Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04000672
Other study ID # 2019.050
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date July 1, 2019
Est. completion date December 6, 2023

Study information

Verified date December 2023
Source Chinese University of Hong Kong
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Medial open wedge high tibial osteotomy is a surgery performed to treat knee osteoarthritis in young patients.Recently with our department advance of technology, the investigators performed computed tomography for the patient's lower limb and 3D reconstruct the image. Based on the 3D image, the investigators planned our planned osteotomy cut on computer software Materialize 3 and the investigators then 3D printed a metal jig that has a slot to produce the osteotomy and also protected the neurovascular bundles. Therefore these metal jigs are specific to each patients. The investigators have performed a few cases of HTO under this extra metal jig protection and guidance and noted it has improved accuracy and safety clinically. However, whether it has scientific significance difference in accuracy is not known.


Description:

Medial open wedge high tibial osteotomy is a surgery performed to treat knee osteoarthritis in young patients. Currently the investigators perform high tibial osteotomy under the guidance of computer navigation to achieve the required alignment. During conventional high tibial osteotomy the bone cut is done by free hand cutting, there are risks of cutting into the posterior proximal tibia compartment and transect the neurovascular bundles which is a surgical disaster and may then lead to loss of limb. And the accuracy of free hand cutting is limited by experience of surgeons. In our conventional high tibial osteotomy transection of neurovascular bundles has never happened given our meticulous surgical technique but the investigators believe an extra protection is always beneficial to our patients. Recently with our department advance of technology, the investigators performed computed tomography for the patient's lower limb and 3D reconstruct the image. Based on the 3D image, the investigators planned our planned osteotomy cut on computer software Materialize 3 and the investigators then 3D printed a metal jig that has a slot to produce the osteotomy and also protected the neurovascular bundles. Therefore these metal jigs are specific to each patients. The investigators have performed a few cases of HTO under this extra metal jig protection and guidance and noted it has improved accuracy and safety clinically. However, whether it has scientific significance difference in accuracy is not known.


Recruitment information / eligibility

Status Completed
Enrollment 40
Est. completion date December 6, 2023
Est. primary completion date December 6, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years to 70 Years
Eligibility Inclusion Criteria: - symptomatic patient with medial compartment knee OA - medial compartment OA was grade 3 or milder according to Kellgren-Lawrence classification Exclusion Criteria: - lateral compartment OA - symptomatic patellofemoral compartment OA, - inflammatory arthritis, - significant loss of knee joint range in flexion (less than 100°) or in extension (less than - 10°), - ligamentous instability, - obesity with a body mass index greater than 30, - significant psychological disorder - inability to communicate in Chinese or English language

Study Design


Related Conditions & MeSH terms


Intervention

Procedure:
3D printed patient specific metal jigs (PSI jig)
PSI jig is created based on the pre-operative CT image. Standard medial open wedge osteotomy described previously is performed. Incision is made in the midway between posteromedial border of the tibia and medial aspect of the tibial tuberosity. Sartorius fascia is cut and retracted medially to expose the medial collateral ligament (MCL). Then the PSI jig is positioned onto the tibia. Due to the jig patient specific design (individually based on each patient's CT image), it can fit closely to the proximal tibia. The slot opening on the PSI jig corresponds to 4 cm below the medial joint line and the slot design allow the sawblade cut direction toward the safe zone of the lateral cortex under fluoroscopy. The PSI Jig is removed after the bone cut completed and would not retain in patient's body.
HTO with navigation
In brief, an incision is made in the midway between posteromedial border of the tibia and medial aspect of the tibial tuberosity. Sartorius fascia is cut and retracted medially to expose the medial collateral ligament (MCL). Two to three K-wires are placed 4 cm below the medial joint line toward the safe zone (an area between the tip of the fibular head and the remnant of fibular head epiphysis line) of the lateral cortex under fluoroscopy and osteotomy is done below and parallel to the k-wires using an oscillating saw leaving the lateral 10 mm intact.

