Comprehensive Assessment of the Musculoskeletal System

NCT ID: NCT02156011

Last Updated: 2017-10-11

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

6 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-06-30

Study Completion Date

2017-10-09

Brief Summary

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The objective of this research is to synchronously assess in vivo loading data of the knee joint, tibio-femoral 3D kinematics by means of automated video-fluoroscopy, whole leg kinematics by means of skin markers, ground reaction forces, as well as muscle activity patterns in 4 to 6 subjects with instrumented total knee arthroplasty (TKA) during dynamic functional activities of daily life. The comprehensive in vivo dataset will provide unique information to evaluate the relationship between the kinematics, respectively the alignment of the TKA, and the resulting loading of the implant in vivo.

The whole data package will be made available for download on a public database, such that it can be utilized for the testing and improvement of TKA designs as well as for the validation and improvement of musculoskeletal modelling by researchers around the world.

Detailed Description

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STUDY SUBJECTS:

4-6 subjects with an instrumented TKA, that has been implanted within the study "Kniemessprothese: Belastungsmessung bei Patienten mittels einer instrumentierten Knie-Endoprothese" (EA4/069/06) approved and conducted at the Charité- Universitätsmedizin in Berlin, Germany, will be involved in this project. This instrumented prosthesis was implanted in 9 subjects with osteoarthritis.

DATA ACQUISITION:

The testing will be performed at the Institute for Biomechanics at the ETH Zurich. The kinematic and kinetic measurements include video-fluoroscopic tibio-femoral 3D implant motion; whole leg motion capture based on skin markers as well as ground reaction forces. Simultaneously the joint loading is assessed by means of the instrumented TKA and a telemetry unit for transmitting the strain gage signals. In all subjects, muscle activity is additionally simultaneously assessed using surface electromyography (EMG). The electrodes are placed onto the skin at the sites of eight muscles in the lower limbs. At the beginning of the test session, the maximal voluntary contraction will be assessed by means of the EMG electrodes, performing the following four motion tasks:

* One legged standing and lifting the heel to stand on tiptoe.
* Extension of the knee joint against a load by means of a strap around the lower leg just above the ankle. (Subject is sitting on a bench, lower legs are hanging down).
* Flexion of the knee joint against a load by means of a strap around the lower leg just above the ankle. (Subject is sitting on a bench, lower legs are hanging down).
* Dorsiflexion of the ankle against a manual resistant force of the investigator. (Subject is sitting on a bench, lower legs are hanging down).

To familiarize the subjects with the dynamic data acquisition protocol, six test trials will be conducted that just include the motion capture system (motion capture trials, each performed twice). This is followed by the main test procedure, which will consist of two static (static trials) and three dynamic trials (dynamic trials) assessed simultaneously by the video-fluoroscopy, the motion capture systems the force plates, as well as the instrumented TKA. During the dynamic trials the fluoroscopic measurement unit mounted on an automated trolley will move along the subject and capture the motion of the knee in question.

Motion capture trials:

* Standing trial in an anatomic upright position
* Calibration motion (Standing in upright position, followed by free movement of legs and arms)
* Four basic motion tasks to define functional estimated joint axis, respectively centers: dorsiplantarflexion motion of the ankle, inversion/eversion motion of the ankle, flexion/extension motion of the knee, hip circumduction (List et al., 2012b)

Static trials:

* Standing trial in an anatomic upright position captured from the side.
* Standing trial in an anatomic upright position captured from an angle of 45°.

Dynamic trials:

For each of the following activities the subjects has to perform five valid gait cycles or repetitions respectively. A trial is considered valid, when the knee is in the field of view of the image intensifier during the whole cycle and the force plate got hit for level gait, walking downhill and stair descent.

* Level gait
* Stair descent a two steps staircase
* Downhill walking a 10° inclined slope
* Sit down and stand up from a chair
* Squatting

For documentation, all dynamic trials will additionally be captured by two video cameras. All anonymized data will be made available for download on a public database.

Conditions

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Total Knee Arthroplasty

Keywords

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In vivo knee joint kinematics In vivo knee joint loading Video-fluoroscopy Instrumented implants Optical motion capture Ground reaction forces Electromyography

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Instrumented knee implant

4-6 subjects with an instrumented TKA, that has been implanted within the study "Kniemessprothese: Belastungsmessung bei Patienten mittels einer instrumentierten Knie-Endoprothese" (EA4/069/06) approved and conducted at the Charité- Universitätsmedizin in Berlin, Germany, will be involved in this project.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Instrumented TKA
* Participant of the study EA4/069/06, Charité- Universitätsmedizin Berlin, Germany,

Exclusion Criteria

* Not able to walk freely without walking aid
* Any medical condition that could impact on study results
Minimum Eligible Age

50 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Robert Mathys Stiftung, Bettlach, Switzerland

UNKNOWN

Sponsor Role collaborator

Charite University, Berlin, Germany

OTHER

Sponsor Role collaborator

Swiss Federal Institute of Technology

OTHER

Sponsor Role lead

Responsible Party

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William R. Taylor

Professor of Movement Biomechanics

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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William R Taylor, PhD

Role: PRINCIPAL_INVESTIGATOR

Institute for Biomechanics ETH Zurich Switzerland

Locations

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Institute for Biomechanics, ETH Zurich

Zurich, , Switzerland

Site Status

Countries

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Switzerland

References

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Konig C, Sharenkov A, Matziolis G, Taylor WR, Perka C, Duda GN, Heller MO. Joint line elevation in revision TKA leads to increased patellofemoral contact forces. J Orthop Res. 2010 Jan;28(1):1-5. doi: 10.1002/jor.20952.

