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.
調査の概要
研究の種類
入学 (実際)
参加基準
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- end stage knee OA necessitating TKR surgeries
Exclusion Criteria:
- autoimmune diseases, malignancies, previous knee surgery or post-traumatic arthritis
研究計画
研究はどのように設計されていますか?
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
---|---|
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.
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Concentration of IL-6(pg/mL)
時間枠:24 hours after TKR
|
serum level change from baseline 24 hours after TKR , hemovac level 24 hours after TKR
|
24 hours after TKR
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
---|---|---|
Concentration of IL-10(pg/mL)
時間枠: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)
時間枠:24 hours after TKR
|
serum level change from baseline 24 hours after TKR , hemovac level 24 hours after TKR
|
24 hours after TKR
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
Navigation TKRの臨床試験
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Kantonsspital Baselland Bruderholz完了
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Central Finland Hospital DistrictTurku University Hospital; Oulu University Hospital; Kuopio University Hospital; Seinajoki Central... と他の協力者募集
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Oslo University HospitalMedacta International SA積極的、募集していない
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Corin引きこもった関節リウマチ | 変形性関節症、膝 | 外傷後変形性膝関節症 | 他に分類されない内反変形、膝 | 他に分類されない外反母趾変形、膝 | 屈曲変形、膝 | 大腿骨遠位端骨折 | 脛骨上端骨折
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University of BathNorth Bristol NHS Trust完了