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Comparing Soft tissue hamstring autograft with Quadriceps tendon autograft for ACL - anterior cruciate ligament rupture

Official title: Soft-tissue Quadriceps Autograft ACL-reconstruction in the Skeletally-immature vs. Hamstrings

Soft-tissue Quadriceps Autograft ACL-reconstruction in the Skeletally-immature vs. Hamstrings (SQuASH): A Multi-Centre Randomized Controlled Trial

Condition: ACL - Anterior Cruciate Ligament RuptureSponsor: McMaster UniversityTarget enrollment: 352
  • 2 groups
  • Sites in Hamilton, Ottawa and 2 more cities
  • Recruiting
McMaster University, Hamilton, OntarioChildren's Hospital of Eastern Ontario, Ottawa, OntarioWomen's College Hospital/Research Institute, Toronto, OntarioCHU Sainte-Justine, Montreal, QuebecShriners Hospitals for Children - Canada, Montreal, Quebec

Interventions

  • Medical procedure

    Soft tissue hamstring autograft

    Patients will be prescribed to receive a soft tissue hamstring autograft to for ACL reconstruction.

  • Medical procedure

    Quadriceps tendon autograft

    Patients will be prescribed to receive a quadriceps tendon autograft to for ACL reconstruction.

Canadian Sites (5)

5 of 5 recruiting

  • McMaster University

    Hamilton, Ontario

    Recruiting
  • Children's Hospital of Eastern Ontario

    Ottawa, Ontario

    Recruiting
  • Women's College Hospital/Research Institute

    Toronto, Ontario

    Recruiting

Eligibility Criteria

See who this study is looking for32 criteria

The trial’s own eligibility text, word for word from the registry. Only the trial site can say who takes part.

Inclusion

  • +Patients aged 10-18 years.
  • +History, physical exam, and magnetic resonance imaging (MRI) or arthroscopic image confirmation of ACL insufficiency.
  • +Suitable for anatomic, single-bundle arthroscopic-assisted ACL reconstruction.
  • +X-ray or MRI evidence of skeletal immaturity (i.e., open physes) based on imaging that is closest to the time of injury (and correlated with standard bone age left hand posteroanterior (PA) radiographs).
  • +Patient involved in sport (competitive and/or recreational level) prior to injury.
  • +Patient and parent/guardian speak, read, and understand the language of the clinical siteTrial siteA hospital or clinic where a study is actually run.Read more →.
  • +Patient and parent/guardian provide informed consentInformed consentThe process of being told what taking part involves, then choosing freely.Read more → and/or assent.
  • +Exclusion CriteriaExclusion criteriaThe things that would prevent someone from taking part.Read more →
  • +Evidence (i.e. radiographic and/or arthroscopic) of International Cartilage Repair Society (ICRS) Cartilage Lesion Classification System Grade 2 (i.e., lesions extending down to 50% of the cartilage depth) and higher osteoarthritis that is symptomatic, requiring treatment other than debridement or microfracture.
  • +Tibial eminence/spine fractures treated surgically.
  • +Concomitant collateral, posterior cruciate, and/or cartilage pathology requiring surgical reconstruction and/or advanced restoration techniques (i.e., osteochondral allograft or autograft transfer, matrix-induced autologous chondrocyte implantation, particulate juvenile articular cartilage allograft transplantation).
  • +Previous ACL reconstruction in the affected knee or contralateral knee.
  • +Previous distal femur and/or proximal tibial/fibular physeal injury in the affected knee or contralateral knee.
  • +Allograft or allograft-augmentation, or synthetic augmentation of the ACL reconstruction.
  • +Biological-augmentation of the ACL reconstruction (i.e. platelet-rich-plasma, fibrin clot, reinforced bioinductive implants, etc.).
  • +ACL reconstruction utilizing synthetic grafts.
  • +Primary ACL repair.
  • +Patient diagnosed with inflammatory arthropathy.
  • +Significant medical co-morbidities (requiring daily assistance for activities of daily living).
  • +Patient, parent/guardian, and/or clinical investigatorPrincipal investigatorThe doctor or researcher responsible for running the study at a site.Read more → believe the patient will have difficulty maintaining follow-upFollow-upContinued check-ins after the treatment part is finished.Read more →.

