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CompletedNCT04419311Updated Mar 16, 2021Results posted

Isokinetic Performance After Cruciate-substituting Ultra-congruent and Posterior Stabilized Total Knee Arthroplasties

An interventional study of Vanguard® Knee System in Osteoarthritis, Knee and Knee Arthritis, sponsored by Aksaray University Training and Research Hospital. Completed at 1 site in Turkey. Open to participants aged 55 Years to 80 Years. Per ClinicalTrials.gov, last updated 2021-03-16.

Sponsored by Aksaray University Training and Research Hospital · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 3 years 4 months after the study started (first participant enrolled Jan 2017, registered Jun 2020).
Phase
Not applicable
Study type
Interventional
Enrollment
66
Allocation
Randomized
Ages
55 Years to 80 Years
Sex
All
01

Study summary

The choice between ultra-congruent (UC) insert or posterior cruciate ligament-stabilized (PS) insert in posterior cruciate ligament (PCL) sacrificing total knee arthroplasty (TKA) remains debatable. Despite the potential advantages of the UC insert over PS insert with its different design, there are concerns about inferior clinical outcome related to its use. Therefore, isokinetic performance was used in this study to objectively evaluate knee function after TKA and the clinical scores of the patients were also evaluated. To the best of our knowledge, no prospective randomized study has compared the isokinetic performance of the knee following the use of UC and PS inserts in TKA. The hypothesis of the present study was that compared with the PS insert, the UC insert would be associated with a lower clinical outcome and isokinetic performance following TKA.

A total of 65 patients scheduled to undergo TKA on for primary knee osteoarthritis were randomly assigned to either the UC (32 patients) or the PS group (33 patients). The Knee Society Score (KSS) and isokinetic performance results of each patient were recorded preoperatively and at postoperative 3, 6 and 12 months. The physiatrist performing isokinetic tests and patients were blinded to the study.

Read the detailed description

Eligibility of all patients between 55 and 80 years, scheduled to undergo unilateral TKA on for primary knee osteoarthritis will be evaluated. The exclusion criteria are rheumatological joint diseases, previous knee surgery, neuromuscular diseases, bilateral TKA, or insufficiency of collateral ligaments. Patients will be randomized in a 1:1 ratio via computer-generated randomization using Microsoft Excel 2016 (Microsoft Corporation, Seattle, WA, USA) to be allocated in the UC insert or PS insert group before the operation. Unblinded senior resident will implement the randomization. Patients and physiatrists performing isokinetic measurements will be blinded to group allocation.

During the UC and PS operations, Vanguard® Complete Knee System prosthesis (Zimmer Biomet Inc., Warsaw, IN, USA) will be implanted using the same surgical technique in all patients. The Vanguard anterior-stabilized (AS) insert is a UC deep-dish design with a 10 mm prominent anterior lip and 5mm posterior lip. This bone-conserving design prevents anterior femoral subluxation because of the prominent anterior lip. The insert design allows it to be used with the Vanguard cruciate-retaining femoral component and the highly congruent articulating surface increases rotational stability. There is more contact area between the femoral component and the weight-bearing surface to decrease the shear stress between the femur and polyethylene insert.

A tourniquet will be inflated to pressure of 300 mmHg after spinal anesthesia. All operations will be performed with the same surgical technique by a single senior surgeon. Patellar surface arthroplasty will be performed in all the cases. Both femoral and tibial prostheses will be implanted with pressured bone cement. A suction drain will be placed inside the knee capsule. On the morning of the first day after surgery patients will be mobilized under the supervision of the physical therapist. All patients will undergo the same rehabilitation procedure during the outpatient period and will be examined by the same physiatrist at the regular 3, 6, and 12-month follow-up visits.

The primary outcome is isokinetic performance, measured as peak knee extensor and flexor torque values in Newton-meters, on the operated knee. Measurements wilil be done preoperatively and at 3, 6, and 12-month follow-up examinations under the supervision of the same physiatrist. At same time points, the Knee Society Score (KSS) will be evaluated as well. Isokinetic measurements will be performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc., Shirley, NY, USA) by the same senior physiatrist. Patients will be positioned on the dynamometer with the hip in 90° in a sitting position for the knee flexion and extension measurements. Lateral movement of the knee will be prevented during full extension and flexion of the knee by a thigh strap on the operated leg. The physical therapist will help the patients to achieve proper positioning before each test. Concentric isokinetic knee flexion-extensions will be assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions will be completed by each patient. Instructions will be provided, and one trial repetition will then performed by all patients before the measurements were taken.

