Wounds and Injuries Clinical Trial
Official title:
Accelerated Reduction of Post-operative Edema and Early Return to Function Following Total Knee Arthroplasty (TKA)
The purpose of this study is to determine if patients undergoing a total knee arthroplasty
(TKA) experience a clinically significant reduction in healing time when treated post
operatively with a specific form of micro and nano-ampere current. The results of this trial
will provide a basis for generalizing its outcomes to apply to other joint replacements and
revisions by reducing edema and inflammation and therefore will result in a shorter time to
heal.
The study will compare electrically treated and non electrically treated patients by using
digitally based measurements to determine objective reductions of lower extremity edema
including intra and inter cellular shifts in fluid distribution, increased range of motion
(ROM) and muscle strength, and improved functional tests of ambulation.
Status | Enrolling by invitation |
Enrollment | 40 |
Est. completion date | October 2016 |
Est. primary completion date | October 2016 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Both |
Age group | 18 Years to 80 Years |
Eligibility |
Inclusion Criteria: 1. Patients must be scheduled for a primary total knee replacement surgery 2. Age: 18 - 80 years old 3. Males/Females all ethnicities 4. Must have a minimum serum albumin of 4 and a minimum Hgb of 11 5. Ability to mark appropriately the visual analog scales, keep a log of symptoms, medication use, and ODIN1® use 6. Ability to understand all instructions and the informed consent document before signing it Exclusion Criteria: 1. Subject younger than 18 years of age 2. Any patient with an electrically implanted device such as a pacemaker, neural stimulator, etc. 3. Subject has any known neoplasms 4. A demonstrated lack of compliance as determined by the Principal Investigator, nurse, or wound care specialist 5. Current participation in another clinical study of an investigational device or drug. 6. Any other condition or finding, which in the opinion of the investigator, would make the subject unsuitable for enrollment or could interfere with the subject participating in and completing the protocol 7. Subject unwilling or unable to provide informed consent 8. Subjects receiving any medication or having any condition that significantly interferes with the healing process such as a patient taking systemic steroids or immune suppressants or patient has diabetes mellitus with an HbA1c of greater than 7.5, etc. 9. Any female who has experienced menstruation and is less than 5 years postmenopausal shall have a urine pregnancy test before the initial treatment. An additional test will be performed at 3 weeks from the initial treatment date. Any subject with a positive pregnancy test shall be excluded 10. Subjects with significant peripheral extremity lymph edema 11. Subjects with Stage III or IV peripheral vascular disease, as defined by the Fontaine stages 12. Subjects with venous insufficiencies of Class III or greater, as defined by the Comprehensive Classification System for Chronic Venous Disorders (CEAP) 13. Subjects with muscle skeletal disorders that are not related to the knee 14. Subjects with uncontrolled Blood Pressure 15. Subjects with neurological disease affecting locomotion 16. Subjects with BMI > 35 17. Subjects that are active smokers 18. Subjects that live on the second floor or higher without elevator access 19. Subjects must not have had a prior TKA. This study is for Primary TKA patients |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United States | Centennial Hills Hospital | Las Vegas | Nevada |
United States | Nevada Orthopedic and Spine Center | Las Vegas | Nevada |
Lead Sponsor | Collaborator |
---|---|
Bioelectric Research Corporation |
United States,
Hotary KB, Robinson KR. Endogenous electrical currents and voltage gradients in Xenopus embryos and the consequences of their disruption. Dev Biol. 1994 Dec;166(2):789-800. — View Citation
Li L, Gu W, Du J, Reid B, Deng X, Liu Z, Zong Z, Wang H, Yao B, Yang C, Yan J, Zeng L, Chalmers L, Zhao M, Jiang J. Electric fields guide migration of epidermal stem cells and promote skin wound healing. Wound Repair Regen. 2012 Nov-Dec;20(6):840-51. doi: 10.1111/j.1524-475X.2012.00829.x. Epub 2012 Oct 19. — View Citation
Lin F, Baldessari F, Gyenge CC, Sato T, Chambers RD, Santiago JG, Butcher EC. Lymphocyte electrotaxis in vitro and in vivo. J Immunol. 2008 Aug 15;181(4):2465-71. — View Citation
Man IO, Markland KL, Morrissey MC. The validity and reliability of the Perometer in evaluating human knee volume. Clin Physiol Funct Imaging. 2004 Nov;24(6):352-8. — View Citation
McCaig CD, Rajnicek AM, Song B, Zhao M. Controlling cell behavior electrically: current views and future potential. Physiol Rev. 2005 Jul;85(3):943-78. Review. — View Citation
Pichonnaz C, Bassin JP, Currat D, Martin E, Jolles BM. Bioimpedance for oedema evaluation after total knee arthroplasty. Physiother Res Int. 2013 Sep;18(3):140-7. doi: 10.1002/pri.1540. Epub 2012 Nov 27. — View Citation
