Pilot Study of PEMF Therapy in Treatment of Post-operative Pain Following Total Knee Arthroplasty

NCT ID: NCT02211534

Last Updated: 2017-10-27

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

35 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-09-30

Study Completion Date

2016-03-31

Brief Summary

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The purpose of this study is to investigate whether pulsed electromagnetic energy field (PEMF) therapy is effective in the treatment of persistent pain following total knee arthroplasty (TKA)

Detailed Description

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This is a multi-site randomized, double-blinded, parallel-group prospective pilot study of the analgesic effectiveness of twice-daily PEMF therapy in the treatment of persistent post-operative pain following Total Knee Arthroplasty (TKA). Following a run-in period of 10 days to collect their baseline pain intensity scores, activity levels and opioid consumption, eligible subjects will be randomized in a 2:1 ratio to receive therapy with an active PEMF device or an identical inactive Sham device. Subjects will self-treat twice daily for 60 days while at home. Subjects will collect electronic patient-reported outcome (ePRO) data each morning through Day 75. Subjects will be evaluated at the research center for Interim Visits at Day 21, Day 41, Day 61 and Day 75 for assessment of safety, concomitant medications, range of motion, weight, peripheral edema, and quality of life outcomes. At Day 90, Day 150, and Day 240 assessment of pain intensity, opioid consumption, safety, review of concomitant medications and interval history will be performed, with data collected via telephone contact.

Conditions

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Post-Operative Pain Following Total Knee Arthroplasty

Keywords

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Pulsed Electromagnetic Energy Fields Total Knee Arthroplasty Pain Intensity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Pulsed Electromagnetic Field Device

Pulsed Electromagnetic Field therapy device; self-administered at home twice daily for 30 minutes.

Group Type ACTIVE_COMPARATOR

Pulsed Electromagnetic Field Device (Provant)

Intervention Type DEVICE

The PEMF device delivers non-thermal, non-ionizing pulsed electromagnetic energy to the target tissue, using 27.12 megahertz pulses lasting 42 microseconds and delivered 1000 times per second. The system generates an electromagnetic field that is continuously monitored and regulated to ensure consistent dosing. The therapeutic electromagnetic field is delivered by means of an applicator pad that is placed against the treatment site. The active and sham devices will be identical in appearance and all other physical characteristics in order to maintain the masking of the treatment.

Sham Pulsed Electromagnetic Field Device

Inactive Pulsed Electromagnetic Field Therapy device; self-administered at home twice daily for 30 minutes.

Group Type SHAM_COMPARATOR

Sham Pulsed Electromagnetic Field Device

Intervention Type DEVICE

The Sham device will be identical in appearance, physical characteristics and operation to the Active device.

Interventions

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Pulsed Electromagnetic Field Device (Provant)

The PEMF device delivers non-thermal, non-ionizing pulsed electromagnetic energy to the target tissue, using 27.12 megahertz pulses lasting 42 microseconds and delivered 1000 times per second. The system generates an electromagnetic field that is continuously monitored and regulated to ensure consistent dosing. The therapeutic electromagnetic field is delivered by means of an applicator pad that is placed against the treatment site. The active and sham devices will be identical in appearance and all other physical characteristics in order to maintain the masking of the treatment.

Intervention Type DEVICE

Sham Pulsed Electromagnetic Field Device

The Sham device will be identical in appearance, physical characteristics and operation to the Active device.

