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Comparative Effect of Mechanical and Functional Alignment in Bilateral Total Knee Arthroplasty on Ankle Alignment

Not Applicable
Completed
Conditions
Arthropathy of Knee
Interventions
Other: Mechanical alignment
Other: Functional alignment
Registration Number
NCT06259032
Lead Sponsor
Rajavithi Hospital
Brief Summary

Mechanical alignment (MA) in total knee arthroplasty (TKA) is the most commonly used with well-documented long-term results, however 20% of patients express dissatisfaction following primary TKA. Alternative alignment philosophies have been proposed, aiming to improve patient clinical outcomes and satisfaction. However, evaluation is focused mainly on knee alignment, the pathological findings and other adaptational changes in the ankles and hips are usually neglected.

Thia study aim to comparative effect between mechanical and functional alignment in patient undergone bilateral robotic TKA on ankle alignment and functional outcomes.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Age 20-80 years
  • Symptomatic bilateral knee Osteoarthritis requiring primary TKA
  • Willing to undergo bilateral simultaneous TKA
  • Able to give informed consent
Exclusion Criteria
  • ligament deficiency requiring constrained prosthesis
  • bone loss with augmentation need
  • history of fracture around knee or previous osteotomy
  • history of ankle fracture
  • patient with neuromuscular disorder or movement disorder
  • patient is unable to attend the study follow-up program

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Mechanical alignmentMechanical alignment-
Functional alignmentFunctional alignment-
Primary Outcome Measures
NameTimeMethod
Radiographic outcomes : Hip-knee-ankle anglepre-operative within 2 weeks and post-operative at 2,4,8,12 weeks

angle in degree between line from center of head of Femur to intercondylar notch and line from tibial interspinous to center of tibial plafond

Radiographic outcomes :Talar inclinationpre-operative within 2 weeks and post-operative at 2,4,8,12 weeks

angle in degree between talar dome and vertical axis

Radiographic outcomes : Tibial plafond inclinationpre-operative within 2 weeks and post-operative at 2,4,8,12 weeks

angle in degree between subchondral plate of distal tibial articular surface and vertical axis

Radiographic outcomes : Tibiotalar tilt anglepre-operative within 2 weeks and post-operative at 2,4,8,12 weeks

angle in degree between subchondral plate of distal tibial articular surface and talar dome

Secondary Outcome Measures
NameTimeMethod
Quality of Life score : EQ-5D-5Lpre-operative within 2 weeks and post-operative at 2,4,8,12 weeks

assess patient five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels, Index scores range from -0.42 to 1; 1 is the best possible health state. Negative values represent health states perceived as worse than dead, which is equal to 0.

Clinical outcomes : Knee injury and Osteoarthritis Outcome Score (KOOS)pre-operative within 2 weeks and post-operative at 2,4,8,12 weeks

a questionnaire assesses patient pain (9 items), other symptoms (7 items), function in daily living (17 items), function in sport and recreation (5 items), and knee related quality of life (4 items). Scores range from 0 to 100 with a score of 0 indicating the worst possible knee symptoms and 100 indicating no knee symptoms.

Forgotten Joint Scorepre-operative within 2 weeks and post-operative at 2,4,8,12 weeks

consists of 12 questions and is transform on a 0-100 scale.The higher the score, the less the patient is aware of their affected joint when performing daily activities

Clinical outcomes : American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scorepre-operative within 2 weeks and post-operative at 2,4,8,12 weeks

evaluation of the clinical status of the ankle-hindfoot, both subjective and objective information. Patients report their pain, and physicians assess alignment. The patient and physician work together to complete the functional portion. Scores range from 0 to 100, with healthy ankles receiving 100 points.

Trial Locations

Locations (1)

Rajavithi Hospital

🇹🇭

Ratchathewi, Bangkok, Thailand

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