Sample size estimation will be performed using the extension peak torque as a primary effect variable. As there is no similar study with isokinetic measurements regarding this subject, a difference in mean values of 10 Nm and standard deviation of 12 Nm were assumed for each group. The group sample sizes of 31 and 31 achieved a power of 0.90 to detect a difference of 10 Nm between the two groups with estimated group standard deviations of 12 for each group and with a significance level (alpha) of 0.05 using a two-sided, two-sample test. Considering the loss to follow-up, two patients were added to each group. Thus, recruitment will end after 33 patients were assigned to either groups. All data will be calculated as mean and standard deviation. The Student's t-test will be used for statistical analysis of the patient data. Statistical calculations will be performed with SPSS 22.0 software (IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.). A value of p\< 0.05 will be considered statistically significant.

02

Conditions studied

  • Osteoarthritis, Knee
  • Knee Arthritis

Keywords

  • Ultra-congruent insert
  • Posterior cruciate ligament-stabilized insert
  • Isokinetic test
  • Strength
  • Total knee arthroplasty
03

In context

Osteoarthritis, Knee

3,302 studies on the registry are indexed under Osteoarthritis, Knee; 608 are open to participants now.

This study's enrollment of 66 is close to the median of 70 across 2,731 interventional studies indexed under Osteoarthritis, Knee.

Browse Osteoarthritis, Knee studies →

Lead sponsor

Aksaray University Training and Research Hospital is the lead sponsor of 25 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
55 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age between 55 and 80 years
  • Scheduled to undergo unilateral TKA on for primary knee osteoarthritis

Exclusion criteria

Exclusion Criteria:

  • Rheumatological joint diseases
  • Previous knee surgery
  • Neuromuscular diseases
  • Bilateral TKA
  • Insufficiency of collateral ligaments
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
66 participants (actual)

Study arms

  • Experimental
    Ultra-congruent insert group

    Ultra-congruent inserts were used during total knee arthroplasty in patients randomized to this group.

    Device: Vanguard® Knee System

  • Experimental
    Posterior cruciate ligament-stabilized insert

    Posterior cruciate ligament-stabilized inserts were used during total knee arthroplasty in patients randomized to this group.

    Device: Vanguard® Knee System

Interventions

  • DeviceVanguard® Knee System

    Posterior cruciate ligament retention versus sacrificing is one of the main debates in total knee arthroplasty (TKA) and retention or sacrificing depends on the individual preference of the surgeon during the surgery. Whenever the surgeon decides to sacrifice the posterior cruciate ligament (PCL), another controversial question arises regarding the tibial insert type. While the posterior cruciate ligament-stabilized (PS) insert is widely used as the tibial insert in PCL-sacrificing TKA, it has some disadvantages such as increased polyethylene wear, additional bone resection, breakage of the post and patellar clunk syndrome. The ultra-congruent (UC) insert was designed to prevent bone loss in particular, and the other mentioned disadvantages of the conventional PS insert. However, patients with postoperative hyperextension have been seen to be associated with inferior clinical outcomes and knees become gradually more extended until two years after TKA using the UC insert.

06

What researchers measure

Primary outcomes

  1. Baseline Assessment of Peak Knee Extensor Torque Preoperatively

    Peak extensor torque values of each patient was recorded for the operated knee preoperatively under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

    Time frame: Preoperative

  2. Baseline Assessment of Peak Knee Flexor Torque Preoperatively

    Peak flexor torque values of each patient was recorded for the operated knee preoperatively under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

    Time frame: Preoperative

  3. Assessment of Peak Knee Extensor Torque at 3 Months Postoperatively

    Peak extensor torque values of each patient was recorded for the operated knee at postoperative 3 months under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

    Time frame: 3 months postoperative

  4. Assessment of Peak Knee Flexor Torque at 3 Months Postoperatively

    Peak flexor torque values of each patient was recorded for the operated knee at postoperative 3 months under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