Exclusion

  • Evidence (i.e. radiographic and/or arthroscopic) of International Cartilage Repair Society (ICRS) Cartilage Lesion Classification System Grade 2 (i.e., lesions extending down to 50% of the cartilage depth) and higher osteoarthritis that is symptomatic, requiring treatment other than debridement or microfracture.
  • Tibial eminence/spine fractures treated surgically.
  • Concomitant collateral, posterior cruciate, and/or cartilage pathology requiring surgical reconstruction and/or advanced restoration techniques (i.e., osteochondral allograft or autograft transfer, matrix-induced autologous chondrocyte implantation, particulate juvenile articular cartilage allograft transplantation).
  • Previous ACL reconstruction in the affected knee or contralateral knee.
  • Previous distal femur and/or proximal tibial/fibular physeal injury in the affected knee or contralateral knee.
  • Allograft or allograft-augmentation, or synthetic augmentation of the ACL reconstruction.
  • Biological-augmentation of the ACL reconstruction (i.e. platelet-rich-plasma, fibrin clot, reinforced bioinductive implants, etc.).
  • ACL reconstruction utilizing synthetic grafts.
  • Primary ACL repair.
  • Patient diagnosed with inflammatory arthropathy.
  • Significant medical co-morbidities (requiring daily assistance for activities of daily living).
  • Patient, parent/guardian, and/or clinical investigatorPrincipal investigatorThe doctor or researcher responsible for running the study at a site.Read more → believe the patient will have difficulty maintaining follow-upFollow-upContinued check-ins after the treatment part is finished.Read more →.
5 concepts to explore on this page · up to 1,300 pointsTap any term to learn what it means.

In plain language

Assembled directly from this trial’s registry record. Every sentence traces to a field below — nothing here is generated or interpreted.

Learning 
What this study is

This study is testing a treatment for a condition.

This study is not organised into the usual phase numbers — that is common for device, behavioural, and diagnostic research.

From the trial registry

Built from these fields:

  • designModule.designInfo.primaryPurpose
  • designModule.phases
Who receives what

There are 2 groups in this study.

Group A, the comparison group, receives Soft tissue hamstring autograft.

Registry label: A: Soft-tissue hamstring

Group B, the comparison group, receives Quadriceps tendon autograft.

Registry label: B: Quadriceps tendon

From the trial registry

Built from these fields:

  • armsInterventionsModule.armGroups[].label
  • armsInterventionsModule.armGroups[].type
  • armsInterventionsModule.armGroups[].interventionNames
How the study is run

Which group you would be placed in is decided by chance, like a coin flip — not by you and not by your doctor.

One group of people involved — usually the participants — is not told which treatment is which.

From the trial registry

Built from these fields:

  • designModule.designInfo.allocation
  • designModule.designInfo.maskingInfo.masking
Is there a placebo?

This study does not list a placeboPlaceboA dummy treatment with no active medicine, used for comparison.Read more → group.

One group receives an existing treatment, so the two can be compared.

From the trial registry

Built from these fields:

  • armsInterventionsModule.armGroups[].type
  • armsInterventionsModule.armGroups[].interventionNames
Who the study is looking for

The study lists an age range of 10 years to 18 years.

The study is open to people of any sex.

The study does not accept healthy volunteersHealthy volunteerSomeone without the condition being studied who takes part anyway.Read more →.

These are the criteria the study lists. Only the trial siteTrial siteA hospital or clinic where a study is actually run.Read more → can decide whether someone can take part.

From the trial registry

Built from these fields:

  • eligibilityModule.minimumAge
  • eligibilityModule.maximumAge
  • eligibilityModule.sex
  • eligibilityModule.healthyVolunteers
How big and how long

The study aims to enrol about 352 people.

The study is currently expected to finish around January 2030.

The main measurement is taken over: 2 years.

From the trial registry

Built from these fields:

  • designModule.enrollmentInfo.count
  • statusModule.completionDateStruct.date
  • outcomesModule.primaryOutcomes[].timeFrame
What the study measures

Rate of ACL failure — measured over 2 years.

From the trial registry

Built from these fields:

  • outcomesModule.primaryOutcomes[].measure
  • outcomesModule.primaryOutcomes[].timeFrame

Source: NCT03896464 on ClinicalTrials.gov. The full registry text is further down this page — this summary never replaces it.

Not medical advice. What do these terms mean?

What is being tested — in plain terms

About Soft tissue hamstring autograftProcedure

Patients will be prescribed to receive a soft tissue hamstring autograft to for ACL reconstruction.

From the trial registry — its own words, unedited.