Intervention Type DEVICE

Other Intervention Names

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Provant Therapy System Sham Provant Therapy System

Eligibility Criteria

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Inclusion Criteria

1. Subject age is greater or equal to 18 years.
2. Subject has undergone a total knee replacement for the treatment of osteoarthritis, and has persistent post-operative pain in the index knee for \> 3 months and \< 36 months following surgery.
3. Subject has been receiving medication for persistent post-operative knee pain, including opioid or non-opioid analgesic medication that is administered on an "as needed" (prn) basis, and is on a stable analgesic dosing regimen (i.e. the same medications and dosages) for \> 30 days prior to the screening visit.
4. Mean Pain Intensity (calculated as the mean of the daily average pain intensity scores) is ≥3 and \< 9 as measured on Numeric Pain Rating Scale (NPRS) during the run-in phase.
5. Subject has completed a minimum of 80% (8 of 10 possible) of the pain intensity assessments during the run-in phase.
6. Subject is willing and able to wear an activity meter from the screening visit through Day 75.
7. Subject is able to access an internet browser in the home environment.
8. Subject is willing and able to give written informed consent and to comply with all parts of the study protocol.
9. Female Subjects must be post menopausal, surgically sterile, abstinent, or practicing (or agree to practice) an effective method of birth control if they are sexually active for the duration of the study. (Effective methods of birth control include prescription hormonal contraceptives, intrauterine devices, double-barrier methods, and/or male partner sterilization).

Exclusion Criteria

1. Subject has undergone simultaneous bilateral knee arthroplasty or revision arthroplasty on the index knee.
2. Subject requires revision surgery prior to Day 75.
3. Subject has undergone manipulation under anesthesia of the index knee or any local injection into the index knee within 30 days prior to the Screening Visit, or within 6 weeks prior to the Screening Visit for long acting lidocaine injection products.
4. Subject has received any investigational drug or device within 30 days prior to the Screening Visit or is enrolled in another clinical trial.
5. Subjects consuming an average of \> 100 mg oral Morphine Sulfate equivalents per day during the run-in phase.
6. Subject has evidence on physical or radiological exam of joint instability or infection involving the index knee.
7. Passive range of motion demonstrates maximal flexion of the index knee \< 90 degrees or maximal extension of the index knee \< -10 degrees.
8. Body Mass Index (BMI) \< 19 kg/m2, or \> 38 kg/m2.
9. Subject has a history of any uncontrolled medical illness that in the investigator's judgment places the subject at unacceptable risk for receipt of Provant therapy.
10. Subject has an ongoing painful condition that in the opinion of the Investigator might have a confounding influence on the safety or effectiveness analysis for this study.
11. Use of systemic corticosteroids within 2 months of the Screening visit.
12. Subject anticipates the need for surgery of any type through the Day 75 visit.
13. Subjects whom, in the judgment of the Investigator, have serious psychosocial co-morbidities.
14. History of drug or alcohol abuse within one year prior to screening.
15. Subject has a history of malignancy within the past five years other than successfully treated non-metastatic basal cell or squamous cell carcinomas of the skin in the treatment area and/or localized carcinoma in situ of the cervix.
16. Subject has an implanted pacemaker, defibrillator, neurostimulator, spinal cord stimulator, bone stimulator, cochlear implant, or other implanted device with an implanted metal lead(s).
17. Existing or planned pregnancy.
18. Subject has been previously treated with study device.
19. Subject is in current litigation related to the index knee or is receiving Worker's Compensation for an injury related to the index knee.
20. Subject is unwilling or unable to follow study instructions, comply with the treatment regimen, study visits, and ePRO assessments.
21. Standard deviation around the mean of the average pain intensity scores during the run-in period is \>2.0.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Regenesis Biomedical, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Birmingham, Alabama, United States

Site Status

Phoenix, Arizona, United States

Site Status

Phoenix, Arizona, United States

Site Status

El Cajon, California, United States

Site Status

Lone Tree, Colorado, United States

Site Status

Bradenton, Florida, United States

Site Status

Fort Lauderdale, Florida, United States

Site Status

Las Vegas, Nevada, United States

Site Status

New York, New York, United States

Site Status

Raleigh, North Carolina, United States

Site Status

Spartanburg, South Carolina, United States

Site Status

St. George, Utah, United States

Site Status

Danville, Virginia, United States

Site Status

Spokane, Washington, United States

Site Status

Countries

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United States

Other Identifiers

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RBI.2014.002

Identifier Type: -

Identifier Source: org_study_id