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Total Knee Arthroplasty: Functional and Clinical Outcomes

28 avril 2017 mis à jour par: Duke University

Clinical and Functional Outcomes Following Total Knee Replacement Using Two Different Implants

The purpose of this study is to assess the differences in functional and patient reported outcomes between total knee replacement (TKA) implants. In addition, this work will examine the correlation between functional assessments and patient reported outcomes following surgery. All subjects will complete assessments preoperatively, 4-6 weeks following TKA and then one year following TKA. Subjects will complete a series of patient reported outcomes as well as a series of functional outcomes at each of the time points of interest. The analysis will include a repeated measures design to determine differences between groups across time as well as correlations between the functional and patient reported outcomes. This work will hopefully determine the importance of using objective functional outcomes following TKA as well as determining the need for patient assessments out to one year following surgery.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Description détaillée

The number differences in subjects analyzed from baseline to 6 weeks to 52 weeks are due to the fact that we did not use the 6 week time point in the final analysis based on the clinical decision that 6 weeks was too early in recovery to provide accurate information for clinical decision making. Therefore the patients used in the final analysis were those subjects who were able to and completed the assessment at pre-op and 1 year post-op which is how we get to the 20 subjects per group.

Type d'étude

Interventionnel

Inscription (Réel)

60

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • États-Unis
    • North Carolina
      • Durham, North Carolina, États-Unis, 27710
        • Duke University Medical Center

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans à 85 ans (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  1. Patients requiring primary total knee replacement
  2. Patients willing and able to comply with the follow-up visits and evaluations
  3. Patients willing to sign informed consent approved by the Institutional Review Board

Exclusion Criteria:

  1. Patients with inflammatory arthritis
  2. Patients with diabetic neuropathy
  3. Patients unable to ambulate without the use of an assistive device prior to surgery
  4. Patients unable to stand in single limb stance on each foot prior to surgery.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Soins de soutien
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Comparateur actif: Stryker
Subjects will be receiving the Stryker Triathlon total knee replacement
Dispositif: Stryker
Comparateur actif: Zimmer
Subjects will be receiving a Zimmer NexGen total knee replacement
Dispositif: Zimmer

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Change in Lower Quarter Y-Balance Test (YBT-LQ) (Dynamic Balance) From Baseline to 6 Weeks Following Total Knee Replacement
Délai: Baseline (Pre-Operative) to 6 weeks following total knee replacement
The lower quarter y-balance test (YBT-LQ) is a test of dynamic balance in unilateral stance that has been deemed to be reliable and valid. The YBT-LQ consists of each patient standing on one leg and reaching as far as they can with their non-stance leg in the anterior, posteromedial and posterolateral direction while standing on the other foot on a centralized stance platform. The composite score is calculated as the sum of the three reach directions divided by 3 time the limb length and will be reported as a percentage of limb length.
Baseline (Pre-Operative) to 6 weeks following total knee replacement
Change in Lower Quarter Y-Balance Test (YBT-LQ) (Dynamic Balance) From Baseline to 52 Weeks Following Total Knee Replacement
Délai: Baseline (Pre-Operative) to 52 weeks following total knee replacement
The lower quarter y-balance test (YBT-LQ) is a test of dynamic balance in unilateral stance that has been deemed to be reliable and valid. The YBT-LQ consists of each patient standing on one leg and reaching as far as they can with their non-stance leg in the anterior, posteromedial and posterolateral direction while standing on the other foot on a centralized stance platform. The composite score is calculated as the sum of the three reach directions divided by 3 time the limb length and will be reported as a percentage of limb length.
Baseline (Pre-Operative) to 52 weeks following total knee replacement

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Change in Walking Speed From Baseline to 52 Weeks Following Total Knee Replacement.
Délai: Baseline and 52 weeks following total knee replacement
Each subject will complete three walking trials at a self-selected comfortable walking speed along a 5 meter walkway in order to record walking speed at each time point.
Baseline and 52 weeks following total knee replacement
Walking Speed at 6 Weeks Following Total Knee Replacement.
Délai: 6 weeks following total knee replacement
Each subject will complete three walking trials at a self-selected comfortable walking speed along a 5 meter walkway in order to record walking speed at each time point.
6 weeks following total knee replacement

