Quadriceps Muscle Atrophy Clinical Trial
Official title:
Evaluation of Ischemia and Reperfusion Interval With Neuromonitorization in Tourniquet Application
The goal of this clinical trial is to compare two differential tourniquet pressure in lower extremity surgery cases. The main questions it aims to answer are: - What are the perioperative neurophysiological effects of ischemia and compression in the tissue under the tourniquet? - Are the effects of two different tourniquet pressures on neuromonitoring significantly different? - Can the ideal time of the reperfusion interval be evaluated by neuromonitoring? - Are the effects of two different tourniquet pressures on the quadriceps denervation significantly different from each other? Participants meeting the inclusion criteria will be evaluated for parameters to be used preoperatively. It will be evaluated in the 1st day, 1st week and 1-month follow-ups in the postoperative period. The investigators will compare two different tourniquet pressure ( Limb occlusion pressure +50 mmHg / + 100 mmHg) to see if it will be evaluated whether there is a significant difference in terms of quadriceps denervation, vas scores, total blood estimate volume loss, intraoperative MEP decrease, and recovery times, quadriceps tendon thickness, thigh circumfrences.
Status | Recruiting |
Enrollment | 24 |
Est. completion date | January 2024 |
Est. primary completion date | November 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 65 Years |
Eligibility | Inclusion Criteria: - Operation planning in the foot and ankle area Exclusion Criteria: - Having a history of previous foot and ankle surgery, - Having a history of previous knee surgery or spinal surgery, - Diagnosis of diabetes mellitus, - Having a known diagnosis of a disease affecting the peripheral nervous system (peripheral neuropathy, previous spinal surgery, stroke, etc.), - Having a diagnosis of a disease affecting the known peripheral vascular system (Peripheral vascular disease, calcified popliteal artery, peripheral arterial bypass surgery, vasculitis, advanced chronic venous insufficiency), - Having a disease that affects the ideal tourniquet application (Chronic Lymphedema, BMI>35, Stage 3 and above chronic renal failure, uncontrollable hypertension), - Having been diagnosed with a known coagulation disorder, - History of pulmonary embolism or deep vein thrombosis. - ASA score above 3 - Surgery time to be less than 80 minutes |
Country | Name | City | State |
---|---|---|---|
Turkey | Department of Orthopaedics and Traumatology, Istanbul University, Istanbul, Turkey | Istanbul | Fatih-Topkapi |
Lead Sponsor | Collaborator |
---|---|
Istanbul University |
Turkey,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | MEP 50% reduction in intraoperative neuromonitorization | Time with more than 50% reduction in perioperative MEP will be compared in groups in which two different tourniquet pressures were applied. | Intraoperative | |
Primary | MEP full recovery intraoperative neuromonitorization | Time with full recovery in perioperative MEP will be compared in groups in which two different tourniquet pressures were applied. | Intraoperative | |
Secondary | Quadriceps Tendon Thickness-USG | In the study, quadriceps tendon thickness measurements will be performed in B Mode using the Clarius Portable L7 HD3 Linear Ultrasound device (13-4 MHz).The measurements of the patients will be performed in the supine position with the knee flexed to 30 degrees with a pillow placed in the popliteal web to prevent anisotropy in the quadriceps. The USG probe will be parallel to the long axis of the femur in the sagittal plane, and the patella will be placed at the midpoint of the proximal pole with its distal part. Quadiceps tendon thickness was measured at three different levels, 5-10-15 mm from the proximal patella. The quadriceps tendon borders were determined as the first hyperechoic region, superficial and deep. | Preoperative, Postoperative 1st day and 4th week will be evaluated | |
