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Foot and Ankle Post-operative Oedema Management Using Geko™

Not Applicable
Completed
Conditions
Edema
Surgery
Interventions
Device: geko™ therapy
Registration Number
NCT04927234
Lead Sponsor
Firstkind Ltd
Brief Summary

The multicentre randomised geko™ Foot and Ankle Trial will prospectively and systematically collect clinical data on patients randomised, on a 1:1 basis, to either standard care or standard care plus geko™ therapy to assess oedema management and patient outcomes during a follow-up period of up to three months post-surgery.

Detailed Description

The geko™ device has a wide range of clinical applications including the post-operative management of oedema.

Although many short-term acute studies have been completed using the device, little clinical data has been collected on the effect of geko™ use in current standard care pathways for oedema management on patient outcomes during long term follow-up after surgery.

This study is an open label, multi-centre prospective randomised study. The study patient population will be randomised on a 1:1 basis into two groups of 61 patients each. These groups are defined as Group A patients who receive geko™ therapy and SC i.e. the intervention group and Group B patients who receive Standard Care (SC) only i.e. no intervention. The participants will be assessed pre-surgery and up to 90 days post-surgery.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
123
Inclusion Criteria
  • Aged ≥ 18 years
  • Intact healthy skin at the site of geko™ device application.
  • Patients that have been listed for forefoot and / or hindfoot surgery
  • Patient understands and is willing to participate in the study and can comply with study procedures
  • Patient is willing and able to give written informed consent
Exclusion Criteria
  • Pregnant
  • Use of any other neuro-modulation device.
  • Trauma to the lower limbs that would prevent geko™ from stimulating the common peroneal nerve.
  • No response to geko™ therapy i.e. no involuntary rhythmic upward and outward movement of the foot (dorsiflexion) at the maximum tolerable device setting
  • Participation in any other clinical study that may interfere with the outcome of either study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Standard of care + geko™ Therapygeko™ therapyIn addition to their standard of care, for patients randomised to the intervention arm, geko™ therapy will be applied immediately post-surgery on the operated leg and administered for 24 hours / day whilst the patient remains in hospital, after which geko™ therapy will then be applied for 12hrs / day until the patient returns for their first post-operative follow-up visit (Day 14 ± 2 days post-surgery)
Primary Outcome Measures
NameTimeMethod
Assessment of post-operative oedema formation using the figure-of-eight tape measurementFrom pre-surgery assessment until up to 90 days post-surgery

To assess the effect of geko™ therapy on oedema formation following foot and / or ankle surgery. This will be done using the figure of eight tape measurement method

Assessment of post-operative oedema formation using bioimpedance analysis (US sites only)From pre-surgery assessment until up to 90 days post-surgery

To assess the effect of geko™ therapy on oedema formation following foot and / or ankle surgery using a bioimpedance device to measure resistance to electrical current in both legs and calculating the percentage difference between the operated leg and the contralateral limb.

Assessment of post-operative oedema formation using the pitting oedema scaleFrom pre-surgery assessment until up to 90 days post-surgery

To assess the effect of geko™ therapy on oedema formation following foot and / or ankle surgery using the pitting oedema scale, where following a 2 second firm thumb press, 0 (min) indicates no oedema and 4 (max) is a very deep pit.

Secondary Outcome Measures
NameTimeMethod
Incidence of surgical wound healingFrom surgery until up to 90 days post-surgery

Visually assessing the surgical wound healing status as either healed/progressing/static/deteriorating/severe.

Change in analgesia frequencyFrom pre-surgery assessment until up to 90 days post-surgery

Assessing changes of frequency of recorded analgesic medication taken by the patient

Incidence of Adverse Events in each groupFrom pre-surgery assessment until up to 90 days post-surgery
Incidence of device deficienciesfrom start of geko treatment (immediately post-surgery) until up to 90 days post-surgery

To assess the number of geko device deficiencies (if any)

Change in pain level using a visual analogue scale (VAS) scoreFrom pre-surgery assessment until up to 90 days post-surgery

Assessing pain levels using a visual analogue scale (VAS) score, where 0 means no pain and 100 is the worst pain possible.

Change in analgesia dosageFrom pre-surgery assessment until up to 90 days post-surgery

Assessing changes in dosage of recorded analgesic medication taken by the patient

Change in patient reported outcomes via Manchester-Oxford Foot & Ankle Questionnaire (MOxFQ)From pre-surgery assessment until up to 90 days post-surgery

Domains that are assessed in this questionnaire include walking/standing, pain and social interaction. Scores will range from 0 to 100, where 100 is most severe.

Trial Locations

Locations (5)

Hospital Clinic Barcelona

🇪🇸

Barcelona, Spain

Maidstone and Tunbridge Wells NHS Trust

🇬🇧

Tunbridge Wells, United Kingdom

The Royal National Orthopaedic Hospital NHS Trust

🇬🇧

Stanmore, United Kingdom

Golden State Orthopedics and Spine

🇺🇸

Capitola, California, United States

Hospital Universitario Vall d'Hebron

🇪🇸

Barcelona, Spain

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