Treatment With Iovera° for Total Knee Arthroplasty (TKA) Post-Operative Pain
A Post-Market, Prospective, Randomized, Controlled Study To Evaluate The Iovera° Device In Treating Pain Associated With Total Knee Arthroplasty
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Tennessee
-
Germantown, Tennessee, United States, 38138
- Campbell Clinic
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 22 to 79 years of age
- Scheduled to undergo primary unilateral TKA under spinal anesthesia for primary diagnosis of osteoarthritis
- Participant is a class I-III on the American Society of Anesthesiology (ASA) Physical Classification System
- Anticipation of discharge to home after inpatient acute post-op phase based on age, co-morbidities, home environment, and social support are in favor of discharge to home in the opinion of the Investigator.
- Participant is willing and able to give written informed consent.
- Participant is fluent in verbal and written English.
- Participant is willing and able to comply with study instructions and commit to all follow-up visits for the duration of the study.
- Participant is in good general health and free of any systemic disease state or physical condition that might impair evaluation or which in the Investigator's opinion, exposes the participant to an unacceptable risk by study participation.
Exclusion Criteria:
- Chronic opioid use (defined as daily or almost daily use of opioids for >3 months).
- Concurrent painful physical condition, surgery, or musculoskeletal disease that requires analgesic treatment during study follow-up that is not strictly related to the target knee being treated with iovera°, which have the potential to confound the postoperative assessments (e.g., significant pain from other joints, chronic neuropathic pain, concurrent or planned contralateral TKA, concurrent foot, neck, spine, hip, or other musculoskeletal disease, arthritis, or planned surgery, etc.).
- Greater than 15° malalignment (varus or valgus) on pre-operative radiograph.
- Previous Myoscience treatment.
- Previous Partial or Total Knee Arthroplasty. Partial or Total Knee Arthroplasty of the contralateral knee is permitted if surgery was completed at least nine (9) months prior to Screening.
- Body Mass Index ≥ 40
- Prior surgery in the treatment areas that may alter the anatomy of the infrapatellar branch of the saphenous nerve (ISN) or the anterior femoral cutaneous nerve (AFCN) or result in scar tissue in the treatment area.
- Any clotting disorder and/or use of an anticoagulant (e.g. warfarin, clopidogrel, etc.) within seven (7) days prior to administration of the device. Low dose aspirin (81mg or less daily) for cardiac prophylaxis allowed.
- Any local skin condition at the treatment sites that in the Investigator's opinion would adversely affect treatment or outcomes.
- Open and/or infected wound in the treatment areas.
- Allergy to lidocaine.
- History of cryoglobulinemia
- History of paroxysmal cold hemoglobinuria.
- History of cold urticaria.
- History of Raynaud's disease.
- History of opioid or alcohol abuse.
- Participant is pregnant or planning to become pregnant while enrolled in the study.
- Current enrollment in any investigational drug or device study or participation within 30 days prior to screening.
- Currently being treated for related knee injury under worker's compensation claim or equivalent (i.e. legal case).
- Any chronic medical condition that in the Investigator's opinion would prevent adequate participation.
- Any chronic medication use (prescription, over-the-counter, etc.) that in the Investigator's opinion would affect study participation or participant safety.
- For any reason, in the opinion of the Investigator, the participant may not be a suitable candidate for study participation (i.e., history of noncompliance, drug dependency, etc.).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: iovera° Device Treatment Group
Iovera° device presurgical cryoneurolysis treatment, 5 (+/- 2) days prior to TKA.
Additionally, all participants received treatment as per all the standard pre-, peri-, and post-operative surgical protocols.
|
The iovera° device applies cold to a target nerve to cause a temporary peripheral nerve block based on a process called Wallerian degeneration (2nd degree axonotmesis) without disrupting connective nerve tissue.
|
|
No Intervention: Standard of Care Treatment Group
All participants received treatment as per all the standard pre-, peri-, and post-operative surgical protocols.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Cumulative Opioid Consumption
Time Frame: From the time of TKA surgery to 6 weeks post-TKA surgery
|
The cumulative consumption of opioids was determined from the time of Total Knee Arthroplasty (TKA) surgery to 6 weeks post-TKA surgery.
Opioid consumption was converted to morphine milligram equivalents (MME) and participant consumption was verified by pill count at follow-up visits.
