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Not yet recruitingNCT07834242SPIGAUpdated Sep 22, 2026

Anaesthesia for Hip and Knee Arthroplasty (SPIGA)

An interventional study of Spinal anaesthesia and General anaesthesia in Hip Arthroplasty, Knee Arthroplasty and Spinal Anesthesia, sponsored by Zealand University Hospital. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-22.

Sponsored by Zealand University Hospital · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
3,000
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Beneficial and harmful effects of spinal versus general anaesthesia in patients undergoing hip and knee arthroplasty.

Read the detailed description

Effective and safe anaesthesia is fundamental to perioperative care. Hip and knee arthroplasty are among the most frequently performed surgical procedures worldwide and are typically performed under either spinal or general anaesthesia. However, high-quality comparative evidence regarding the benefits and harms of these anaesthetic techniques remains limited and inconclusive.

Both techniques are associated with short- and long-term risks, including postoperative nausea and vomiting, hypotension, nerve injury, acute kidney injury, and respiratory and cardiovascular complications. In addition, they may differentially modulate the surgical stress response, potentially influencing postoperative recovery and risk of complications.

Objective:

To compare the benefits and harms of spinal versus general anaesthesia in patients undergoing hip or knee replacement. We hypothesise that spinal anaesthesia results in better postoperative outcomes than general anaesthesia.

Intervention:

Patients undergoing elective primary hip or knee arthroplasty will be randomised to receive either spinal or general anaesthesia, with randomisation stratified by participating centre.

Design:

The SPIGA trial is an investigator-initiated, multicentre, randomised, superiority clinical trial. Participants will be randomly allocated at a 1:1 ratio using a central, computer-generated randomisation sequence. A total sample size of 3000 participants was determined using simulation-based methods to provide at least 90% power to detect a prespecified minimally clinically important difference, corresponding to an increase of one hospital-free day in at least 10% of participants at a two-sided significance level of 0.05.

Planned sub-studies

  • Short-term perioperative outcomes (0-24h postoperatively)
  • Stratified analysis of anaesthetic regimens
  • Impact of preoperative clinical frailty
02

Conditions studied

  • Hip Arthroplasty
  • Knee Arthroplasty
  • Spinal Anesthesia
  • General Anesthesia
  • Length of Hospital Stay
  • Postoperative Complications
  • Patient Satisfaction
  • Quality of Recovery (QoR-15)
  • Health-Related Quality-of-Life (EQ-5D-5L)
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Scheduled for elective primary elective hip or knee arthroplasty, including unicompartmental knee

Exclusion criteria

Exclusion Criteria:

  • Scheduled for elective primary hip or knee arthroplasty, including unicompartmental knee
  • Age ≥ 18 years
  • Unable to communicate in written and/or spoken Danish Contraindications against either spinal or general anaesthesia
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
3,000 participants (estimated)

Study arms

  • Experimental
    Spinal Anaesthesia

    Procedure: Spinal anaesthesia

  • Active comparator
    General Anaesthesia

    Procedure: General anaesthesia

Interventions

  • ProcedureSpinal anaesthesia

    Spinal anaesthesia according to local practice, including optional sedation with sedative-hypnotic pharmacological agents

  • ProcedureGeneral anaesthesia

    General anaesthesia according to local practice

05

What researchers measure

Primary outcomes

  1. Hospital-free days within 30 days

    Defined as the number of days within the first 30 days following hip or knee arthroplasty surgery during which a participant is alive and not admitted to a hospital.

    Time frame: Postoperative day 0-30

Secondary outcomes

  1. Major complications

    A major complication is defined as a major intra- or postoperative adverse event occurring from the initiation of anaesthesia through 30 days postoperatively.

    Time frame: Postoperative day 0-30

  2. Quality of Recovery

    Quality of Recovery-15 questionnaire (QoR-15)

    Time frame: 24 hours postoperatively

Other outcomes

  1. Patient satisfaction with anaesthesia

    Assessed 24 hours postoperatively by asking patients to rate their satisfaction on a numeric rating scale (NRS) from 0-10, where 0 indicates not satisfied at all/completely dissatisfied and 10 indicates extremely satisfied/fully satisfied.

    Time frame: 24 hours postoperatively

  2. Health-related quality of life (EQ5D5L-VAS)

    Evaluation of health-related quality of life using the EuroQol EQ5D5L- VAS questionnaire.

    Time frame: Postoperative day 30

  3. Number of unplanned hospital-visits

    Defined as the number of any unplanned contact with the emergency department, outpatient clinic, or other hospital department.

    Time frame: Postoperative day 0-30

  4. Willingness to repeat the type of anaesthesia

    Assessed at 24 hours postoperatively by asking participants whether they would choose the same type of anaesthesia again in case of future surgery.

    Time frame: 24 hours postoperatively

  5. Day-case discharge

    Number of patients assessed as eligible for day-case surgery being discharged on the day of surgery.

    Time frame: Postoperative day 0

06

Study locations

No study locations are listed for this record.

07

References and documents

Individual participant data

Plan to share: Yes — Data will be published anonymised in accordance with ICMJE (International Committee of Medical Journal Editors) guidelines.

Supporting information: Study protocol, Sap

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07834242
Lead sponsor
Zealand University Hospital
Responsible party
Ole Mathiesen (MD, PhD, Chair Professor, Zealand University Hospital) — Principal investigator
First posted
Sep 22, 2026
Start date
Oct 2026 (estimated)
Primary completion
Sep 2031 (estimated)
Completion
Sep 2031 (estimated)
Last update
Sep 22, 2026

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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