    Time frame: 3 months postoperative

  5. Assessment of Peak Knee Extensor Torque at 6 Months Postoperatively

    Peak extensor torque values of each patient was recorded for the operated knee at postoperative 6 months under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

    Time frame: 6 months postoperative

  6. Assessment of Peak Knee Flexor Torque at 6 Months Postoperatively

    Peak flexor torque values of each patient was recorded for the operated knee at postoperative 6 months under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

    Time frame: 6 months postoperative

  7. Assessment of Peak Knee Extensor Torque at 12 Months Postoperatively

    Peak extensor torque values of each patient was recorded for the operated knee at postoperative 12 months under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

    Time frame: 12 months postoperative

  8. Assessment of Peak Knee Flexor Torque at 12 Months Postoperatively

    Peak flexor torque values of each patient was recorded for the operated knee at postoperative 12 months under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

    Time frame: 12 months postoperative

Secondary outcomes

  1. Baseline Knee Society Clinical Score Evaluation

    The Knee Society Score were applied preoperatively. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

    Time frame: Preoperative

  2. Knee Society Clinical Score Evaluation at 3 Months Postoperatively

    The Knee Society Clinical Score were applied at postoperative 3 months. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

    Time frame: 3 months postoperative

  3. Knee Society Clinical Score Evaluation at 6 Months Postoperatively

    The Knee Society Clinical Score were applied at postoperative 6 months. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

    Time frame: 6 months postoperative

  4. Knee Society Clinical Score Evaluation at 12 Months Postoperatively

    The Knee Society Clinical Score were applied at postoperative 12 months. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

    Time frame: 12 months postoperative

  5. Baseline Knee Society Functional Score Evaluation

    The Knee Society Functional Score were applied preoperatively. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

    Time frame: Preoperative

  6. Knee Society Functional Score Evaluation at 3 Months Postoperatively

    The Knee Society Functional Score were applied at postoperative 3 months. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

    Time frame: 3 months postoperative

  7. Knee Society Functional Score Evaluation at 6 Months Postoperatively

    The Knee Society Functional Score were applied at postoperative 6 months. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

    Time frame: 6 months postoperative

  8. Knee Society Functional Score Evaluation at 12 Months Postoperatively

    The Knee Society Functional Score were applied at postoperative 12 months. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

    Time frame: 12 months postoperative

07

Results

Posted Feb 21, 2021

Participant flow

Participant flow — Overall Study
MilestoneUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Started3333
Completed3233
Not completed10
Withdrew: Lost to follow-up10

Outcome measures

PrimaryBaseline Assessment of Peak Knee Extensor Torque Preoperatively

Peak extensor torque values of each patient was recorded for the operated knee preoperatively under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

Time frame:
Preoperative
Reported as:
Mean · Newton meters
Baseline Assessment of Peak Knee Extensor Torque Preoperatively
Newton metersUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Baseline Assessment of Peak Knee Extensor Torque Preoperatively55.56 ± 8.6558.33 ± 8.96
PrimaryBaseline Assessment of Peak Knee Flexor Torque Preoperatively

Peak flexor torque values of each patient was recorded for the operated knee preoperatively under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

Time frame:
Preoperative
Reported as:
Mean · Newton meters
Baseline Assessment of Peak Knee Flexor Torque Preoperatively
Newton metersUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Baseline Assessment of Peak Knee Flexor Torque Preoperatively37.84 ± 9.5640.3 ± 7.79
PrimaryAssessment of Peak Knee Extensor Torque at 3 Months Postoperatively

Peak extensor torque values of each patient was recorded for the operated knee at postoperative 3 months under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

Time frame:
3 months postoperative
Reported as:
Mean · Newton meters
Assessment of Peak Knee Extensor Torque at 3 Months Postoperatively
Newton metersUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Assessment of Peak Knee Extensor Torque at 3 Months Postoperatively44.38 ± 7.3745.85 ± 7.46
PrimaryAssessment of Peak Knee Flexor Torque at 3 Months Postoperatively

Peak flexor torque values of each patient was recorded for the operated knee at postoperative 3 months under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

Time frame:
3 months postoperative
Reported as:
Mean · Newton meters
Assessment of Peak Knee Flexor Torque at 3 Months Postoperatively
Newton metersUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Assessment of Peak Knee Flexor Torque at 3 Months Postoperatively31.91 ± 10.1129.39 ± 7.16
PrimaryAssessment of Peak Knee Extensor Torque at 6 Months Postoperatively

