Arthritis Clinical Trial
Official title:
Five Year Survival and Functional Assessment of the Triathlon Cementless Total Knee System Using the Tritanium Tibial Baseplate
The aim of the study is to assess the performance of the cementless Triathlon Tritanium tibial baseplate for total knee replacement, with a minimum follow up of 5 years.
All potential total knee arthroplasty patients from two consultant orthopaedic surgeons at
the Golden Jubilee National Hospital (GJNH) will be screened in relation to the
inclusion/exclusion criteria. Invitation letters and participant information sheets (PIS)
will be sent out to suitable patients who have been referred to the GJNH for total knee
replacement (allocated patients) prior to their pre-operative consultation with their
surgeon. They will be approached at their consultation visit to seek consent to take part in
the study. Patients who have been referred to the GJNH for assessment for a knee replacement
(see and treat patients) will be approached only if they are deemed eligible for knee
replacement by their consultant, and will be given a copy of the participant information
sheet along with the invitation letter. They will be approached for consent to take part in
the study at their pre-operative assessment. All patients will be given the opportunity to
ask questions about the study before signing the consent form. Consent will be taken by the
chief investigator or their delegate, using a signed form.
One hundred patients will be recruited to the study. They will have their surgery performed
by one of the participating consultants using the study implant, the Triathlon Tritanium
cementless tibial baseplate manufactured by Stryker Corporation.
Participants will receive their standard in-patient care and rehabilitation. Standard
hospital care for knee arthroplasty patients is for them to return to the hospital for a
post-operative review at 6 weeks and then 1 year and 7 years after operation. Study
participants will also be asked to attend the GJNH for two additional research specific
appointments at six months and five years. They will be also contacted by post or via
telephone to complete a study questionnaire (patient satisfaction) at 3 years post operation.
During the standard care appointments, patients will be reviewed by a member of the
arthroplasty team who will collect routine data on the clinical and functional outcomes and
implant stability. These data include the Oxford Knee Score (OKS), EURO Quality of life
questionnaire (EQ-5D 5L), patient satisfaction and standard radiographic assessment of the
implant.
Detailed radiographic analysis will be carried out on radiographs collected as standard and
specifically for the study. These will be post-operation at day one (standard), 6 weeks
(standard), 6 months (study), 1 year (standard) and the 5 years (study) time points. Study
specific radiographic assessment will consist of assessment for radiolucency and osteolysis
at specific regions around the tibial and femoral components. Pre-operatively, a standard
weight bearing long- leg anterior-posterior (AP) view, lateral view and a skyline view is
obtained as per standard care. Post-operatively, standard care consists of a standard weight
bearing long-leg AP radiograph at 6 weeks and a short AP and Lateral view at all other
reviews.
Study participants will also have two sessions of specialised functional assessment
(biomechanical movement analysis and 6-minute walk test) before operation and 1 year after
operation during their standard pre and postoperative visits. Biomechanical movement analysis
will be carried out in an on-site movement analysis laboratory. Study participants will be
required to wear suitable clothing (e.g. tee shirt and shorts) and be barefoot. A number of
reflective markers will be attached to specific locations on the body using suitable double
sided tape which can be tracked by a number of infrared cameras. participants will be asked
to perform the following tasks; walking, stepping up, stepping down, sit-to-stand,
stand-to-sit and single leg balance. Each task will be performed at least three times to
enable the collection of three good sets of data. In addition, the two stepping tasks will be
repeated for each limb. The single leg balance will be performed once for each leg and data
will be collected for 30 seconds per limb. A motion capture system will collect limb and
torso movements during the task performances while force plates will collect ground reaction
forces. The 6-minute walk test requires the participant to walk around a course during a six
minute period. They are allowed to have rest breaks for as long and as often as they require.
They will be asked to stop walking six minutes after the start of the test and the distance
covered during the period will be noted.
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