A groundbreaking national research study is exploring whether a common diabetes medication, metformin, could prevent osteoarthritis (OA) in patients recovering from anterior cruciate ligament (ACL) tears. OA is the most common form of arthritis and a leading cause of disability, often developing after knee injuries.
Dr. Matthew Tao, an orthopaedic surgeon, highlights the risk: “At 10 years post-injury, about 50% of people show signs of osteoarthritis on X-rays. By 20 years, it jumps to 70%.” Alarmingly, ACL injuries leave individuals aged 30-39 up to 20 times more likely to require knee replacements than their peers.
The Preventing Injured Knees from osteoArthritis: Severity Outcomes (PIKASO) trial, led by top researchers from nine institutions, aims to determine whether metformin can reduce knee inflammation and slow cartilage degradation following ACL reconstruction. Co-principal investigators Dr. Liz Wellsandt and Dr. Yvonne Golightly from the University of Nebraska Medical Center (UNMC) are spearheading this effort locally.
“Metformin has shown promise in reducing inflammation in previous studies, particularly in people with obesity and knee osteoarthritis,” says Dr. Wellsandt. “The PIKASO study is the first to test its effects following an ACL injury.”
This randomized, double-blind clinical trial assigns participants to take either metformin or a placebo daily for one year. Researchers will monitor knee pain and early OA signs using MRI scans over two years.
Dr. Tao notes the transformative potential of this study: “If successful, metformin could revolutionize sports medicine by offering an easy, safe solution to a major long-term problem.”
Enrollment is open at UNMC for individuals aged 19 to 45, with the trial expected to conclude in 2028. If proven effective, metformin could significantly improve post-injury knee health and quality of life for patients.