The cumulative morphine equivalent was divided by the number of days to provide the total daily morphine equivalent (TME) for the participant,
|
From the time of TKA surgery to 6 weeks post-TKA surgery
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Area Under the Curve (AUC)/Time for Change From Baseline in Knee Injury and Osteoarthritis Outcomes Score (KOOS JR.) Overall Score Through 6 Weeks Post-TKA
Time Frame: Baseline to 6 weeks post-TKA surgery
|
The KOOS JR. was a participant completed questionnaire that consists of 7 questions from 3 subscales: stiffness (1 question), pain (4 questions), and function in daily living (2 questions).
Standardized answer options are given (5 Likert boxes) and each question was assigned a score from none (0) to extreme (4).
A normalized score (100 indicating no symptoms and 0 indicating extreme symptoms) was calculated.
A positive change from baseline indicates improvement.
AUC/time based on Changes from Baseline in KOOS JR. scores through 6 weeks post-TKA, is the AUC of Change in KOOS JR. scores from the Baseline visit through the 6-week visit divided by the number of days from TKA until the 6-week visit.
AUC was calculated using the trapezoidal rule and the changes in the KOOS JR. score at the following time points: Baseline (change=0), 72 hours, 2 weeks, and 6 weeks post-TKA.
|
Baseline to 6 weeks post-TKA surgery
|
|
AUC/Time for Change From Baseline in Numeric Rating Scale (NRS) for Pain Through 6 Weeks Post-TKA
Time Frame: Baseline to 6 weeks post-TKA surgery
|
NRS was an 11-point scale for self-reporting of pain intensity by participants.
Scores range from 0 to 10, where 0 points equals "no pain" and 10 points equals the "worst pain imaginable".
A positive change represented improvement (or reduction) in pain intensity.
AUC/time based on Changes from Baseline in NRS Pain score through 6 weeks post-TKA, is the AUC of Change in NRS for Pain score from the Baseline visit through the 6-week visit divided by the number of days from TKA until the 6-week visit.
AUC was calculated using the trapezoidal rule and the changes in the NRS for Pain score at the following time points: Baseline (change=0), 72 hours, 2 weeks, and 6 weeks post-TKA.
|
Baseline to 6 weeks post-TKA surgery
|
|
AUC/Time for Change From Baseline in Timed Get Up and Go (TUG) Tests Through 6 Weeks Post-TKA
Time Frame: Baseline to 6 weeks post-TKA surgery
|
The time required by the participants to raise from sitting, walk 10 feet, turn around, walk back and sit back down was measured in seconds.
A positive change from baseline indicates improvement.
AUC/time based on Changes from Baseline in the TUG test through 6 weeks post-TKA, is the AUC of Change in TUG test from the Baseline visit through the 6-week visit divided by the number of days from TKA until the 6-week visit.
AUC was calculated using the trapezoidal rule and the changes in the TUG test at the following time points: Baseline (change=0), 72 hours, 2 weeks, and 6 weeks post-TKA.
|
Baseline to 6 weeks post-TKA surgery
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: William Mihalko, MD, PhD, UTHSC - COM - Orthopaedic Surgery & Biomedical Engineering
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- MYO-1265
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Total Knee Arthroplasty
-
NCT07584915Enrolling by invitationTotal Knee Arthroplasty | Total Knee Arthroplasty Recovery
-
NCT05314491RecruitingTotal Knee Arthroplasty | Revision Total Knee Arthroplasty
-
NCT01576263CompletedTotal Knee Arthroplasty | Total Hip Arthroplasty
-
NCT07067060Not yet recruitingKnee Arthroplasty | Total Knee Arthroplasty | Unicompartmental Knee Arthroplasty
-
NCT03443284TerminatedTotal Knee Arthroplasty; Total Hip Arthroplasty
-
NCT03386786TerminatedTotal Knee Arthroplasty; Total Hip Arthroplasty
-
NCT04090125CompletedKnee Arthroplasty, Total | Knee Replacement, Total
-
NCT07199478CompletedTotal Knee Arthroplasty | Total Hip Arthroplasty | ERAS
-
NCT03876431CompletedTotal Knee Arthroplasty | Total Knee Replacement
-
NCT05434767CompletedTotal Knee Arthroplasty | Total Knee Replacement
Clinical Trials on iovera°
-
NCT05604144Active, not recruitingPain Management | Morton's Neuroma
-
NCT02284113Completed
-
NCT06340451RecruitingSpasticity, Cerebral or Spinal Condition
-
NCT06016127CompletedLow Back Pain | Facet Joint Pain
-
NCT03688477WithdrawnAnterior Cruciate Ligament Reconstruction
-
NCT01950065Completed
-
NCT01984619Completed
-
NCT03818022WithdrawnOsteo Arthritis Knee
-
NCT02260921CompletedKnee Osteoarthritis
-
NCT03567187Completed