (PI) and team performing the injection will not care for the subject during follow up.
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Fibrin Glue
Arm Type
Active Comparator
Arm Description
Single 4 milliliter (mL) injection of 0.9% normal saline and fibrin glue solution
Arm Title
SVF cells and Fibrin Glue
Arm Type
Experimental
Arm Description
Nucleated adipose-derived cells loaded in a fibrin glue scaffold
Intervention Type
Drug
Intervention Name(s)
Tisseel Injectable Product
Other Intervention Name(s)
Fibrin Glue
Intervention Description
Fibrin glue will provide an inert, biocompatible, viscous substance able to remain within the Rotator Cuff (RC) defect rather than injecting SVF cells in saline.
Intervention Type
Biological
Intervention Name(s)
Stromal Vascular Fraction Cells
Intervention Description
Stromal Vascular Fraction cells are autologously harvested, processed and reinjected into the affected shoulder.
Primary Outcome Measure Information:
Title
Primary Efficacy - MRI-measured healing rate in the rotator cuff tear
Description
Healing rates between the treatment with stromal vascular fraction (SVF) cells and exercise program (EP) group will be compared to the sham and EP group.
Time Frame
24 months
Title
Primary Safety - Incidence/Rates of adverse events (AEs) involving the affected joint
Description
Both study-related AE assessments and the clinical record will be interrogated to determine if the subjects had any adverse events involving the affected joint. Incidence and rates of AEs between the treatment with stromal vascular fraction (SVF) cells and exercise program (EP) group will be compared to the sham and EP group.
Time Frame
24 months
Secondary Outcome Measure Information:
Title
Patient-reported measures Western Ontario Rotator Cuff (WORC) Index
Description
WORC score - Compare clinical outcomes between treatment with stromal vascular fraction (SVF) cells and EP and sham injection and EP. The investigators expect the SVF-treated patients to improve by over 12% on the WORC at the final 2-yr follow-up.
Time Frame
24 months
Title
Patient-reported measures Patient Reported Outcomes Measurement Information System (PROMIS)
Description
PROMIS score - Compare clinical outcomes between treatment with stromal vascular fraction (SVF) cells and EP and sham injection and EP.expect the SVF-treated patients to improve by 10 points on the PROMIS at the final 2-yr follow-up.
Time Frame
24 months
Title
Patient-reported measures Visual Analog Scale (VAS)
Description
Pain VAS score - Compare clinical outcomes between treatment with stromal vascular fraction (SVF) cells and EP and sham injection and EP. expect the SVF-treated patients to improve by over 12% on the WORC, by 10 points on the PROMIS, and by 20% on the pain VAS by the final 2-yr follow-up. expect the SVF-treated patients to improve by 20% on the pain VAS at the final 2-yr follow-up.
Time Frame
24 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria
Male and female patients 30-65 years of age
Symptomatic partial-thickness rotator cuff tears
Suitable candidate for lipoaspiration and autologous adipose derived stem cell therapy as per physician.
Exclusion Criteria
History of RC repair of affected shoulder, osteomyelitis or septic arthritis;
Primary diagnosis of osteoarthritis, primary adhesive capsulitis;
Full thickness rotator cuff tear
RC tear of the subscapularis (SSc) or teres minor (TM), or a RC tear at the musculotendinous junction.
Prescribed physical therapy or injection (of any nature) to shoulder prior to initial visit (within past 3 months);
Clinically significant medical diseases that can impact tissue healing (i.e. Cardiovascular/peripheral vascular disease, diabetes, cancer, endocrine disease, hepatic disease (hepatitis), renal disease, autoimmune/inflammatory disease, HIV;
Cervical spine radiculopathy;
Current anticoagulation therapy (excluding Aspirin 81mg), immunosuppressant medication, narcotic use;
Women of child bearing potential must test negative on standard urine pregnancy test and must agree to practice appropriate contraception for the first year of the study (i.e. oral contraceptive, barrier method, intrauterine device (IUD), intramuscular contraceptive);
Subjects with abnormal hematology or serum chemistry lab results, outside of the normal range, as defined by the American Board of Internal Medicine (ABIM) Laboratory Test Reference Ranges, which are clinically significant, in the opinion of the investigator;
BMI greater than 40 kg/m2;
History of tobacco use within last 3 years;
Subject has been diagnosed with any bleeding disorders, including but not limited to: hemophilia A or B, Von Willebrand Disease;
Currently participating, or has participated in any other clinical trials within 6 months prior to the screening visit;
Subjects has any significant medical condition, that in the option of the investigator, would make them unable to provide informed consent and/or interfere with their compliance of study requirements;
Subject has a documented allergy to the anesthetic or any component of the injectable, including but not limited to: aprotinin.
Subject has a contraindication for completing the MRI (i.e. pacemaker, aneurysm clip, metal fragments, etc that may become dislodged) or has problems with loud noises or claustrophobia.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tariq Awan, DO
Organizational Affiliation
AdventHealth Orlando
Official's Role
Principal Investigator
Facility Information:
Facility Name
AdventHealth Orlando
City
Orlando
State/Province
Florida
ZIP/Postal Code
32803
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Stromal Vascular Fraction (SVF) Cells for Non-Operative Treatment of Small Rotator Cuff Tears
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