Peak extensor torque values of each patient was recorded for the operated knee at postoperative 6 months under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

Time frame:
6 months postoperative
Reported as:
Mean · Newton meters
Assessment of Peak Knee Extensor Torque at 6 Months Postoperatively
Newton metersUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Assessment of Peak Knee Extensor Torque at 6 Months Postoperatively53.53 ± 7.9552.64 ± 6.83
PrimaryAssessment of Peak Knee Flexor Torque at 6 Months Postoperatively

Peak flexor torque values of each patient was recorded for the operated knee at postoperative 6 months under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

Time frame:
6 months postoperative
Reported as:
Mean · Newton meters
Assessment of Peak Knee Flexor Torque at 6 Months Postoperatively
Newton metersUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Assessment of Peak Knee Flexor Torque at 6 Months Postoperatively36.19 ± 9.8635.27 ± 7.35
PrimaryAssessment of Peak Knee Extensor Torque at 12 Months Postoperatively

Peak extensor torque values of each patient was recorded for the operated knee at postoperative 12 months under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

Time frame:
12 months postoperative
Reported as:
Mean · Newton meters
Assessment of Peak Knee Extensor Torque at 12 Months Postoperatively
Newton metersUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Assessment of Peak Knee Extensor Torque at 12 Months Postoperatively59.34 ± 8.9761.52 ± 9.88
PrimaryAssessment of Peak Knee Flexor Torque at 12 Months Postoperatively

Peak flexor torque values of each patient was recorded for the operated knee at postoperative 12 months under the supervision of the same physiatrist. The Isokinetic measurements were performed using a Biodex System III Isokinetic Dynamometer, version 3.03 (Biodex Medical Inc.,Shirley, NY, USA). Concentric isokinetic knee flexion-extensions were assessed at a preset velocity of 60º/sec, over a range of motion of 0º to 110º for both parameters. A fixed number of 10 flexion-extension repetitions was completed by each patient. Torque was assessed in Newton-meters (N m).

Time frame:
12 months postoperative
Reported as:
Mean · Newton meters
Assessment of Peak Knee Flexor Torque at 12 Months Postoperatively
Newton metersUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Assessment of Peak Knee Flexor Torque at 12 Months Postoperatively39.94 ± 9.9641.18 ± 7.63
SecondaryBaseline Knee Society Clinical Score Evaluation

The Knee Society Score were applied preoperatively. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

Time frame:
Preoperative
Reported as:
Mean · score on a scale
Baseline Knee Society Clinical Score Evaluation
score on a scaleUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Baseline Knee Society Clinical Score Evaluation47.69 ± 12.649.15 ± 11.68
SecondaryKnee Society Clinical Score Evaluation at 3 Months Postoperatively

The Knee Society Clinical Score were applied at postoperative 3 months. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

Time frame:
3 months postoperative
Reported as:
Mean · score on a scale
Knee Society Clinical Score Evaluation at 3 Months Postoperatively
score on a scaleUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Knee Society Clinical Score Evaluation at 3 Months Postoperatively78.81 ± 11.7379.48 ± 10.80
SecondaryKnee Society Clinical Score Evaluation at 6 Months Postoperatively

The Knee Society Clinical Score were applied at postoperative 6 months. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

Time frame:
6 months postoperative
Reported as:
Mean · score on a scale
Knee Society Clinical Score Evaluation at 6 Months Postoperatively
score on a scaleUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Knee Society Clinical Score Evaluation at 6 Months Postoperatively86.81 ± 5.6488.39 ± 6.29
SecondaryKnee Society Clinical Score Evaluation at 12 Months Postoperatively

The Knee Society Clinical Score were applied at postoperative 12 months. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

Time frame:
12 months postoperative
Reported as:
Mean · score on a scale
Knee Society Clinical Score Evaluation at 12 Months Postoperatively
score on a scaleUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Knee Society Clinical Score Evaluation at 12 Months Postoperatively90.69 ± 4.4192.24 ± 4.44
SecondaryBaseline Knee Society Functional Score Evaluation

