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Status unknownNCT03339557Updated Feb 4, 2019

Comparison of Three Knee Replacements

An interventional study of NexGen and Persona in Osteoarthritis, Knee, Arthroplasty and Total Knee Replacement, sponsored by Coxa, Hospital for Joint Replacement. Status unknown at 1 site in Finland. Open to participants aged 50 Years to 70 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2019-02-04.

Sponsored by Coxa, Hospital for Joint Replacement · Not applicable, Interventional, and Treatment

The sponsor has not verified this record recently (last verified Feb 2019), so the status shown — last known as Active, not recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
240
Allocation
Randomized
Ages
50 Years to 70 Years
Sex
All
01

Study summary

The present randomized controlled trial is designed to compare one novel total knee replacement (TKR) design and two conventional TKR designs in terms of functional outcome. 80 patients will be randomized in each of the three arms (240 altogether).

Read the detailed description

The study will compare the short-term functional outcome (at 2 years) of TKR performed with a novel TKR design (Persona , Zimmer, Warsaw, IN, USA) against TKRs performed with two conventional designs (PFC, DePuy, Warsaw, IN, USA and Nexgen, Zimmer, Warsaw, IN, USA).

02

Conditions studied

  • Osteoarthritis, Knee
  • Arthroplasty
  • Total Knee Replacement
03

Who can participate

Ages eligible
50 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • patients undergoing total knee replacement surgery for primary osteoarthritis
  • no previous open major surgery in the joint ( e.g. osteotomy)
  • unilateral operative treatment, with no plans for surgical treatment of the contralateral knee in the near future
  • patients living in the local hospital district (Pirkanmaa Hospital District)
  • Kellgren-Lawrence grade 3-4 knee osteoarthritis in plain radiographs

Exclusion criteria

Exclusion Criteria:

  • Unwilling to provide informed consent
  • > 15 degrees varus or valgus, or >15 degree fixed flexion deformity
  • predominantly patellofemoral osteoarthritis
  • Physical, emotional or neurological conditions that would compromise the patient´s compliance with postoperative rehabilitation and follow-up (e.g. drug or alcohol abuse, serious mental illness, general neurological conditions such as Parkinson, MS, etc.)
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Outcomes assessor)
Enrollment
240 participants (actual)

Study arms

  • Active comparator
    PFC Total Knee Replacement

    PFC, Conventional design Perioperative treatment will be carried out according to routine protocol of the hospital.

    Device: NexGen · Device: Persona

  • Active comparator
    NexGen Total Knee Replacement

    NexGen, Conventional design Perioperative treatment will be carried out according to routine protocol of the hospital.

    Device: Persona · Device: PFC

  • Active comparator
    Persona Total Knee Replacement

    Persona, Novel design Perioperative treatment will be carried out according to routine protocol of the hospital.

    Device: NexGen · Device: PFC

Interventions

  • DeviceNexGen

    Comparing two conventional designs and one novel design

  • DevicePersona

    Comparing two conventional designs and one novel design

  • DevicePFC

    Comparing two conventional designs and one novel design

05

What researchers measure

Primary outcomes

  1. Changes in patient reported outcome measures scores (PROMs), Functional improvement

    Oxford Knee Score (OKS)

    Time frame: preoperative, postoperative at 2-3 months, at 1 year and at 2 years

Secondary outcomes

  1. Changes in PROMs, Functional improvement

    Forgotten Joint Score (FJS)

    Time frame: preoperative, postoperative at 2-3 months, at 1 year and at 2 years

  2. Changes in health-related quality of life (HRQoL)

    15D

    Time frame: preoperative, postoperative at 2-3 months, at 1 year and at 2 years

  3. Changes in activity rating scale

    UCLA activity score

    Time frame: preoperative, postoperative at 2-3 months, at 1 year and at 2 years

  4. Changes in pain scale measurement

    VAS pain scale

    Time frame: preoperative, postoperative at 2-3 months, at 1 year and at 2 years

06

Study locations

1 site
  • Coxa, Hospital for Joint Replacement
    Tampere, Pirkanmaa 33101, Finland
07