What a procedure is here: A surgery, technique or clinical procedure being studied.

Read the full explanation → · in clinical review

About Quadriceps tendon autograftProcedure

Patients will be prescribed to receive a quadriceps tendon autograft to for ACL reconstruction.

From the trial registry — its own words, unedited.

What a procedure is here: A surgery, technique or clinical procedure being studied.

Read the full explanation → · in clinical review

Common questions

Answered from this trial’s registry record. Where the record doesn’t say, these answers say so rather than filling the gap.

Am I eligible for this trial?

Only the trial siteTrial siteA hospital or clinic where a study is actually run.Read more → can decide whether someone can take part. Concord cannot make that determination, and neither can any tool that has not examined you.

What the study lists: an age range of 10 years to 18 years.

The full inclusionInclusion criteriaThe things you must have or be for a study to consider you.Read more → and exclusion criteriaExclusion criteriaThe things that would prevent someone from taking part.Read more → are published on this page, exactly as the study team wrote them.

The useful next step is to bring this trial to your doctor. Answering a few questions first gives them something concrete to review.

From the trial registry
  • eligibilityModule.minimumAge
  • eligibilityModule.maximumAge
  • eligibilityModule.eligibilityCriteria
Is there a placebo?

This study does not list a placeboPlaceboA dummy treatment with no active medicine, used for comparison.Read more → group.

One group receives an existing treatment so the two can be compared.

From the trial registry
  • armsInterventionsModule.armGroups[].type
Would I know which treatment I am getting?

One group of people involved — usually the participants — is not told which treatment is which.

Which group you would be placed in is decided by chance, like a coin flip — not by you and not by your doctor.

From the trial registry
  • designModule.designInfo.maskingInfo.masking
  • designModule.designInfo.allocation
Who can join?

The study lists an age range of 10 years to 18 years.

It is open to people of any sex.

It does not accept healthy volunteersHealthy volunteerSomeone without the condition being studied who takes part anyway.Read more →.

Only the trial siteTrial siteA hospital or clinic where a study is actually run.Read more → can confirm whether a particular person can take part.

From the trial registry
  • eligibilityModule.minimumAge
  • eligibilityModule.maximumAge
  • eligibilityModule.sex
  • eligibilityModule.healthyVolunteers
How long would this take?

The study's main measurement is taken over: 2 years.

The study as a whole is currently expected to finish around 2030-01-01.

How long any one person takes part can differ from the study length. The study team can tell you what the schedule looks like in practice.

From the trial registry
  • outcomesModule.primaryOutcomes[].timeFrame
  • statusModule.completionDateStruct.date
How many people are taking part?

The study aims to enrol about 352 people.

From the trial registry
  • designModule.enrollmentInfo.count
Where is this happening?

This study lists 4 locations, including: Hamilton, Ontario, Canada; Ottawa, Ontario, Canada; Toronto, Ontario, Canada; Montreal, Quebec, Canada.

Sites can open and close during a study, so confirm with the team before travelling.

From the trial registry
  • trial_locations

About This Trial

To date, the use of the quadriceps tendon as an autograft option in primary paediatric Anterior Cruciate Ligament (ACL) reconstruction has not been well studied. The 2018 International Olympic Committee (IOC) Consensus Statement now outlines the quadriceps tendon as a possible autograft option. However, no Randomised Control Trial (RCT) has examined the efficacy of the quadriceps tendon autograft in primary paediatric ACL reconstruction compared to the historical "gold-standard" soft-tissue hamstring autograft in this population. In light of its evidence for favourable outcomes in the adult population, and the (albeit limited) evidence showing safety and promise in the paediatric population, clinical equipoise exists for assessing its impact on outcomes in paediatric patients at the index surgery. This is a parallel, international, multi-centre, blinded randomized controlled trial of 352 skeletally-immature (at the time of injury) patients (ages 10-18 years, inclusive) undergoing primary ACL reconstruction to compare the effect of autograft tendon choice (i.e. hamstring versus soft-tissue quadriceps) on the rates of ACL graft failure, return-to-sport, knee function, pain, health-related quality of life and health utility, psychological factors, range of motion and stability, and any other adverse events at 24 months.

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This page is for informational purposes only and does not constitute medical advice. Clinical trial eligibility can only be determined by the trial site after proper screening. Trial information is sourced from ClinicalTrials.gov and may not reflect the most current status. Always consult your healthcare provider before making decisions about clinical trial participation.