Sato MJ, Kuwayama H, van Egmond WN, Takayama AL, Takagi H, van Haastert PJ, Yanagida T, Ueda M. Switching direction in electric-signal-induced cell migration by cyclic guanosine monophosphate and phosphatidylinositol signaling. Proc Natl Acad Sci U S A. 2009 Apr 21;106(16):6667-72. doi: 10.1073/pnas.0809974106. Epub 2009 Apr 3. — View Citation
Shi R, Borgens RB. Three-dimensional gradients of voltage during development of the nervous system as invisible coordinates for the establishment of embryonic pattern. Dev Dyn. 1995 Feb;202(2):101-14. — View Citation
Soong HK, Parkinson WC, Bafna S, Sulik GL, Huang SC. Movements of cultured corneal epithelial cells and stromal fibroblasts in electric fields. Invest Ophthalmol Vis Sci. 1990 Nov;31(11):2278-82. — View Citation
Zhao M, Dick A, Forrester JV, McCaig CD. Electric field-directed cell motility involves up-regulated expression and asymmetric redistribution of the epidermal growth factor receptors and is enhanced by fibronectin and laminin. Mol Biol Cell. 1999 Apr;10(4):1259-76. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Rate of Reduction of post-operative edema | Determine the rate of reduction in edema by measuring the volume changes in the operated lower extremity over time | 120 days | No |
Primary | Decrease in time to heal | Determine the rate of healing by measuring the time elapsed from surgery to reach optimal function by measuring muscle strength, range of knee motion, standardized rehabilitation testing designed to quantitatively measure ambulation. When these measurements show no signs of improvement for a period of 30 days or greater, then the time elapsed after surgery until the beginning of this 30 day or greater period will be recorded and used as a measure of time to heal. | 120 Days | No |
Secondary | Reduction of pain | Record the degree of pain experienced by measuring the pain level on the universal pain scale of 1-10 over time elapsed since surgery. | 90 days | No |
Secondary | Reduction of bacterial infections | Compare the incidence of TKA related infections in all participants. The measurement will be the number of recorded infections, related to the surgery, that has occurred within the first 60 days of that surgery in all participants. That number will be compared between the experimental and the control groups. | 60 Days | No |
Secondary | Increased healing of the surgical incision | Photograph and rate incision healing from 1st post-op day through day 60 comparing all participants. | From the 1st post-op day until 60 Days post-op | No |
Secondary | Reduction of Pain Medication Usage | Record the consumption of all pain medications consumed to mitigate post-operative pain. A total dosage will be calculated in terms of morphine equivalent strengths and compared between the groups. | 90 days | No |
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT04554212 -
Blood Flow Restriction Training After Patellar INStability
|
N/A | |
Suspended |
NCT02932176 -
Machine Learning for Handheld Vascular Studies
|
||
Recruiting |
NCT04803253 -
Study of the Social and Professional Reintegration Improvements Using a Set of Solutions for Upper Limb Amputation
|
N/A | |
Completed |
NCT00116337 -
Spinal Cord Stimulation to Restore Cough
|
N/A | |
Completed |
NCT03463720 -
Outcome for Patients With War-Associated Extremity Wound Infection
|
N/A | |
Completed |
NCT03113253 -
TRANexamic Acid to Reduce Bleeding in BURN Surgery
|
Phase 4 | |
Not yet recruiting |
NCT05492903 -
COMmunity of Practice And Safety Support for Navigating Pain (COMPASS-NP)
|
N/A | |
Terminated |
NCT02909231 -
One-year Patient Reported Outcomes Following Hospitalization for Trauma
|
N/A | |
Completed |
NCT02432456 -
Ketamine Infusion Therapy for the Management of Acute Pain in Adult Rib Fracture Patients
|
Phase 4 | |
Completed |
NCT02266771 -
Impact of V.A.C. Veraflo Therapy in Wounds Requiring Debridement Within an Orthopedic Practice
|
N/A | |
Completed |
NCT02744144 -
Wound Bacterial Microbiota and Their Antibiotic Resistance
|
N/A | |
Completed |
NCT02394821 -
Odor Management in Fungating Wounds Comparing Metronidazole and Polihexanide
|
Phase 3 | |
Not yet recruiting |
NCT01665963 -
Efficacy of TopClosure(C)System in Healing Complicated Pacemaker Wounds
|
N/A | |
Completed |
NCT00151112 -
Comparison of Two Different Procedures for Plexus Anesthesia
|
N/A | |
Not yet recruiting |
NCT03872544 -
Short Term Status of Free Dermal Fat Autografts for Complex Craniofacial Wounds
|
||
Recruiting |
NCT04596124 -
Effectiveness and Tolerability of Fitostimoline Plus Cream and Gauze vs Connettivina Bio Plus Cream and Gauze
|
N/A | |
Recruiting |
NCT05800834 -
Benefits of Morphine Gel for Pain Reduction in Patients With Cancer Wounds
|
Phase 2 | |
Enrolling by invitation |
NCT03880188 -
Long Term Status of Free Dermal Fat Autografts for Complex Craniofacial Wounds
|
||
Terminated |
NCT04775316 -
Prospective, International, Multicenter, Observational Study to Evaluate the Clinical Performance and Safety of a Silicone-coated Transparent Postoperative Dressing
|
||
Enrolling by invitation |
NCT03312504 -
Implementing a School Prevention Program to Reduce Injuries Through Neuromuscular Training
|
N/A |