References and documents

Publications

  • Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster JY. Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am. 2004 May;86(5):963-74. doi: 10.2106/00004623-200405000-00012. PubMed 15118039 ↗
  • Rasanen P, Paavolainen P, Sintonen H, Koivisto AM, Blom M, Ryynanen OP, Roine RP. Effectiveness of hip or knee replacement surgery in terms of quality-adjusted life years and costs. Acta Orthop. 2007 Feb;78(1):108-15. doi: 10.1080/17453670610013501. PubMed 17453401 ↗
  • Jenkins PJ, Clement ND, Hamilton DF, Gaston P, Patton JT, Howie CR. Predicting the cost-effectiveness of total hip and knee replacement: a health economic analysis. Bone Joint J. 2013 Jan;95-B(1):115-21. doi: 10.1302/0301-620X.95B1.29835. PubMed 23307684 ↗
  • Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007 Apr;89(4):780-5. doi: 10.2106/JBJS.F.00222. PubMed 17403800 ↗
  • Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res. 2010 Jan;468(1):57-63. doi: 10.1007/s11999-009-1119-9. PubMed 19844772 ↗
  • Scott CE, Howie CR, MacDonald D, Biant LC. Predicting dissatisfaction following total knee replacement: a prospective study of 1217 patients. J Bone Joint Surg Br. 2010 Sep;92(9):1253-8. doi: 10.1302/0301-620X.92B9.24394. PubMed 20798443 ↗
  • Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open. 2012 Feb 22;2(1):e000435. doi: 10.1136/bmjopen-2011-000435. Print 2012. PubMed 22357571 ↗
  • Giesinger K, Hamilton DF, Jost B, Holzner B, Giesinger JM. Comparative responsiveness of outcome measures for total knee arthroplasty. Osteoarthritis Cartilage. 2014 Feb;22(2):184-9. doi: 10.1016/j.joca.2013.11.001. Epub 2013 Nov 18. PubMed 24262431 ↗
  • Hamilton DF, Gaston P, Simpson AH. Is patient reporting of physical function accurate following total knee replacement? J Bone Joint Surg Br. 2012 Nov;94(11):1506-10. doi: 10.1302/0301-620X.94B11.30081. PubMed 23109630 ↗
  • Behrend H, Giesinger K, Giesinger JM, Kuster MS. The "forgotten joint" as the ultimate goal in joint arthroplasty: validation of a new patient-reported outcome measure. J Arthroplasty. 2012 Mar;27(3):430-436.e1. doi: 10.1016/j.arth.2011.06.035. Epub 2011 Oct 13. PubMed 22000572 ↗
  • Thienpont E, Opsomer G, Koninckx A, Houssiau F. Joint awareness in different types of knee arthroplasty evaluated with the Forgotten Joint score. J Arthroplasty. 2014 Jan;29(1):48-51. doi: 10.1016/j.arth.2013.04.024. Epub 2013 May 18. PubMed 23688851 ↗
  • Klit J, Jacobsen S, Rosenlund S, Sonne-Holm S, Troelsen A. Total knee arthroplasty in younger patients evaluated by alternative outcome measures. J Arthroplasty. 2014 May;29(5):912-7. doi: 10.1016/j.arth.2013.09.035. Epub 2013 Oct 1. PubMed 24269097 ↗
  • Grosu I, Lavand'homme P, Thienpont E. Pain after knee arthroplasty: an unresolved issue. Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1744-58. doi: 10.1007/s00167-013-2750-2. Epub 2013 Nov 8. PubMed 24201900 ↗
  • Singh JA, Gabriel S, Lewallen D. The impact of gender, age, and preoperative pain severity on pain after TKA. Clin Orthop Relat Res. 2008 Nov;466(11):2717-23. doi: 10.1007/s11999-008-0399-9. Epub 2008 Aug 5. PubMed 18679762 ↗
  • Perez-Prieto D, Gil-Gonzalez S, Pelfort X, Leal-Blanquet J, Puig-Verdie L, Hinarejos P. Influence of depression on total knee arthroplasty outcomes. J Arthroplasty. 2014 Jan;29(1):44-7. doi: 10.1016/j.arth.2013.04.030. Epub 2013 May 20. PubMed 23702267 ↗
  • Hanusch BC, O'Connor DB, Ions P, Scott A, Gregg PJ. Effects of psychological distress and perceptions of illness on recovery from total knee replacement. Bone Joint J. 2014 Feb;96-B(2):210-6. doi: 10.1302/0301-620X.96B2.31136. PubMed 24493186 ↗
