Does Robotic-assisted Total Knee Arthroplasty Improves Functional Outcome and Gait Pattern in Comparison to Conventional Total Knee Arthroplasty With Use of Bicruciate-stabilized (BS) Implant? Randmized-controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 200
- 试验地点
- 2
- 主要终点
- Changes in patients reported outcome measures - Lysholm knee scoring scale
研究概览
简要总结
This study compares and evaluates differences in movement analysis, patient-reported outcome and radiological assesment between patients undergoing robotic-assisted total knee arthroplasty and conventional one.
详细描述
Osteoarthritis causes the joints to become painful and stiff. Osteoarthritis of the knee is a common condition that is expected to be a lot more frequent in the next two decades. As a consequence, an increase of total knee replacement surgery is predicted. Total knee replacement surgery is offered when knee pain and stiffness caused by osteoarthritis can no longer be managed and these symptoms significantly impact on an individual's normal activities of daily living. Most total knee replacements are successful but up to 34% of all patients have poor functional outcomes following surgery. This leaves affected people at a greater risk of reduced physical activity and thus impacts longer-term general health. Poor outcomes are therefore of importance to patients and have a considerable financial and service-provision impact on National Health Service (NHS) care. While patient-related characteristics and their relationship to patient outcomes have been identified, few studies have been undertaken to determine how kinematic outcomes (how the prosthetic knee moves) are related to functional outcome and patient satisfaction. The kinematic outcome of a total knee replacement is hypothesised to relate to both the structural design (shape) of the implant and the surgical procedure itself. In recent years, there has been development of high technology tools to help surgeon restoring proper joint biomechanics. Nowadays on the market there are several robots designed to fulfill this function. To date, no studies have investigated the kinematic outcomes of robotic-assisted total knee arthroplasty in comparison to conventional surgery. Whilst it is known that long term success of total knee replacement depends largely upon correct alignment of the prosthesis components during surgery, no studies have looked at the anatomical alignments of the osteoarthritic knee prior to undergoing surgery (using Computerised Tomography (CT) scanning). The aim of the study is to examine relationships between movement analysis (kinematic and functional outcomes), patient reported outcome measures (PROMS) with use of the combination of either Oxford score or KOOS score with addition of WOMAC and Lysholm scores and CT measurement, both pre- and post-operatively, between robotic-assisted total knee arthroplasty and conventional surgery.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
盲法说明
Participant will not be informed whether theis surgery was performed with robotics assist.
Outcomes Assessor, Care provider, Investigator will not be informed which type of prosthesis was used in particular patient.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Listed for a primary total knee replacement (TKR)
- •Indication for the TKR is primary osteoarthritis of the knee joint involving one or more compartments
- •Aged 18 or over
- •Patient willing to provide full informed consent to the trial
排除标准
- •Listed for a single-stage one-sided TKR procedure
- •Severe symptoms in the contralateral knee so as to require staged bilateral knee replacements within 6 months of the primary procedure
- •Fixed flexion deformity of 15 degrees or greater who will require excessive resection of the distal femur
- •Clinically assessed uncorrectable varus/valgus deformity of 15 degrees or greater
- •Any co-morbidity which, in the opinion of the investigator, is severe enough to present an unacceptable risk to the patient's safety
- •Inflammatory arthritis
- •Previous septic arthritis in the affected knee joint
- •Previous surgery to the collateral ligaments of the affected knee
- •A contralateral total knee replacement that has been implanted less than one year from the date of consultation
- •A contralateral total knee replacement that is severely painful
- •Patients on warfarin or novel oral anticoagulants (NOACs)
- •Will not be resident in the catchment area for at least 6 months post-surgery
- •Undertaking the surgery as a private patient
- •Patients who, in the opinion of the clinical staff, do not have capacity to consent
- •Patients who are pregnant
- •Unable to understand written and spoken Polish
结局指标
主要结局
Changes in patients reported outcome measures - Lysholm knee scoring scale
时间窗: At baseline, 6-8 weeks post-operatively and 12 months post-operatively.