The Knee Society Functional Score were applied preoperatively. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

Time frame:
Preoperative
Reported as:
Mean · units on a scale
Baseline Knee Society Functional Score Evaluation
units on a scaleUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Baseline Knee Society Functional Score Evaluation49.53 ± 14.1151.27 ± 11.60
SecondaryKnee Society Functional Score Evaluation at 3 Months Postoperatively

The Knee Society Functional Score were applied at postoperative 3 months. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

Time frame:
3 months postoperative
Reported as:
Mean · units on a scale
Knee Society Functional Score Evaluation at 3 Months Postoperatively
units on a scaleUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Knee Society Functional Score Evaluation at 3 Months Postoperatively64.47 ± 14.1965.73 ± 11.90
SecondaryKnee Society Functional Score Evaluation at 6 Months Postoperatively

The Knee Society Functional Score were applied at postoperative 6 months. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

Time frame:
6 months postoperative
Reported as:
Mean · units on a scale
Knee Society Functional Score Evaluation at 6 Months Postoperatively
units on a scaleUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Knee Society Functional Score Evaluation at 6 Months Postoperatively70.22 ± 12.9872.21 ± 11.73
SecondaryKnee Society Functional Score Evaluation at 12 Months Postoperatively

The Knee Society Functional Score were applied at postoperative 12 months. The Knee Society Score (KSS) is comprised to two sections (each worth 100 points) for a maximum 200 points. The KSS Scale ranges from 0 to 200. One section is the Knee Society Clinical Score (KSCS) - points are given for pain, motion, and stability and points are deducted for flexion contracture, extension lag, and misalignment. The KSCS ranges from 0 to 100. The other section is the Knee Society Functional Score (KSFS) - points are assigned for walking distances and climbing stairs and points are deducted for use of walking aids. The KSFS ranges from 0 to 100. For each section, a score of 80-100 was considered excellent; 70-79, good; 60-69, fair; \< 60, poor.

Time frame:
12 months postoperative
Reported as:
Mean · units on a scale
Knee Society Functional Score Evaluation at 12 Months Postoperatively
units on a scaleUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Knee Society Functional Score Evaluation at 12 Months Postoperatively81.47 ± 10.4582.79 ± 10.06

Adverse events

Collected over 1 year. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Ultra-congruent Insert Group0/32 (0%)1/32 (3.1%)0/32 (0%)
Posterior Cruciate Ligament-stabilized Insert0/33 (0%)2/33 (6.1%)0/33 (0%)
Most frequent serious events
Most frequent serious events
EventUltra-congruent Insert GroupPosterior Cruciate Ligament-stabilized Insert
Deep vein thrombosisVascular disorders1/321/33
Superficial infectionInfections and infestations0/321/33

Baseline characteristics

Age, Continuous
Age, Continuous(years)Ultra-congruent Insert GroupPosterior Cruciate Ligament-stabilized InsertTotal
Mean69.18 ± 8.5567.67 ± 8.1268.42 ± 8.31
Sex: Female, Male
Sex: Female, Male(Participants)Ultra-congruent Insert GroupPosterior Cruciate Ligament-stabilized InsertTotal
Female292655
Male4711
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)Ultra-congruent Insert GroupPosterior Cruciate Ligament-stabilized InsertTotal
Count of participants——0
Region of Enrollment
Region of Enrollment(participants)Ultra-congruent Insert GroupPosterior Cruciate Ligament-stabilized InsertTotal
Turkey333366
08

Study locations

1 site
  • Aksaray University Training and Research Hospital
    Aksaray, 68200, Turkey
09

References and documents

Study documents

  • Protocol and statistical analysis plan · Jun 8, 2020

Documents are hosted by the registry — open the source record to download them.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 16, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT04419311
Lead sponsor
Aksaray University Training and Research Hospital
Responsible party
Erdem A Sezgin (Co-Principal Investigator, Aksaray University Training and Research Hospital) — Principal investigator
First posted
Jun 5, 2020
Start date
Jan 19, 2017
Primary completion
Mar 30, 2018
Completion
Mar 30, 2018
Results posted
Feb 21, 2021
Last update
Mar 16, 2021

Study contacts

Deniz Çankaya, MD
principal investigator · Aksaray University Training and Research Hospital

Oversight

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

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