  • Dowsey MM, Nikpour M, Dieppe P, Choong PF. Associations between pre-operative radiographic osteoarthritis severity and pain and function after total hip replacement : Radiographic OA severity predicts function after THR. Clin Rheumatol. 2016 Jan;35(1):183-9. doi: 10.1007/s10067-014-2808-7. Epub 2014 Oct 24. PubMed 25339125 ↗
  • Keurentjes JC, Fiocco M, So-Osman C, Onstenk R, Koopman-Van Gemert AW, Poll RG, Kroon HM, Vliet Vlieland TP, Nelissen RG. Patients with severe radiographic osteoarthritis have a better prognosis in physical functioning after hip and knee replacement: a cohort-study. PLoS One. 2013;8(4):e59500. doi: 10.1371/journal.pone.0059500. Epub 2013 Apr 3. PubMed 23573200 ↗
  • Berend KR, Lombardi AV Jr, Adams JB. Which total knee replacement implant should I pick? Correcting the pathology: the role of knee bearing designs. Bone Joint J. 2013 Nov;95-B(11 Suppl A):129-32. doi: 10.1302/0301-620X.95B11.32835. PubMed 24187370 ↗
  • van der Voort P, Pijls BG, Nouta KA, Valstar ER, Jacobs WC, Nelissen RG. A systematic review and meta-regression of mobile-bearing versus fixed-bearing total knee replacement in 41 studies. Bone Joint J. 2013 Sep;95-B(9):1209-16. doi: 10.1302/0301-620X.95B9.30386. PubMed 23997134 ↗
  • Becker R, Hirschmann MT, Karlsson J. Does implant design and surgical technique improve the clinical outcome in total knee arthroplasty? Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1716-8. doi: 10.1007/s00167-014-3145-8. No abstract available. PubMed 24981991 ↗
  • Nunley RM, Nam D, Berend KR, Lombardi AV, Dennis DA, Della Valle CJ, Barrack RL. New total knee arthroplasty designs: do young patients notice? Clin Orthop Relat Res. 2015 Jan;473(1):101-8. doi: 10.1007/s11999-014-3713-8. PubMed 24903823 ↗
  • Baker PN, Deehan DJ, Lees D, Jameson S, Avery PJ, Gregg PJ, Reed MR. The effect of surgical factors on early patient-reported outcome measures (PROMS) following total knee replacement. J Bone Joint Surg Br. 2012 Aug;94(8):1058-66. doi: 10.1302/0301-620X.94B8.28786. PubMed 22844046 ↗
  • Piepers MJ, van Hove RP, van den Bekerom MP, Nolte PA. Do refinements to original designs improve outcome of total knee replacement? A retrospective cohort study. J Orthop Surg Res. 2014 Feb 6;9:7. doi: 10.1186/1749-799X-9-7. PubMed 24502700 ↗
  • Pritchett JW. Patients prefer a bicruciate-retaining or the medial pivot total knee prosthesis. J Arthroplasty. 2011 Feb;26(2):224-8. doi: 10.1016/j.arth.2010.02.012. Epub 2010 Oct 6. PubMed 20932707 ↗
  • Irmola T, Kangas J, Eskelinen A, Niemelainen M, Huhtala H, Mattila VM, Moilanen T. Functional outcome of total knee replacement: a study protocol for a prospective, double-blinded, parallel-group randomized, clinical controlled trial of novel, personalized and conventional implants. BMC Musculoskelet Disord. 2019 Oct 12;20(1):443. doi: 10.1186/s12891-019-2830-7. PubMed 31604440 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03339557
Lead sponsor
Coxa, Hospital for Joint Replacement
Responsible party
Tero Irmola (orthopaedic surgeon, Coxa, Hospital for Joint Replacement) — Principal investigator
First posted
Nov 13, 2017
Start date
Sep 1, 2015
Primary completion
May 31, 2021 (estimated)
Completion
May 31, 2021 (estimated)
Last update
Feb 4, 2019

Study contacts

Tero Irmola, MD
principal investigator · Coxa, Hospital for Joint Replacement

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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