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Tourniquet vs. Short Time Tourniquet in Primary Robotic Assisted TKA

Not Applicable
Completed
Conditions
Knee Arthropathy
Interventions
Other: Primary Robotic-Assisted Total Knee Arthroplasty with the use of a tourniquet
Other: Primary Robotic-Assisted Total Knee Arthroplasty with a short tourniquet time
Registration Number
NCT03942939
Lead Sponsor
University of Louisville
Brief Summary

The goal of this prospective, randomized study is to compare the outcomes of patients undergoing Robotic Arm-Assisted TKA (RA-TKA) with the intraoperative use of a tourniquet to those undergoing RA-TKA with a short tourniquet time.

Detailed Description

The goal of this prospective, randomized study is to compare the outcomes of patients undergoing Robotic Arm-Assisted TKA (RA-TKA) with the intraoperative use of a tourniquet to those undergoing RA-TKA with a short tourniquet time. The primary objectives will be to compare the total duration of hospital stay, quadriceps function, and the amount of postoperative narcotics utilized and VAS pain levels. The secondary objective will be to compare variables of patient functionality at five postoperative intervals.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
101
Inclusion Criteria
  1. Patient is over the age of 21
  2. Patient is scheduled to undergo a unilateral, cementless primary RA-TKA, secondary to osteoarthritis
  3. Surgical approach is subvastus approach
  4. Patient's BMI (body mass index) is less than 40 at time of surgery.
  5. Patient agrees to participate as a study subject and signs the Informed Consent and Research Authorization documents
  6. Patient is able to read and speak English
Exclusion Criteria
  1. Patient is under the age of 21
  2. Patient's primary diagnosis is not osteoarthritis (e.g. post-traumatic arthritis)
  3. Patient is scheduled to undergo a bilateral TKA surgery
  4. Patient BMI is > 40
  5. Patient is unable to read and speak English

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
B - TKA with tourniquetPrimary Robotic-Assisted Total Knee Arthroplasty with the use of a tourniquet50 arms: subjects will receive a tourniquet during TKA surgery.
A - TKA with short tourniquet timePrimary Robotic-Assisted Total Knee Arthroplasty with a short tourniquet time50 arms: subjects will receive a tourniquet with a short tourniquet time during TKA surgery. Short tourniquet time is defined in this study as the release of the tourniquet after the initial exposure, resulting in a total tourniquet time of only 10-15 minutes.
Primary Outcome Measures
NameTimeMethod
Knee Society Scoreoutcome measure will be taken 1 year (± 2 months) postoperatively

Knee Society Score. The score is on a scale from 0-100. A higher value represents a better outcome.

WOMAC Scoreoutcome measure will be taken 1 year (± 2 months) postoperatively

WOMAC score. The score is on a scale from 0-100. In contrast to the Knee Society Score, on the WOMAC a lower value represents a better outcome.

Active range-of-motion (ROM)outcome measure will be taken 1 year (± 2 months) postoperatively

Active ROM (range-of-motion) as measured by a goniometer (range of 0-135 degrees)

Ability to rise from a chair independentlyoutcome measure will be taken 6 weeks (± 2 weeks) postoperatively

Ability to rise from a chair independently (Yes/No)

Amount of narcotic medication utilizedoutcome measure will be taken 6 weeks (± 2 weeks) postoperatively

Amount of narcotic medication utilized (daily dosage measured as a Milligram Morphine Equivalent (MME) value).

Use of an ambulatory assistive deviceoutcome measure will be taken 6 weeks (± 2 weeks) postoperatively

Use of an ambulatory assistive device (Yes/No)

Incidence of postop transfusionoutcome measure will be taken at 2 weeks postoperatively

Incidence of postop transfusion as defined by one or more transfusions of blood to the subject postoperatively

Change in creatinine level (CKMB)outcome measures will be taken preoperatively (4-6 weeks prior to date of surgery) and on postoperative day number two.

Change in CKMB (creatinine level) as defined by the CKMB values recorded in the participant's lab report

Visual Analog Scaleoutcome measure will be taken 6 weeks (± 2 weeks) postoperatively

The Visual Analog Scale measures the patient's level of knee pain on a scale of zero to ten via what the patient expresses verbally. The Visual Analog Scale (VAS) represents the degree of pain that the patient is experiencing at the time the measure is taken. Zero represents "pain-free". A 10 would represent pain so excruciating as to warrant emergency medical assistance, or as it is described to the patient, "the worst pain imaginable". Obviously, the lower the number, the better the outcome. There is no subscale.

Distance that patient is able to walkoutcome measure will be taken 6 weeks (± 2 weeks) postoperatively

Distance that patient is able to walk, as measured in feet

Return to drivingoutcome measure will be taken 6 weeks (± 2 weeks) postoperatively

Return to driving (Yes/No)

Level of Patient Satisfaction: 5-point Likert scaleoutcome measure will be taken 1 year (± 2 months) postoperatively

Level of Patient Satisfaction as measured using a 5-point Likert scale

total length of hospital stayoutcome measure will be taken at 2 weeks postoperatively

total length of hospital stay as defined by number of days from date of surgery to date of discharge

Operative Timeoutcome measure will be taken at 2 weeks postoperatively

Total Operative Time as defined in minutes

Estimated Blood Loss (EBL)outcome measure will be taken at 2 weeks postoperatively

Estimated Blood Loss as defined by the amount of intraoperative blood loss measured in cubic centimeters (cc).

Change in hemoglobin level (HgB)outcome measures will be taken preoperatively (4-6 weeks prior to date of surgery) and on postoperative day number two.

Change in HgB as defined by the HgB values recorded in the participant's lab report

Quadriceps Functionoutcome measure will be taken 1 year (± 2 months) postoperatively

Quadriceps Function as measured in peak force in kilograms by a Hand-held dynamometer (model 01163; Lafayette Instrument Company, Lafayette, Ind., USA)

Dates of postoperative examsoutcome measure will be taken 1 year (± 2 months) postoperatively

Dates of postoperative exams as defined by dates that subject returns to the P.I.'s office for postoperative exam

Secondary Outcome Measures
NameTimeMethod
Number of Participants with postoperative complicationsoutcome measure will be taken at 1 year (± 2 months) postoperatively

Number of Participants with postoperative complications. A postoperative complication is defined as any diagnosis or condition that necessitates a re-operation on the surgical knee

Trial Locations

Locations (1)

Jewish Hospital

🇺🇸

Louisville, Kentucky, United States

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