Secondary | Quadriceps Tendon Thickness-MRI | In the study, the thickness of the quadriceps tendon will also be evaluated with MRI. In the sagittal T1 sequence of knee MRI images, the portion with the largest diameter 1.5 and 3 cm proximal to the superior pole of the patella will be taken as the tendon thickness. | Preoperative, Postoperative third month | |
Secondary | Thigh Diameter | Thigh diameters were measured comparatively with a non-flexible 7 mm tape measure from 10 cm proximal to the midpoint of the proximal patella. As the leg length, the distance from the level of the tibial plateau to the medial malleolus type was measured. | Preoperative, Postoperative 1st day, first week and 4th week will be evaluated | |
Secondary | Total Blood Estimate Volume Loss | Total blood volume will be calculated with the formula Nadler previously presented in the literature. Total blood volume loss will be calculated using preoperative and postoperative hemogram and hematocrit parameters. | Preoperative, Postoperative 1st day | |
Secondary | CK levels | Creatinine kinase, one of the blood parameters showing muscle degradation, will be evaluated by taking blood samples from the patients before and after the surgery. | Preoperative, Postoperative 1st day, Postoperative 1 st month | |
Secondary | EMG | ENMG is an electrophysiological study often used to evaluate nerve injuries. Permanent nerve damage will be evaluated with a nerve conduction study performed by an experienced neurologist comparing both extremities at the first postoperative month of the participants. Peroneal and tibial nerves as motor nerves, sural and s.peroneal nerves as sensory nerves will be evaluated. The latency, amplitude and nerve conduction velocities of the nerves will be compared. | Postoperative 1 st month | |
Secondary | Surgical Area Pain | The pain of the surgical area will be evaluated over the VAS score. | Preoperative, Postoperative 1st day, Postoperative 1 st month |
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT03440593 -
Indirect Calorimetry Usage and Effect in Ventilator-free Days and Muscle Thickness in Septic Ventilated Patients
|
N/A | |
Active, not recruiting |
NCT05184023 -
The Effect of PEMF for Patients With Quadriceps Muscle Weakness After ACLR
|
N/A | |
Completed |
NCT05089253 -
Effect of Physical Therapy Modalities in Osteoarthritis
|
N/A | |
Completed |
NCT04834050 -
Can 4 Weeks of Exercise Program Change Quadriceps Architecture in Patients With Rheumatoid Arthritis
|
N/A | |
Recruiting |
NCT05174611 -
Vitamin D to Improve Quadricep Muscle Strength
|
Phase 2 | |
Recruiting |
NCT04988828 -
The Effects of Whole-body Vibration on Increasing Quadriceps Strength in Patients With ACL Ruptures
|
N/A | |
Completed |
NCT04495075 -
Neuromuscular Control in Individuals Following ACL-Reconstruction
|
N/A | |
Recruiting |
NCT05754632 -
The Impact of Blood Flow Restriction Training in Adolescents After ACL Reconstruction: A Randomized Controlled Trial
|
N/A | |
Recruiting |
NCT04042818 -
Reliability of Rehabilitative Ultrasound for the Quadriceps Muscle and Sarcopenia in Poststroke Patients
|
||
Not yet recruiting |
NCT04674072 -
The Effect of the Reverse Nordic Curl Exercise on Quadriceps Femoris Muscles Injury Rate Among Soccer Players
|
N/A | |
Recruiting |
NCT04875052 -
Vibration and Post-traumatic Osteoarthritis Risk Following ACL Injury
|
N/A | |
Recruiting |
NCT05355922 -
Efficacy of the Aussie Current in Patients With Knee Osteoarthritis.
|
N/A | |
Completed |
NCT05768022 -
Origin to Insertion Kinesio Tapping vs Non-Directional Kinesio Tapping on Quadriceps Peak Torque
|
N/A | |
Withdrawn |
NCT03794570 -
BFR Therapy After ACL Reconstruction
|
N/A | |
Withdrawn |
NCT04105816 -
Ultrasound for Rectus Femoris Measurement
|
N/A | |
Not yet recruiting |
NCT05500872 -
Blood Flow Restriction After Anterior Cruciate Ligament Reconstruction (ACLR)
|
N/A | |
Completed |
NCT04722445 -
Ultrasound Measurement of Quadriceps Shortening During Neuromuscular Electrical Stimulation in Critically Ill Patients
|
||
Recruiting |
NCT05956964 -
NM Balance Regulation With ULLS and Loss of Sleep
|
N/A | |
Recruiting |
NCT05568784 -
Straight Leg Raise Continuation
|