- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT03163888
Effects of Navigation Versus Conventional Total Knee Arthroplasty on the Levels of Inflammation Markers
Effects of Computer Navigation Versus Conventional Total Knee Arthroplasty on the Levels of Inflammation Markers: A Prospective Comparative Study
Total knee arthroplasty (TKA) is a well-established modality for the treatment of advanced knee osteoarthritis with high satisfaction rate. However, the traditional cutting jigs for distal femur cutting inevitably violates the medullary canal of femoral bone. The process of intramedullary reaming for the insertion of distal femur cutting jigs stimulated the dissipation of marrow emboli that reported lead to increased risk of myocardial infarction or cardiac stress perioperatively. There are emerging refinements aiming to reduce the insult to the medullary canal of the distal femur as well as to improve the prosthetic alignment, such as navigation assisted TKA or robotic surgery.
In addition to better prosthetic alignment, computer-assisted navigation TKAs also mitigate perioperative blood loss and systemic emboli. The publication previously published by the investigators showed that navigation TKAs can lead to lesser extent of elevation of endothelial injury markers than the traditional TKAs. However, the detrimental effects of intramedullary reaming seem to be multi-dimensional and the whole picture has not been elucidated clearly at present.
Previous studies have shown that operative trauma can trigger marked immune responses. Operative procedures can simultaneously stimulate the pro-inflammatory and anti-inflammatory response, with 80% of the leucocyte transcriptome being affected. Most studies of hip or knee surgery found that operation-triggered immune reactions are associated with postoperative recovery, infection, and even mortality.
The navigation TKAs avoid the process of intra-medullary reaming, which is the mandatory part of conventional TKA for the distal femur cutting. The investigators hypothesize that the reaming process may exert substantial inflammatory response, which can be manifested by higher level of inflammatory markers in the serum and hemovac drainage samples obtained from the participants undergoing conventional TKAs.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Undersøgelsestype
Tilmelding (Faktiske)
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Barn
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Prøveudtagningsmetode
Studiebefolkning
Beskrivelse
Inclusion Criteria:
- end stage knee OA necessitating TKR surgeries
Exclusion Criteria:
- autoimmune diseases, malignancies, previous knee surgery or post-traumatic arthritis
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Kohorter og interventioner
Gruppe / kohorte |
Intervention / Behandling |
---|---|
Navigation TKR group
TKR performed under computer navigation without violating distal femur bone marrow.
|
Traditional over Conventional TKR
|
Conventional TKR group
TKR performed under conventional distal femur cutting juts with violation of distal femur bone marrow.
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
---|---|---|
Concentration of IL-6(pg/mL)
Tidsramme: 24 hours after TKR
|
serum level change from baseline 24 hours after TKR , hemovac level 24 hours after TKR
|
24 hours after TKR
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
---|---|---|
Concentration of IL-10(pg/mL)
Tidsramme: 24 hours after TKR
|
serum level change from baseline 24 hours after TKR , hemovac level 24 hours after TKR
|
24 hours after TKR
|
Concentration of TNF-alpha (pg/mL)
Tidsramme: 24 hours after TKR
|
serum level change from baseline 24 hours after TKR , hemovac level 24 hours after TKR
|
24 hours after TKR
|
Samarbejdspartnere og efterforskere
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- 100-0038A3
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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Kliniske forsøg med Inflammatorisk respons
-
BioglaneUniversity Rovira i Virgili; National Research Council, Spain; Technological...AfsluttetInsulinemisk respons | Glykæmisk responsSpanien
-
Arkansas Children's Hospital Research InstituteEunice Kennedy Shriver National Institute of Child Health and Human Development...AfsluttetSIRS (Systemic Inflammatory Response Syndrome)Forenede Stater
-
PepsiCo Global R&DAfsluttetGlykæmisk respons | Insulinemisk respons | Emne Hunger ResponseCanada
-
PepsiCo Global R&DAfsluttetGlykæmisk respons | Insulinemisk respons | Subjectvie SultCanada
-
Chinese PLA General HospitalAfsluttetSepsis | SIRS (Systemic Inflammatory Response Syndrome)Kina
-
Chinese PLA General HospitalUkendtSepsis | SIRS (Systemic Inflammatory Response Syndrome)Kina
-
Azienda Ospedaliera Specializzata in Gastroenterologia...AfsluttetSunde emner | Glykæmisk respons | Insulinemisk responsItalien
-
University of ArkansasAfsluttetPædiatriske patienter med SIRS (Systemic Inflammatory Response Syndrome)Forenede Stater
-
Ankara City Hospital BilkentIkke rekrutterer endnuInflammatorisk responsKalkun
-
Nutricia ResearchRekrutteringGlykæmisk responsCanada
Kliniske forsøg med Navigation TKR
-
Istituto Clinico HumanitasAfsluttet
-
Royal Devon and Exeter NHS Foundation TrustStryker NordicRekruttering
-
Kantonsspital Baselland BruderholzAfsluttetSlidgigt | Røntgenstråler; EffekterSchweiz
-
Central Finland Hospital DistrictTurku University Hospital; Oulu University Hospital; Kuopio University Hospital og andre samarbejdspartnereRekruttering
-
University of LeedsZimmer BiometAfsluttetKnæ slidgigtDet Forenede Kongerige
-
ElsanIkke rekrutterer endnu
-
Zimmer BiometRekrutteringRheumatoid arthritis | Slidgigt i knæetJapan
-
Oslo University HospitalMedacta International SAAktiv, ikke rekrutterende
-
Geisinger ClinicApos Medical and Sports Technology Ltd.RekrutteringSlidgigt, knæForenede Stater
-
Riphah International UniversityIkke rekrutterer endnu