MOntelukast as a Potential CHondroprotective Treatment Following Anterior Cruciate Ligament Reconstruction (MOCHA Trial)

Abstract As part of this pilot randomized, placebo-controlled trial, we will specifically target older anterior cruciate ligament (ACL) reconstruction patients with concomitant meniscal injuries as this group is at greatest risk of rapid posttraumatic osteoarthritis (PTOA) progression.28-30 Patients will randomly be assigned to receive oral montelukast (10 mg) versus placebo daily for 6 months after surgery. Patients will be assessed at baseline and 6 and 12 months. In addition, we will perform secondary analyses of previously collected MRI scans to vet bone shape change after ACL reconstruction as a viable biomarker and determine if these changes are altered by preoperative corticosteroid injection. The complimentary aims will allow us to assess the joint as an organ and provide evidence for a novel, disease modifying treatment approach with an approved and available therapeutic to target multiple mechanisms of PTOA. These short-term mechanistic results will inform a subsequent multicenter clinical trial to further evaluate the efficacy of this treatment approach and longitudinally assess cartilage integrity with MRI.