- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03869203
Prospective Randomized Controlled Trial of Impact of Enhanced Recovery After Surgery(ERAS) for Outcomes of Total Knee and Hip Arthroplasty
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The patients who underwent radiologic examination at Severance Hospital of Severance Hospital and who will received total knee arthroplasty or total hip arthroplasty due to primary degenerative osteoarthritis or osteonecrosis of femoral head. Patients will be divided into two groups: ERAS (early recovery after surgery) protocol group and standard protocol group. On the day before the surgery, the patient group was randomly assigned by the researcher (research nurse) who did not participate in the surgical procedure.
The patients in the ERAS group were given a pre-treatment drug [300 mg (gabapentin) and 10 mg oxycontin (oxycontin) and 2 mg prednisolone (prednisolone 10 mg)] on the evening before surgery. And pre-operative fasting should not exceed 6 hours, and clear liquid fasting should not exceed 2 hours. In addition, 400 ml of oral carbohydrate should be taken 2 to 4 hours before surgery to ensure adequate blood sugar and encourage regular diet (light meal) as soon as possible within a tolerable range after surgery. The initial pain after surgery is actively controlled by oral drugs such as celebrex and IR codon, and injections such as tramadol and demerol. On the first postoperative day, the urinary catheter is removed and CPM (continuous passive motion) rehabilitation is started.
On the other hand, in standard group, there is no medication as a pre-treatment drug. Patients should be fasted for 8 hours in both solid and liquid preoperatively. After the surgery, allow a small amount of clear liquid to remain at the 4-hour fasting period after the operation, and allow the fluid to start within a tolerable range after 4 hours. The urinary catheter is removed on the first postoperative day and CPM rehabilitation is started from the afternoon. Post-operative ambulation should begin as early as possible on the second postoperative day.
All patients will undergo anesthesia for general anesthesia or spinal anesthesia with a nerve block (adductor canal block or femoral nerve block). The quality of recovery index was assessed on the day before surgery and on the POD 1 quality of recovery score (QoR) 40 questionnaire. And the length of hospital stay, first eating time, first assisted walking time, and start of rehabilitation after surgery of all patients will be recorded. The number of times that need antiemetics due to nausea / vomiting during the hospitalization period will be recorded. After discharge from the hospital, the patient will visit outpatient clinic at 4 ± 2 weeks postoperatively and will be checked a physical examination such as the ROM of the knee. At 3 ± 1 months and 6 ± 1 months after surgery, VAS, WOMAC, AKS, knee ROM, and PF score of all patients would be checked in outpatients clinic. In addition, morbidity, complications, mortality, and re-admission before and up to 6 months after surgery would be recorded.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Seoul, Korea, Republic of
- Recruiting
- Department of Orthopedic Surgery, Yonsei University, College of Medicine
-
Contact:
- Kwan Kyu Park, PhD
- Phone Number: 82-2-2228-2180
- Email: kkpark@yuhs.ac
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 1. elective total knee arthroplasty for degenerative osteoarthritis
- 2. elective total hip arthroplasty for osteoarthritis of osteonecrosis of femoral head
Exclusion Criteria:
- 1. ASA class >3
- 2. severe medical comorbidities
- 3. inflammatory arthritis including rheumatoid arthritis
- 4. severe instability of knee or hip
- 5. revision surgery
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Enhanced recovery after surgery (ERAS) patients
Patients planned to undergoing total knee arthroplasty or total hip arthroplasty, following the ERAS perioperative care.
|
The patients in the ERAS group were given a pre-treatment drug [300 mg (gabapentin, Neurontin 300mg) and 10 mg oxycontin (oxycontin, Oxycontin CR 10mg) and 2 mg prednisolone (prednisolone 10 mg, Solondo 5mg)] on the evening before surgery.
And pre-operative fasting should not exceed 6 hours, and clear liquid fasting should not exceed 2 hours.
In addition, 400 ml of oral carbohydrate should be taken 2 to 4 hours before surgery to ensure adequate blood sugar and encourage regular diet (light meal) as soon as possible within a tolerable range after surgery.
The initial pain after surgery is actively controlled by oral drugs such as celebrex and IR codon, and injections such as tramadol and demerol.
On the first postoperative day, the urinary catheter is removed and CPM (continuous passive motion) rehabilitation is started.
|
No Intervention: Control patients
Patients planned to undergoing total knee arthroplasty or total hip arthroplasty, following the traditional perioperative care.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Quality of recovery score(QoR40)
Time Frame: 1 day before surgery
|
Before surgery, QoR40 questionnaires will be used to compare the quality of recovery after anesthesia.
