Effects of Computer Navigation Versus Conventional Total Knee Arthroplasty on Endothelial Damage Marker Levels

NCT ID: NCT02206321

Last Updated: 2017-02-06

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

UNKNOWN

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2011-03-31

Study Completion Date

2019-12-31

Brief Summary

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1. Prospective follow-up and comparative analysis of early, midterm, and long-term surgical results and complications between navigation assisted TKA and conventional TKA.
2. Prospective comparative analysis of cytokines (including ICAM, VCAM, and PECAM) from blood, tissues, and drainage between navigation assisted TKA and conventional TKA.
3. Prospective follow-up of surgical results of navigation-assisted TKA.

Detailed Description

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Total knee arthroplasty (TKA) is one of the most successful surgery in orthopaedic field. However, occasional outliner from perfect alignment after prosthesis implantation and unavoidable complications are still concerns. The usage of navigation-assisted system on total knee arthroplasty has provided better accuracy of the component alignment and quantity in knee kinematics, which theoretically affords better and consistent functional outcome.

In addition to better alignment, the design of navigation system avoids violation of the medullary canal. This less invasive environment might be contributable to the less blood loss in the drainage bottle, less blood transfusion more stable hemodynamic status, fewer hospitalization days, and fewer complications.

Systemic emboli phenomena during preparation of the femur and tibia are well recognized during total knee arthroplasty. They are widely believed to be the cause of intraoperative hypotension and reduced cardiac output, which may lead to circulatory collapse, change of mental status or cerebral infarction. Kalairajah et al reported that navigation-assisted total knee arthroplasty, when compared with conventional jig-based surgery, significantly reduces systemic emboli as detected by transcranial Doppler ultrasonography. Church et al undertook a prospective, double-blind, randomized study to compare the cardiac emboli load by tranesophageal echocardiography and demonstrated that computer-assisted TKA resulted in the release of significant fewer systemic emboli than the conventional procedure using intramedullary alignment. The increased blood loss in conventional TKA may be due to intramedullary jigging of both femur and tibia, bleeding from sinusoids at the cut cancellous bone surfaces with continuous suction drainage and more soft tissue dissection during balancing of the prosthesis. The investigators have underwent more than 730 computer-assisted TKA since 2005. The investigators data shows less bleeding and fewer transfusion after navigation assisted TKA. The investigators wish to further follow-up and delineate the differential clinical outcomes and perioperative markers (including ICAM, VCAM, and PECAM and other cytokines )between computer-assisted TKA and conventional TKA.

Conditions

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Computer-assisted Navigation Versus Conventional Total Knee Replacement

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Navigation total knee arthroplasty

Navigation total knee arthroplasty

Navigation total knee arthroplasty

Intervention Type PROCEDURE

computer assisted navigation total knee arthroplasty without femur intramedullary involvement

Conventional total knee arthroplasty

Conventional total knee arthroplasty

Conventional total knee arthroplasty

Intervention Type PROCEDURE

conventional technique with femur intramedullary violation

Interventions

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Navigation total knee arthroplasty

computer assisted navigation total knee arthroplasty without femur intramedullary involvement

Intervention Type PROCEDURE

Conventional total knee arthroplasty

conventional technique with femur intramedullary violation

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* degenerative osteoarthritis of the knee

Exclusion Criteria

* autoimmune diseases, rheumatoid arthritis, malignancies, previous knee surgery or post-traumatic arthritis
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Chang Gung Memorial Hospital

OTHER

Sponsor Role lead

Responsible Party

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Jih-Yang Ko

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jih-Yang Ko, MD

Role: PRINCIPAL_INVESTIGATOR

Chang Gung Memorial Hospital

Locations

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Chang Gung Memorial Hospital

Kaohsiung City, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Jih-Yang Ko, MD

Role: CONTACT

886-7-731-7123 ext. 8003

Facility Contacts

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Jih-Yang Ko, MD

Role: primary

886-7-731-7123 ext. 8003

References

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Kuo SJ, Wang FS, Wang CJ, Ko JY, Chen SH, Siu KK. Effects of Computer Navigation versus Conventional Total Knee Arthroplasty on Endothelial Damage Marker Levels: A Prospective Comparative Study. PLoS One. 2015 May 8;10(5):e0126663. doi: 10.1371/journal.pone.0126663. eCollection 2015.

Reference Type DERIVED
PMID: 25955252 (View on PubMed)

Other Identifiers

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ChangGungMH

Identifier Type: OTHER

Identifier Source: secondary_id

IRB 100-0038A3

Identifier Type: -

Identifier Source: org_study_id

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