Autres mesures de résultats

Mesure des résultats
Description de la mesure
Délai
Change in University of California, Los Angeles (UCLA) Activity Score From Baseline to 52 Weeks Following Total Knee Replacement.
Délai: Baseline and 52 weeks following total knee replacement
The UCLA activity score is a validated patient reported outcome of overall physical activity. Results on a scale of 1 to 10, 1 is "Wholly Inactive, dependent on others, and can not leave residence" and 10 is "Regularly participates in impact sports".
Baseline and 52 weeks following total knee replacement
University of California, Los Angeles (UCLA) Activity Score at 6 Weeks Following Total Knee Replacement.
Délai: 6 weeks following total knee replacement
The UCLA activity score is a validated patient reported outcome of overall physical activity. Results on a scale of 1 to 10, 1 is "Wholly Inactive, dependent on others, and can not leave residence" and 10 is "Regularly participates in impact sports".
6 weeks following total knee replacement
Change in Knee Injury and Osteoarthritis Outcome Score (KOOS) Total From Baseline to 52 Weeks Following Total Knee Replacement.
Délai: Baseline (Pre-Operative) and 52 weeks following total knee replacement
The KOOS is a standardized and validated patient outcome score that assesses functional limitation in patient with knee problems. KOOS consists of 5 subscales; Pain, other Symptoms, Function in daily living (ADL), Function in sport and recreation (Sport/Rec) and knee related Quality of life (QOL). The previous week is the time period considered when answering the questions. Standardized answer options are given (5 Likert boxes) and each question is assigned a score from 0 to 4. A normalized score (100 indicating no symptoms and 0 indicating extreme symptoms) is calculated for each subscale.
Baseline (Pre-Operative) and 52 weeks following total knee replacement
Change in Forgotten Joint Score (FJS) From 6 Weeks to 52 Weeks Following Total Knee Replacement.
Délai: 6 weeks and 52 weeks following total knee replacement
The FJS is a patient reported measure of how bothersome the total joint replacement is for them, how much it affects daily activity and how much they are aware of the implant. The FJS is a 12-question survey regarding functional outcome, pain, stability, daily living, activity and sport. Scoring is from 0 to 4 with 0 as the best outcome; a low score means high satisfaction. Not all questions must be answered to score, all responses are summed and the total is divided by number of completed items multiplied by 25, with the final result subtracted from 100. The score range is from 0 to 100 with the highest score of 100 indicating the best outcome (the joint is completely "forgotten") and 0 indicating the worst outcome.
6 weeks and 52 weeks following total knee replacement
Knee Society Score (KSS)
Délai: Baseline (Pre-Operative), 6 weeks and 52 weeks following total knee replacement
The KSS is a patient reported measure of knee function that is specific to patients who are scheduled to receive or have previously had a total knee replacement. This outcome measures both patient reported pain and function changes from prior to surgery through recovery. The score range is from 0 to 100. The highest score of 100 points will be obtained by a well-aligned knee with no pain, 125 degrees of motion, and negligible anteroposterior and mediolateral instability.
Baseline (Pre-Operative), 6 weeks and 52 weeks following total knee replacement
Sit to Stand Time
Délai: Baseline (Pre-Operative), 6 weeks and 52 weeks following total knee replacement
The sit to stand test requires patients to stand up and sit down as many times as possible in 10 seconds from a standard arm chair.
Baseline (Pre-Operative), 6 weeks and 52 weeks following total knee replacement
Timed Get up and go
Délai: Baseline (Pre-Operative), 6 weeks and 52 weeks following total knee replacement
The timed up and go requires a patient to rise from a chair walk three meters around a piece of tape and return to the chair again as quickly as possible.
Baseline (Pre-Operative), 6 weeks and 52 weeks following total knee replacement

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Duke University

Les enquêteurs

  • Chercheur principal: Samuel S Wellman, MD, Duke University

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 février 2013

Achèvement primaire (Réel)

26 février 2016

Achèvement de l'étude (Réel)

26 février 2016

Dates d'inscription aux études

Première soumission

12 mars 2013

Première soumission répondant aux critères de contrôle qualité

12 mars 2013

Première publication (Estimation)

14 mars 2013

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

2 juin 2017

Dernière mise à jour soumise répondant aux critères de contrôle qualité

28 avril 2017

Dernière vérification

1 avril 2017

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • Pro00043737
  • 193447 (Autre subvention/numéro de financement: Stryker)

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