Locations

Country Name City State
Hong Kong Prince of Wales Hospital & Alice Ho Miu Ling Nethersole Hospital Sha Tin

Sponsors (1)

Lead Sponsor Collaborator
Chinese University of Hong Kong

Country where clinical trial is conducted

Hong Kong, 

Outcome

Type Measure Description Time frame Safety issue
Primary Knee Society knee score Clinical and functional scores, on a 100-point scale; Knee Society score (KSS) has a "Knee Score" section (7 items) and a "Functional Score" section (3 items). Both sections are scored from 0 to 100 with lower scores being indicative of worse knee conditions and higher scores being indicative of better knee conditions. "Excellent" for score 80-100, "Good" for score 70-79, "Fair" for score 60-69, "Poor" for score below 60. 1 week before surgery
Primary Knee Society knee score Clinical and functional scores, on a 100-point scale; Knee Society score (KSS) has a "Knee Score" section (7 items) and a "Functional Score" section (3 items). Both sections are scored from 0 to 100 with lower scores being indicative of worse knee conditions and higher scores being indicative of better knee conditions. "Excellent" for score 80-100, "Good" for score 70-79, "Fair" for score 60-69, "Poor" for score below 60. 6 months post-op
Primary Knee Society knee score Clinical and functional scores, on a 100-point scale; Knee Society score (KSS) has a "Knee Score" section (7 items) and a "Functional Score" section (3 items). Both sections are scored from 0 to 100 with lower scores being indicative of worse knee conditions and higher scores being indicative of better knee conditions. "Excellent" for score 80-100, "Good" for score 70-79, "Fair" for score 60-69, "Poor" for score below 60. 1 year post-op
Primary Knee Society knee score Clinical and functional scores, on a 100-point scale; Knee Society score (KSS) has a "Knee Score" section (7 items) and a "Functional Score" section (3 items). Both sections are scored from 0 to 100 with lower scores being indicative of worse knee conditions and higher scores being indicative of better knee conditions. "Excellent" for score 80-100, "Good" for score 70-79, "Fair" for score 60-69, "Poor" for score below 60. 2 year post-op
Primary Knee Society function score Clinical and functional scores, on a 100-point scale; Knee Society score (KSS) has a "Knee Score" section (7 items) and a "Functional Score" section (3 items). Both sections are scored from 0 to 100 with lower scores being indicative of worse knee conditions and higher scores being indicative of better knee conditions. "Excellent" for score 80-100, "Good" for score 70-79, "Fair" for score 60-69, "Poor" for score below 60. 1 week before surgery
Primary Knee Society function score Clinical and functional scores, on a 100-point scale; Knee Society score (KSS) has a "Knee Score" section (7 items) and a "Functional Score" section (3 items). Both sections are scored from 0 to 100 with lower scores being indicative of worse knee conditions and higher scores being indicative of better knee conditions. "Excellent" for score 80-100, "Good" for score 70-79, "Fair" for score 60-69, "Poor" for score below 60. 6 months post-op
Primary Knee Society function score Clinical and functional scores, on a 100-point scale; Knee Society score (KSS) has a "Knee Score" section (7 items) and a "Functional Score" section (3 items). Both sections are scored from 0 to 100 with lower scores being indicative of worse knee conditions and higher scores being indicative of better knee conditions. "Excellent" for score 80-100, "Good" for score 70-79, "Fair" for score 60-69, "Poor" for score below 60. 1 year post-op
Primary Knee Society function score Clinical and functional scores, on a 100-point scale; Knee Society score (KSS) has a "Knee Score" section (7 items) and a "Functional Score" section (3 items). Both sections are scored from 0 to 100 with lower scores being indicative of worse knee conditions and higher scores being indicative of better knee conditions. "Excellent" for score 80-100, "Good" for score 70-79, "Fair" for score 60-69, "Poor" for score below 60. 2 year post-op
Primary Oxford Knee Score Clinical and functional scores 1 week before surgery
Primary Oxford Knee Score Clinical and functional scores 6 months post-op
Primary Oxford Knee Score Clinical and functional scores 1 year post-op
Primary Oxford Knee Score Clinical and functional scores 2 year post-op
Primary Range of motion Evaluated using a manual goniometer 1 week before surgery
Primary Range of motion Evaluated using a manual goniometer 1 week before discharge
Primary Range of motion Evaluated using a manual goniometer 3 months post-op
