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Effect of Methylprednisolone on Complement Activation in Patients Undergoing Total Knee-arthroplasty

Phase 3
Completed
Conditions
Osteoarthrosis
Interventions
Registration Number
NCT02332616
Lead Sponsor
Rigshospitalet, Denmark
Brief Summary

This study evaluates the pathophysiological effects of a single dose of methylprednisolone administered prior to total knee-arthroplasty surgery. The investigators examine the effect on complement activation.

Half of participants will receive intravenous Solu-Medrol 125 mg, while the other half will receive placebo.

The investigators hypothesize that the group receiving methylprednisolone will experience beneficial inhibition of the undesirable parts of the complement activation.

Detailed Description

The anti-inflammatory effects of glucocorticoids are well known. The beneficial effects on postoperative pain, postoperative nausea and vomiting are well-documented.

Anaesthesia and surgery are associated with a dramatic increase in the inflammatory response. The complement system participates in the disposal of products due to inflammatory damage. The complement activation generates proinflammatory mediators which amplifies the tissue damage and the inflammation.

Glucocorticoid administration prior to surgery is thought to effectively reduce the inflammatory response and the activation of the complement system. The effect of glucocorticoids on specific complement markers after surgery is unknown and calls for further investigation.

This study is embedded in a primary study registrated as: NCT02319343

For further details please view the EudraCT registration:

EudraCT nr.: 2014-003395-23

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
70
Inclusion Criteria
  • Osteoarthrosis
  • Undergoing total unilateral knee-arthroplasty surgery
  • Speak and understand Danish
  • Have given informed consent
Exclusion Criteria
  • Revision, bilateral or uni chamber knee-arthroplasty surgery
  • General anaesthesia
  • Allergy or intolerance towards Methylprednisolone
  • Local or systemic infection
  • Permanent systemic treatment with steroids within 30 days preoperatively
  • Insulin-dependent diabetes
  • Active treatment of ulcer within 3 months preoperatively
  • Cancer disease
  • Autoimmune disease incl. rheumatoid arthritis
  • Pregnant or breast feeding women
  • Menopause <1 year

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Isotonic Sodium ChlorideIsotonic Sodium ChloridePreoperative single dose of isotonic Sodium Chloride
MethylprednisoloneMethylprednisolonePreoperative single high dose of Solu-Medrol 125 mg iv.
Primary Outcome Measures
NameTimeMethod
Change in plasma and serum Pentraxin-3 concentrations from baseline (before surgery) to 48 hours after surgerybaseline to 48 hours
Secondary Outcome Measures
NameTimeMethod
Change in plasma and serum Complement Component 3 concentrations from baseline (before surgery) to 48 hours after surgerybaseline to 48 hours
Change in plasma and serum Complement Component 4 concentrations from baseline (before surgery) to 48 hours after surgerybaseline to 48 hours
Change in plasma and serum Mannose-binding lectin concentrations from baseline (before surgery) to 48 hours after surgerybaseline to 48 hours
Change in plasma and serum Ficolin-1, -2 and -3 concentrations from baseline (before surgery) to 48 hours after surgerybaseline to 48 hours
Change in plasma and serum Terminal Complement Complex concentrations from baseline (before surgery) to 48 hours after surgerybaseline to 48 hours

Trial Locations

Locations (1)

Bispebjerg Hospital

🇩🇰

Copenhagen NV, Denmark

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