To explore differences between outcome in patients treated with RATKA and conventional total knee arthroplasty. Results range from 0 to 100, with higher scores corresponding to better outcomes.
Changes in patients reported outcome measures - Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
时间窗: At baseline, 6-8 weeks post-operatively and 12 months post-operatively.
To explore differences between outcome in patients treated with RATKA and conventional total knee arthroplasty. Results range from 0 to 96, with lower scores corresponding to better outcomes.
Changes in patients range of motion (ROM)
时间窗: At baseline, 6-8 weeks post-operatively and 12 months post-operatively.
To explore differences between outcome in patients treated with RATKA and conventional total knee arthroplasty. Results range from 0 to 100, with higher scores corresponding to better outcomes.
Changes in patients reported outcome measures - Oxford Knee Score (OKS)
时间窗: At baseline (preoperatively), 6-8 weeks and 12 months postoperatively.
To explore differences between outcome in patients treated with RATKA and conventional total knee arthroplasty. Results range from 0 to 48, with higher scores corresponding to better outcomes.
Changes in patients reported outcome measures - Knee injury and Osteoarthritis Outcome Score (KOOS)
时间窗: At baseline, 6-8 weeks post-operatively and 12 months post-operatively.
To explore differences between outcome in patients treated with RATKA and conventional total knee arthroplasty. Results range from 0 to 100, with higher scores corresponding to better outcomes.
*We take into consideration the possible use of other PROM questionnaires and analysis of different adverse events depending on the unpredictable circumstances.
时间窗: At baseline, 6-8 weeks post-operatively and 12 months post-operatively.
To explore differences between outcome in patients treated with RATKA and conventional total knee arthroplasty. Results range from 0 to 100, with higher scores corresponding to better outcomes.
次要结局
- Changes in patients reported outcome measures - Oxford Knee Score (OKS)([Time Frame: 1 week and 6-8 weeks post-operatively])
- Changes in patients reported outcomes - Forgotten Joint Score (FJS)(Time Frame: 6-8 weeks and 6 months post-operatively)
- Changes in pain medication(Time Frame: 1 week, 6-8 weeks and 3-6 months post-operatively)
- Biomechanical static balance outcomes(Time Frame: at baseline, 6-8 weeks and 12 months post-operatively)
- Biomechanical 3D motion and emg walking outcomes(Time Frame: at baseline, 6-8 weeks and 12 months post-operatively)
- Biomechanical stair climbing outcomes(Time Frame: at baseline, 6-8 weeks and 12 months post-operatively)
- Biomechanical dynamic balance outcomes(Time Frame: at baseline, 6-8 weeks and 12 months post-operatively)
- Leg muscle strength outcomes(Time Frame: at baseline, 6-8 weeks and 12 months post-operatively)
- Changes in patients reported outcomes - Oxford Knee Score Activity & Participation Questionnaire (OKS_APQ)(Time Frame: 1 week, 6-8 weeks and 6 months post- operatively)
- walking abilities(Time Frame: 6-8 weeks and 12 months post-operatively)
- Length of hospital stay(Time Frame: from baseline to discharge from hospital ranging averagely from 1 up to 7 days postoperatively)
- Radiological outcome on CT scans(Time Frame: at baseline preoperatively and 6 weeks post- operatively)
- 6- minute walking abilities(Time Frame: 6-8 weeks and 12 months post-operatively)
- Changes in patients reported outcomes - UCLA (University of California) score(Time Frame: 6-8 weeks and 12 months post-operatively)
- Changes in knee range of motion(Time Frame: preoperatively, 6-8 weeks and 12 months post-operatively)
- arthroplasty related complications(Time Frame: 1 week post- operatively, 6-8 weeks post-operatively and 6-12 months post-operatively)
- arthroplasty revision surgeries(Time Frame: 1 week, 6-8 weeks and 12 months post-operatively)