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Post-marketing Surveillance Study of the Triathlon Tritanium Baseplate

Conditions
Arthritis
Interventions
Procedure: Knee Replacement
Registration Number
NCT02905097
Lead Sponsor
Golden Jubilee National Hospital
Brief Summary

The aim of the study is to assess the performance of the cementless Triathlon Tritanium tibial baseplate for total knee replacement, with a minimum follow up of 5 years.

Detailed Description

All potential total knee arthroplasty patients from two consultant orthopaedic surgeons at the Golden Jubilee National Hospital (GJNH) will be screened in relation to the inclusion/exclusion criteria. Invitation letters and participant information sheets (PIS) will be sent out to suitable patients who have been referred to the GJNH for total knee replacement (allocated patients) prior to their pre-operative consultation with their surgeon. They will be approached at their consultation visit to seek consent to take part in the study. Patients who have been referred to the GJNH for assessment for a knee replacement (see and treat patients) will be approached only if they are deemed eligible for knee replacement by their consultant, and will be given a copy of the participant information sheet along with the invitation letter. They will be approached for consent to take part in the study at their pre-operative assessment. All patients will be given the opportunity to ask questions about the study before signing the consent form. Consent will be taken by the chief investigator or their delegate, using a signed form.

One hundred patients will be recruited to the study. They will have their surgery performed by one of the participating consultants using the study implant, the Triathlon Tritanium cementless tibial baseplate manufactured by Stryker Corporation.

Participants will receive their standard in-patient care and rehabilitation. Standard hospital care for knee arthroplasty patients is for them to return to the hospital for a post-operative review at 6 weeks and then 1 year and 7 years after operation. Study participants will also be asked to attend the GJNH for two additional research specific appointments at six months and five years. They will be also contacted by post or via telephone to complete a study questionnaire (patient satisfaction) at 3 years post operation.

During the standard care appointments, patients will be reviewed by a member of the arthroplasty team who will collect routine data on the clinical and functional outcomes and implant stability. These data include the Oxford Knee Score (OKS), EURO Quality of life questionnaire (EQ-5D 5L), patient satisfaction and standard radiographic assessment of the implant.

Detailed radiographic analysis will be carried out on radiographs collected as standard and specifically for the study. These will be post-operation at day one (standard), 6 weeks (standard), 6 months (study), 1 year (standard) and the 5 years (study) time points. Study specific radiographic assessment will consist of assessment for radiolucency and osteolysis at specific regions around the tibial and femoral components. Pre-operatively, a standard weight bearing long- leg anterior-posterior (AP) view, lateral view and a skyline view is obtained as per standard care. Post-operatively, standard care consists of a standard weight bearing long-leg AP radiograph at 6 weeks and a short AP and Lateral view at all other reviews.

Study participants will also have two sessions of specialised functional assessment (biomechanical movement analysis and 6-minute walk test) before operation and 1 year after operation during their standard pre and postoperative visits. Biomechanical movement analysis will be carried out in an on-site movement analysis laboratory. Study participants will be required to wear suitable clothing (e.g. tee shirt and shorts) and be barefoot. A number of reflective markers will be attached to specific locations on the body using suitable double sided tape which can be tracked by a number of infrared cameras. participants will be asked to perform the following tasks; walking, stepping up, stepping down, sit-to-stand, stand-to-sit and single leg balance. Each task will be performed at least three times to enable the collection of three good sets of data. In addition, the two stepping tasks will be repeated for each limb. The single leg balance will be performed once for each leg and data will be collected for 30 seconds per limb. A motion capture system will collect limb and torso movements during the task performances while force plates will collect ground reaction forces. The 6-minute walk test requires the participant to walk around a course during a six minute period. They are allowed to have rest breaks for as long and as often as they require. They will be asked to stop walking six minutes after the start of the test and the distance covered during the period will be noted.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
100
Inclusion Criteria
  1. Unilateral TKA
  2. Age 18-75 years
  3. BMI <40
  4. From one of the following health boards: Ayrshire & Arran, Forth Valley, Greater Glasgow & Clyde, Highland, Lanarkshire or Lothian
  5. Suitable to receive the study implant
Exclusion Criteria
  1. Revision of existing knee replacement
  2. Previous hip or knee replacement surgery if within the last 12 months
  3. Previous ankle surgery
  4. Diagnosed osteopenia or osteoporosis
  5. Proximal tibial bone defects
  6. Unable to give informed consent
  7. Unwilling to take part
  8. Unable to return to the Golden Jubilee National Hospital for followup appointments

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Arthroplasty cohortKnee ReplacementA cohort of patients who will undergo knee replacement surgery and will receive Triathlon Tritanium (cementless) tibial implant.
Primary Outcome Measures
NameTimeMethod
Implant survival at five years5 years

Kaplan-Meier implant survival at 5 years

Secondary Outcome Measures
NameTimeMethod
Patient satisfaction6 weeks, 6 months, 1, 3, and 5 years

Patient-reported satisfaction of the knee using a five point Likert scale

Component loosening rate5 years

Number of loose components reported

Component migrationreview at 6 weeks, 6 months, 1 and 5 years

Component movement in mm or degrees from the one day post-operative position

EQ5D-5L6 weeks, 6 months, 1, 3 and 5 years

Patient-reported quality of life

Knee function during walking1 year

Knee angles of movement and loads collected using clinical movement analysis

Fracture rate5 years

Number of peri-prosthetic fractures reported

Bone qualityreview at 6 weeks, 6 months, 1 and 5 years

Evidence of bony ingrowth or osteolysis

Knee stability during single leg balance1 year

Body sway collected using clinical movement analysis in mm

6 minute walk test1 year

Aerobic endurance assessed by the distance walked (m) in a six minutes

Infection rate5 years

Number of infections reported

Radiolucencyreview at 6 weeks, 6 months, 1 and 5 years

Degree of radiolucent lines around the components

Knee function during stepping up1 year

Knee angles of movement and loads collected using clinical movement analysis

Knee function during stepping down1 year

Knee angles of movement and loads collected using clinical movement analysis

Oxford Knee Score6 weeks, 6 months, 1, 3 and 5 years

Patient-reported knee pain and function

Knee function during sit-to-stand1 year

Knee angles of movement and loads collected using clinical movement analysis

Revision rate5 years

Number of cases revised for any reason or for infection

Surgeon feedback1 day post-operatively

Surgeon assessment of the implant ease of implantation using a questionnaire

Knee function during stand-sit-to1 year

Knee angles of movement and loads collected using clinical movement analysis

Trial Locations

Locations (1)

Golden Jubilee National Hospital

🇬🇧

Clydebank, West Dunbartonshire, United Kingdom

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