Knee Osteoarthritis Clinical Trial
Official title:
The Effect of Total Knee Arthroplasty on Habitual Physical Activity, Sedentary Behaviour and Health Outcomes in Patients With Osteoarthritis
The purpose of this study is to determine whether habitual physical activity and sedentary behaviour improve six weeks and between three to six months after total knee replacement surgery in people with osteoarthritis.
The aims of this study are to
1. describe habitual physical activity and sedentary behaviour patterns in knee
osteoarthritis patients who are scheduled for total knee arthroplasty,
2. investigate the effects of unilateral primary total knee arthroplasty on objectively
and subjectively measured physical activity, sedentary behaviour and health outcomes of
knee OA patients and
3. compare subjective measures of functional ability and sedentary behaviour
(questionnaires) with objective measures of habitual physical activity and sedentary
behaviour (accelerometry) both before and after total knee arthroplasty.
Study design:
This a longitudinal follow-up study of a cohort of participants who have been diagnosed with
knee osteoarthritis and who will all be undergoing total knee arthroplasty. After enrolment
into the study, baseline assessments will be done prior to total knee arthroplasty. After
total knee arthroplasty, participants will be followed-up and the same assessments done at
baseline will also be done at 6 weeks, and 3 to 6 months post-operatively. Habitual physical
activity and sedentary behaviour will be measured using accelerometry (Actigraph GTX3+ and
ActivPal monitors) at the specific time points.The ActiGraph will be worn by participants
for 24 hours/day for seven days at each of the assessment time points. It will be attached
to an elastic nylon strap which the participants can wear as a belt around the waist on the
side of right/left hip (depending on which knee is being operated on). Thus, the ActiGraph
will be worn on the side of left hip if the total knee arthroplasty is on the left knee and
vice versa. Participants will be asked to remove the ActiGraph when showering, bathing or
swimming. After seven days of accelerometer wear, the accelerometers will be collected at
the next possible visit to the hospital or arrangement will be made for collection from
participants at a location most convenient to them. An ActivPAL will be taped to the thigh
of the patient with waterproof taping and the patient will be asked to keep the ActivPAL on
for the same amount of time as the ActiGraph. The ActivPAL can be covered with waterproof
taping therefore, there will be no need to remove the ActivPAL when showering, bathing or
swimming. The ActivPAL will be collected at the same time as the ActiGraph. In addition,
general health, functional ability, generic quality of life and sleep and pain
questionnaires will be conducted at each time point on each participant.
Study Site:
The study will be conducted at the Charlotte Maxeke Academic Hospital in Johannesburg, South
Africa. It is an accredited central hospital with about 1088 beds serving patients from
across Gauteng and neighbouring provinces. The hospital is situated in Parktown and also,
serves as the main teaching hospital for the University of the Witwatersrand, Faculty of
Health Sciences. Study participants will be recruited from the Division of Orthopaedics in
the hospital. This hospital is chosen because: (1) it is a tertiary hospital that runs
several specialist clinics including the Orthopaedic Division where total knee arthroplasty
is performed and (2) there is a collaboration between the Academic staff of the Faculty of
Health Sciences of University of the Witwatersrand and the hospital Staff for teaching and
research which will facilitate accessibility to patients.
Sample Size Determination:
Based on an anticipated 2% decrease in the amount of time spent in sedentary behaviour per
day (which, for an average 16 hour day, equates to a 20 minute reduction), a sample size
calculation shows that a total sample of 107 participants will be required in this study to
detect a significant effect of knee arthroplasty on sedentary behaviour with a power of 80%.
The effect of the total knee arthroplasty on the change in habitual physical activity and
sedentary behaviour will be assessed between the three timepoints (baseline, six weeks and
three to six months).
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