Primary Range of motion Evaluated using a manual goniometer 6 months post-op
Primary Range of motion Evaluated using a manual goniometer 1 year post-op
Primary Range of motion Evaluated using a manual goniometer 2 year post-op
Primary Pain Visual Analog Scale (VAS) score The VAS is a psychometric response scale and a measurement instrument for subjective characteristics or attitudes that cannot be directly measured. The VAS pain ranges 0-10, with 10 representing the most pain. 1 week before surgery
Primary Pain Visual Analog Scale (VAS) score The VAS is a psychometric response scale and a measurement instrument for subjective characteristics or attitudes that cannot be directly measured. The VAS pain ranges 0-10, with 10 representing the most pain. 1 week before discharge
Primary Pain Visual Analog Scale (VAS) score The VAS is a psychometric response scale and a measurement instrument for subjective characteristics or attitudes that cannot be directly measured. The VAS pain ranges 0-10, with 10 representing the most pain. 3 months post-op
Primary Pain Visual Analog Scale (VAS) score The VAS is a psychometric response scale and a measurement instrument for subjective characteristics or attitudes that cannot be directly measured. The VAS pain ranges 0-10, with 10 representing the most pain. 6 months post-op
Primary Pain Visual Analog Scale (VAS) score The VAS is a psychometric response scale and a measurement instrument for subjective characteristics or attitudes that cannot be directly measured. The VAS pain ranges 0-10, with 10 representing the most pain. 1 year post-op
Primary Pain Visual Analog Scale (VAS) score The VAS is a psychometric response scale and a measurement instrument for subjective characteristics or attitudes that cannot be directly measured. The VAS pain ranges 0-10, with 10 representing the most pain. 2 year post-op
Primary Measurement of knee displacement Measure the displacement (in cm) between femoral head and tibial head on a secured computer using CT scan images and scanogram images 1 week before surgery
Primary Measurement of knee displacement Measure the displacement (in cm) between femoral head and tibial head on a secured computer using CT scan images and scanogram images 1 year after surgery
See also
  Status Clinical Trial Phase
Completed NCT04027634 - Feasibility and Preliminary Effect of Baduanjin Program for People Diagnosed With Schizophrenia N/A
Completed NCT02644096 - Rehabilitation of Patients After THR - Based on Patients´Selfrated Health Phase 1
Completed NCT03284892 - Screening and Intervention of Postextubation Dysphagia N/A
Not yet recruiting NCT06412133 - Conversations in Light and Shadow: Assessing Phototherapy's Impact on Breast Cancer Patients N/A
Completed NCT05299060 - Effectiveness of Cyanoacrylate Glue in the Fixation of Midline and Peripherally Inserted Central Catheters in Hospitalized Adult Patients: Randomised Clinical Trial (CIANO-ETI) N/A
Recruiting NCT06150313 - Efficacy of the Mediational Intervention for Sensitizing Caregivers for Teachers and Self-Administered Versions N/A
Not yet recruiting NCT05939986 - A Protocol for a Virtual Reality Exposure Therapy for Fear of Flying. N/A
Completed NCT04071444 - Exploring the Effects of a Baduanjin Program on the Symptoms of Constipation in Patients With Schizophrenia Spectrum N/A
Not yet recruiting NCT06091501 - LIVING - Physical Activity in a Self-management Program Among Persons With Type 2 Diabetes N/A
Completed NCT03008668 - A Pilot Trial of Acupuncture for Knee Osteoarthritis With Differential Functional Status of Acupoints N/A
Completed NCT00057070 - Facilitating Implementation of the PHS Smoking Cessation Guidelines - RESET N/A
Completed NCT04545346 - The Potential of a Low Glutamate Diet as a Treatment for Pediatric Epilepsy N/A
Completed NCT05069844 - Preoperative Gum Chewing for Different Durations to Prevent Sore Throat After Endotracheal Intubation N/A
Completed NCT06460935 - The Effect of Online Sexual Health Training Given to Nursing Students on Knowledge, Attitude and Self-Efficacy N/A
Recruiting NCT03302572 - Effectiveness Brief Information Advanced Directives Primary Care N/A
Recruiting NCT05634122 - Efficacy of ACT in Patients Scheduled for Lumbar Spine Surgery N/A
Completed NCT04650906 - A Feasibility Study for Evaluating the Effectiveness of Mindhelper - a National Youth Mental Health Promotion Website N/A
Recruiting NCT05527158 - Traditional Chinese Yijinjing Exercise on Hand Dysfunction in Rheumatoid Arthritis Patients N/A
Recruiting NCT06402552 - Comparing Bp-MRI and Mp-MRI for Prostate Cancer Screening Accuracy N/A
Not yet recruiting NCT06330233 - Different Amounts of Moxibustion in the Treatment of DPN: A Clinical RCT Study N/A