QoR40 is a 40 items quality of recovery score that has been validated in a diverse group of patients.
It is comprised of five dimensions which are physical comfort (12 items), emotional state (9 items), physical independence (5 items), psychological support (7 items), and pain (7 items).
Each item of the questionnaire is graded on a five-point Likert scale, and the global QoR-40 scores range from 40 (extremely poor quality of recovery) to 200 (excellent quality of recovery).
|
1 day before surgery
|
Quality of recovery score(QoR40)
Time Frame: postoperative 1 day
|
After surgery, QoR40 questionnaires will be used to compare the quality of recovery after anesthesia.
QoR40 is a 40 items quality of recovery score that has been validated in a diverse group of patients.
It is comprised of five dimensions which are physical comfort (12 items), emotional state (9 items), physical independence (5 items), psychological support (7 items), and pain (7 items).
Each item of the questionnaire is graded on a five-point Likert scale, and the global QoR-40 scores range from 40 (extremely poor quality of recovery) to 200 (excellent quality of recovery).
|
postoperative 1 day
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Length of hospital stay
Time Frame: From pre-surgery to discharge, up to 4 weeks
|
The investigators will record the entire length of hospital stay.
|
From pre-surgery to discharge, up to 4 weeks
|
First eating time
Time Frame: From pre-surgery to discharge, up to 4 weeks
|
The investigators will record how soon the patients have started a normal meal, assisted walking and continuous passive movement rehabilitation after surgery.
|
From pre-surgery to discharge, up to 4 weeks
|
First assisted walking time
Time Frame: From pre-surgery to discharge, up to 4 weeks
|
The investigators will record how soon the patients have started a normal meal, assisted walking and continuous passive movement rehabilitation after surgery.
|
From pre-surgery to discharge, up to 4 weeks
|
Start of rehabilitation(CPM)
Time Frame: From pre-surgery to discharge, up to 4 weeks
|
The investigators will record how soon the patients have started a normal meal, assisted walking and continuous passive movement rehabilitation after surgery.
|
From pre-surgery to discharge, up to 4 weeks
|
Mortality
Time Frame: up to 6 months after surgery
|
The investigators will investigate mortality up to 6 months after surgery.
|
up to 6 months after surgery
|
Morbidity
Time Frame: up to 6 months after surgery
|
The investigators will investigate morbidity up to 6 months after surgery.
|
up to 6 months after surgery
|
Postoperative surgical complication
Time Frame: up to 6 months after surgery
|
The investigators will investigate postoperative complication of surgery up to 6 months after surgery.
|
up to 6 months after surgery
|
Number of readmission
Time Frame: up to 6 months after surgery
|
The investigators will investigate number of readmission up to 6 months after surgery.
|
up to 6 months after surgery
|
Clinical score of total joint arthroplasty (VAS)
Time Frame: at postoperative 3±1 months
|
The investigators will record the clinical score of total joint arthroplasty(VAS) at 3 months after surgery.
|
at postoperative 3±1 months
|
Clinical score of total joint arthroplasty (WOMAC)
Time Frame: at postoperative 3±1 months
|
The investigators will record the clinical score of total joint arthroplasty(WOMAC, The Western Ontario and McMaster Universities Arthritis) at 3 months after surgery.
|
at postoperative 3±1 months
|
Clinical score of total joint arthroplasty (AKS)
Time Frame: at postoperative 3±1 months
|
The investigators will record the clinical score of total joint arthroplasty(AKS, American knee society score) at 3 months after surgery.
|
at postoperative 3±1 months
|
Clinical score of total joint arthroplasty (knee ROM)
Time Frame: at postoperative 3±1 months
|
The investigators will record the clinical score of total joint arthroplasty(knee ROM) at 3 months after surgery.
|
at postoperative 3±1 months
|
Clinical score of total joint arthroplasty (Patellofemoral score)
Time Frame: at postoperative 3±1 months
|
The investigators will record the clinical score of total joint arthroplasty(Patellofemoral score) at 3 months after surgery.
|
at postoperative 3±1 months
|
Clinical score of total joint arthroplasty (Harris hip score)
Time Frame: at postoperative 3±1 months
|
The investigators will record the clinical score of total joint arthroplasty(Harris hip score) at 3 months after surgery.
