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Reinflation After Early Tourniquet Release in Total Knee Arthroplasty

18. Mai 2014 aktualisiert von: Tae Kyun Kim, Seoul National University Hospital

The Effects of Tourniquet Reinflation After Early Tourniquet Release in Total Knee Arthroplasty

This study is aimed to determine the efficacy and the safety of the tourniquet reinflation after early tourniquet release in total knee arthroplasty, compared to the method of early deflation without reinflation. The investigators hypothesized that the reinflation after early release of the tourniquet would be effective in terms of improved visualization of the surgical field and decreased operation time and blood loss, whereas it would increase tourniquet-related complication due to longer tourniquet-use time.

Studienübersicht

Status

Unbekannt

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

Total knee arthroplasty(TKA) is mostly performed with tourniquet applied, because it allows decreased intraoperative blood loss, better visualization of surgical field and better cement fixation of the implants, compared to the TKA without using tourniquet. However, there remains a controversy about the timing of tourniquet release, so the tourniquet may be unreleased throughout the whole operation time or released early just after cement fixation of the implants, atc. Early tourniquet release is generally aimed to control hidden arterial bleeding which would not be revealed if the tourniquet was unreleased. This method was reported to reduce arterial bleeding and its related complications, but it was also known that increase intraoperative bleeding, incidence of transfusion, and operation time. On the other hand, late tourniquet release, which the tourniquet is unreleased until the wound is closed, is reported to increase tourniquet-use time and related complications owing to longer tourniquet time, although it gives shorter operation time. The investigators have been used a way of reinflation of tourniquet after early release, once the arterial bleeding was controlled sufficiently, to balance the advantages and disadvantages of the early tourniquet release. The investigators were able to control arterial bleeding during the time the tourniquet was released, and the remained procedures were performed conveniently with good visualization of the surgical field after the tourniquet was reinflated again. However, there was no previous studies about the efficacy and the safety of the way of reinflation after early release of the tourniquet in the literature. Therefore, the investigators ask in this study whether the reinflation after early tourniquet release has advantages over the method of early tourniquet release without reinflation, in terms of efficacy and safety.

Studientyp

Interventionell

Einschreibung (Voraussichtlich)

174

Phase

  • Phase 4

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

  • Korea, Republik von
    • Gyeonggi-do
      • Seongnam-Si, Gyeonggi-do, Korea, Republik von, 463-707
        • Rekrutierung
        • Joint Reconstruction Center, Seoul National University Bundang Hospital
        • Kontakt:
          • Tae Kyun Kim, MD, PhD
          • Telefonnummer: 82-31-787-7196
          • E-Mail: osktk@snubh.org

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

40 Jahre bis 90 Jahre (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • Diagnosis of primary osteoarthritis of the knee
  • Scheduled for elective total knee arthroplasty
  • Written signed consent

Exclusion Criteria:

  • Revision TKA
  • Diagnosis other than primary osteoarthritis
  • Intra-articular indwelling drainage
  • Refusing participate

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Doppelt

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Reinflation after early deflation
The tourniquet is released after cement implant fixation, and then reinflated, once arterial bleeding was controlled (Reinflation after early tourniquet deflation).
Verfahren: Reinflation after early tourniquet deflation
The tourniquet is released after cement implant fixation, and then reinflated, once arterial bleeding was controlled
Andere Namen:
  • Reinflation after early tourniquet release
Kein Eingriff: No reinflation after early deflation
The tourniquet is released after cement implant fixation, and remained deflated without reinflation, even after hemostasis.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Operation time
Zeitfenster: from skin incision to wound closure
Total time between initial skin incision and wound closure
from skin incision to wound closure

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Tourniquet time
Zeitfenster: total sum of time between inflation and deflation of tourniquet
Total time of tourniquet-use during the operation which defined from skin incision to the wound closure
total sum of time between inflation and deflation of tourniquet
Difficulty of the operation
Zeitfenster: from skin incision to wound closure
Measured by the number of operative field clearance using gauze to make the remained procedure convenient
from skin incision to wound closure
Incidence of transfusion
Zeitfenster: within 2weeks after surgery
The incidence of allogenic or autologous (preoperative autologous blood donation) transfusion after surgery due to significant hemoglobin drop within 2weeks after surgery
within 2weeks after surgery
Wound complications
Zeitfenster: on the 2nd and 14th day after surgery
wound complications evaluated on the 2nd and 14th day after surgery, such as ecchymosis, subcutaneous hematoma, hemarthrosis, and oozing
on the 2nd and 14th day after surgery
Thigh complications
Zeitfenster: within 2 weeks
Thigh complication due to the tourniquet, such as ecchymosis, skin bullae, and skin necrosis around the area of tourniquet application
within 2 weeks
Venous thromboembolism
Zeitfenster: within 2 weeks
symptomatic deep vein thrombosis and pulmonary embolism, detected within 2weeks after surgery
within 2 weeks
Postoperative pain (VAS)
Zeitfenster: on the 2nd and 5th day after surgery.
An independent investigator who was blinded to randomization assessed knee and thigh pain level using 0 to 10 visual analog scale (VAS) that ranged from 0 (no pain) to 10 (worst imaginable pain) on the 2nd and 5th day after surgery.
on the 2nd and 5th day after surgery.
More painful site
Zeitfenster: on the 2nd and 5th day after surgery
An independent investigator who was blinded to randomization assessed the more painful site either knee (operation site) or thigh (tourniquet application site) on the 2nd and 5th day after surgery.
on the 2nd and 5th day after surgery
More painful side in SBTKA
Zeitfenster: on the 2nd and 5th day after surgery.
An independent investigator who was blinded to randomization assessed the more painful side in patients undergoing simultaneous bilateral TKA (SBTKA), whose each knee will be allocated into experimental and control group, respectively.
on the 2nd and 5th day after surgery.
Amount of drainage
Zeitfenster: Until the drainage removal, average of 1 to 2 days after surgery
Total amount of subcutaneous indwelled drainage before removal of it.
Until the drainage removal, average of 1 to 2 days after surgery
Hemoglobin drop on the 2nd day after surgery
Zeitfenster: On the 2nd day after surgery
The hemoglobin drop calculated by subtracting hemoglobin level of postoperative 2nd day from the preoperative value
On the 2nd day after surgery
Hemoglobin drop on the 5th day after surgery
Zeitfenster: On the 5th day after surgery
The hemoglobin drop calculated by subtracting hemoglobin level of postoperative 5th day from the preoperative value
On the 5th day after surgery

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Seoul National University Hospital

Ermittler

  • Hauptermittler: Tae Kyun Kim, MD, PhD, Joint Reconstruction Center, Seoul National University Bundang Hospital

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn

1. Februar 2013

Primärer Abschluss (Voraussichtlich)

1. Dezember 2014

Studienabschluss (Voraussichtlich)

1. Januar 2015

Studienanmeldedaten

Zuerst eingereicht

20. Februar 2013

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

15. April 2013

Zuerst gepostet (Schätzen)

16. April 2013

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Schätzen)

20. Mai 2014

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

18. Mai 2014

Zuletzt verifiziert

1. Mai 2014

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Schlüsselwörter

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • B-1206/158-004

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