Reference Type BACKGROUND
PMID: 19637213 (View on PubMed)

Konig C, Matziolis G, Sharenkov A, Taylor WR, Perka C, Duda GN, Heller MO. Collateral ligament length change patterns after joint line elevation may not explain midflexion instability following TKA. Med Eng Phys. 2011 Dec;33(10):1303-8. doi: 10.1016/j.medengphy.2011.06.008. Epub 2011 Jul 20.

Reference Type BACKGROUND
PMID: 21764353 (View on PubMed)

Taylor WR, Heller MO, Bergmann G, Duda GN. Tibio-femoral loading during human gait and stair climbing. J Orthop Res. 2004 May;22(3):625-32. doi: 10.1016/j.orthres.2003.09.003.

Reference Type BACKGROUND
PMID: 15099644 (View on PubMed)

Trepczynski A, Kutzner I, Kornaropoulos E, Taylor WR, Duda GN, Bergmann G, Heller MO. Patellofemoral joint contact forces during activities with high knee flexion. J Orthop Res. 2012 Mar;30(3):408-15. doi: 10.1002/jor.21540. Epub 2011 Aug 30.

Reference Type BACKGROUND
PMID: 22267190 (View on PubMed)

Zihlmann MS, Gerber H, Stacoff A, Burckhardt K, Szekely G, Stussi E. Three-dimensional kinematics and kinetics of total knee arthroplasty during level walking using single plane video-fluoroscopy and force plates: a pilot study. Gait Posture. 2006 Dec;24(4):475-81. doi: 10.1016/j.gaitpost.2005.12.012. Epub 2006 Feb 10.

Reference Type BACKGROUND
PMID: 16473011 (View on PubMed)

List R, Foresti M, Gerber H, Goldhahn J, Rippstein P, Stussi E. Three-dimensional kinematics of an unconstrained ankle arthroplasty: a preliminary in vivo videofluoroscopic feasibility study. Foot Ankle Int. 2012 Oct;33(10):883-92. doi: 10.3113/FAI.2012.0883.

Reference Type BACKGROUND
PMID: 23050714 (View on PubMed)

List R, Gerber H, Foresti M, Rippstein P, Goldhahn J. A functional outcome study comparing total ankle arthroplasty (TAA) subjects with pain to subjects with absent level of pain by means of videofluoroscopy. Foot Ankle Surg. 2012 Dec;18(4):270-6. doi: 10.1016/j.fas.2012.04.001. Epub 2012 May 12.

Reference Type BACKGROUND
PMID: 23093123 (View on PubMed)

Heller MO, Mehta M, Taylor WR, Kim DY, Speirs A, Duda GN, Perka C. Influence of prosthesis design and implantation technique on implant stresses after cementless revision THR. J Orthop Surg Res. 2011 May 13;6:20. doi: 10.1186/1749-799X-6-20.

Reference Type BACKGROUND
PMID: 21569522 (View on PubMed)

Taylor WR, Kornaropoulos EI, Duda GN, Kratzenstein S, Ehrig RM, Arampatzis A, Heller MO. Repeatability and reproducibility of OSSCA, a functional approach for assessing the kinematics of the lower limb. Gait Posture. 2010 Jun;32(2):231-6. doi: 10.1016/j.gaitpost.2010.05.005. Epub 2010 May 23.

Reference Type BACKGROUND
PMID: 20547061 (View on PubMed)

Stacoff A, Kramers-de Quervain IA, Luder G, List R, Stussi E. Ground reaction forces on stairs. Part II: knee implant patients versus normals. Gait Posture. 2007 Jun;26(1):48-58. doi: 10.1016/j.gaitpost.2006.07.015. Epub 2006 Sep 18.

Reference Type BACKGROUND
PMID: 16979893 (View on PubMed)

Related Links

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http://www.biomech.ethz.ch/

Institute of Biomechanics, ETH Zurich, Switzerland (Primary Study Site)

http://www.orthoload.com/

Free public database from instrumented implants, Charité - Universitätsmedizin Berlin Germany

Other Identifiers

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EA4/069/06

Identifier Type: OTHER

Identifier Source: secondary_id

EK 2013-N-90

Identifier Type: -

Identifier Source: org_study_id