|
at postoperative 3±1 months
|
Clinical score of total joint arthroplasty (VAS)
Time Frame: at postoperative 6±1 months
|
The investigators will record the clinical score of total joint arthroplasty(VAS) at 6 months after surgery.
|
at postoperative 6±1 months
|
Clinical score of total joint arthroplasty (WOMAC)
Time Frame: at postoperative 6±1 months
|
The investigators will record the clinical score of total joint arthroplasty(WOMAC, The Western Ontario and McMaster Universities Arthritis) at 6 months after surgery.
|
at postoperative 6±1 months
|
Clinical score of total joint arthroplasty (AKS)
Time Frame: at postoperative 6±1 months
|
The investigators will record the clinical score of total joint arthroplasty(AKS, American knee society score) at 6 months after surgery.
|
at postoperative 6±1 months
|
Clinical score of total joint arthroplasty (knee ROM)
Time Frame: at postoperative 6±1 months
|
The investigators will record the clinical score of total joint arthroplasty(knee ROM) at 6 months after surgery.
|
at postoperative 6±1 months
|
Clinical score of total joint arthroplasty (Patellofemoral score)
Time Frame: at postoperative 6±1 months
|
The investigators will record the clinical score of total joint arthroplasty(Patellofemoral score) at 6 months after surgery.
|
at postoperative 6±1 months
|
Clinical score of total joint arthroplasty (Harris hip score)
Time Frame: at postoperative 6±1 months
|
The investigators will record the clinical score of total joint arthroplasty(Harris hip score) at 6 months after surgery.
|
at postoperative 6±1 months
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 4-2019-0010
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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 Arthroplasty, Replacement, Knee, Hip
-
Fondazione Don Carlo Gnocchi OnlusCompletedArthroplasty, Replacement, Knee | Arthroplasty, Replacement, HipItaly
-
Bornholms RegionskommuneCompletedArthroplasty, Replacement, Knee | Arthroplasty, Replacement, HipDenmark
-
Campus Bio-Medico UniversityRecruitingArthroplasty, Replacement, Knee | Arthroplasty, Replacement, HipItaly
-
SCRI Development Innovations, LLCWithdrawnArthroplasty, Replacement, Knee | Arthroplasty, Replacement, HipUnited States
-
Sunnybrook Health Sciences CentreActive, not recruitingArthroplasty, Replacement, Knee | Arthroplasty, Replacement, HipCanada
-
University of British ColumbiaThe Arthritis Society, Canada; Centre for Aging SMART; Centre for Advancing Health...Not yet recruitingArthroplasty, Replacement, Knee | Arthroplasty, Replacement, HipCanada
-
University Hospital, Strasbourg, FranceRecruitingArthroplasty, Hip Replacement | Arthroplasty, Knee ReplacementFrance
-
Henry Ford Health SystemConsumer Sleep SolutionsNot yet recruitingArthroplasty, Replacement, Knee | Arthroplasty, Replacement, HipUnited States
-
Haute Ecole de Santé VaudCompletedArthroplasty, Replacement, Knee | Arthroplasty, Replacement, HipSwitzerland
-
The Cleveland ClinicZimmer Biomet; Accelero Health Partners, LLCCompletedArthroplasty, Replacement, Knee | Arthroplasty, Replacement, HipUnited States
Clinical Trials on Enhanced recovery after surgery (ERAS)
-
Instituto Brasileiro de Controle do CancerWithdrawnEnhanced Recovery After Surgery | Gynecologic Surgical ProceduresBrazil
-
The Second Hospital of Shandong UniversityRecruitingLung Cancer | Surgery | ERASChina
-
Instituto Brasileiro de Controle do CancerRecruitingGynecologic Cancer | Enhanced Recovery After SurgeryBrazil
-
University of Colorado, DenverRecruitingEnhanced Recovery After Surgery | Gynecologic DiseaseUnited States
-
University Hospital, GrenobleCompleted
-
University Hospital, Clermont-FerrandMinistry of Health, France; Direction Générale de l'Offre de SoinsUnknown
-
Hartford HospitalCompleted
-
Fudan UniversityUnknownColorectal SurgeryChina
-
Alexandria UniversityCompletedSurgery | Lumbar Spine Disease | ERAS | Non Insulin Dependent Diabetes MellitusEgypt
-
Kocaeli Derince Education and Research HospitalKocaeli UniversityUnknownEnhanced Recovery After Surgery | Open Heart SurgeryTurkey