Knee Osteoarthritis Clinical Trial
Official title:
Randomised Controlled Trial of Patient Specific Instrumentation vs Standard Instrumentation in Total Knee Arthroplasty
Total knee replacement (TKR) is an established treatment for knee osteoarthritis and leads
to a satisfactory outcome in over 75% of patients. The pain and function after TKR can be
dependent on the accuracy of initial implantation, as deviation of more than 3 degrees from
the normal alignment of the limb can lead to abnormal stresses on the implant and
accelerated failure. Patient specific cutting blocks may result in a more individualised
implant placement, improved pain and function following surgery, and a long-lasting implant.
This trial is designed to investigate if there is any benefit to bespoke instrumentation in
terms of pain and function to the patient, and an economic benefit to the NHS.
Status | Recruiting |
Enrollment | 172 |
Est. completion date | February 2020 |
Est. primary completion date | February 2018 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | N/A and older |
Eligibility |
Inclusion Criteria: - Patients with osteoarthritis ('wear and tear') of the knee which is sufficiently symptomatic to require knee arthroplasty as assessed by their consultant orthopaedic surgeon Exclusion Criteria: - Patients with inflammatory arthropathy, patients requiring bone augmentation, ligament incompetence, values deformity > 5 degrees |
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Health Services Research
Country | Name | City | State |
---|---|---|---|
United Kingdom | Royal Infirmary of Edinburgh | Edinburgh | Lothian |
Lead Sponsor | Collaborator |
---|---|
NHS Lothian |
United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Limb alignment | Measured in degrees from Hip-Knee-Ankle radiographs from centre of femoral head to midpoint of the ankle | 1 years | No |
Secondary | Difference between baseline pre-op and one year post-op change in gait measured using a bespoke clinic-appropriate motion analysis system. | Knee range of motion, strength and gait analysis assessments will be carried out on a bespoke clinic-appropriate motion analysis system. This system consists of 8 Vicon B10 Bonita cameras (Vicon Systems, Oxford) which immediately surround a self-paced N-Mill treadmill (Motekforce Link, Amsterdam). | 1 year | No |
Secondary | Difference in patient reported knee pain level as measured by Oxford Knee Score between baseline and one year and also between study groups. | Validated patient reported knee pain questionnaires as measured by Oxford Knee Score (out of 48 points) pre-operation and at one year post-operation. Difference between baseline and one year scores for each patient and also analysed between groups (patient specific cutting blocks compared to conventional cutting blocks). | 1 year | No |
Secondary | Difference in patient reported knee function between baseline and one year and also between study groups. | Validated patient reported knee function questionnaires as measured by EQ-5D pre-operation and at one year post-operation. Difference between baseline and one year scores for each patient and also analysed between groups (patient specific cutting blocks compared to conventional cutting blocks). | 1 year | No |
Secondary | Difference in patient reported quality of life questionnaires between baseline and one year and also between study groups. | Validated quality of life questionnaires as measured by SF-12 score pre-operation and at one year post-operation. Difference between baseline and one year scores for each patient and also analysed between groups (patient specific cutting blocks compared to conventional cutting blocks). | 1 year | No |
Secondary | Healthcare cost | Healthcare cost measured in pounds sterling (GBP). Total cost of performing knee replacement using conventional cutting blocks compared to using bespoke cutting blocks and disposable instrumentation. The measurable contributors to the costs of healthcare include operating time (minutes), number of instrument trays requiring sterilisation (number of trays), length of hospital stay (days), patient transfusion requirement (number of units of packed cells required), cost of bespoke disposable instrumentation (GBP). | 1 year | No |
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