Microcurrent Stimulation Reduces Post-Operative Swelling and Healing Time Following Knee Replacement Surgery

NCT ID: NCT02623660

Last Updated: 2016-01-12

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

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-31

Study Completion Date

2016-10-31

Brief Summary

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The purpose of this study is to determine if patients undergoing a total knee arthroplasty (TKA) experience a clinically significant reduction in healing time when treated post operatively with a specific form of micro and nano-ampere current. The results of this trial will provide a basis for generalizing its outcomes to apply to other joint replacements and revisions by reducing edema and inflammation and therefore will result in a shorter time to heal.

The study will compare electrically treated and non electrically treated patients by using digitally based measurements to determine objective reductions of lower extremity edema including intra and inter cellular shifts in fluid distribution, increased range of motion (ROM) and muscle strength, and improved functional tests of ambulation.

Detailed Description

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This study is intended to assess the efficiency and efficacy of the ODIN1® microcurrent generating device to reduce post-operative edema, shorten the time to heal and regain maximum function in total knee replacement patients. Changes in swelling will be documented by utilizing a 3D scanning device (Perometer) and a Bio-Impedance Spectroscopy (BIS) device (Impedimed SFB7). These instruments quantitate limb volume and inter and intra-cellular fluid respectively with a high degree of accuracy. Measurements will be made from the first post-operative day until the completion of rehabilitation therapy several months later.

Edema volume and fluid distribution data collected from both control and experimental groups will be compared to determine the statistical significance of the difference between these groups. An additional analysis will be performed on data collected from the non-operated lower limb of each patient.

The second primary objective is to determine the time to complete post-op rehabilitation. Completion will be determined by the ability of the patient to experience an optimal outcome by utilizing performance based measurements of knee function including quadriceps strength and range of motion. The time from surgery to optimal post-op rehabilitation will be recorded.

The determinations of statistical significance between the electrically treated and non-electrically treated groups will be made by analysts on a blind basis. They will not know whether a sample data set is from an experimental or control patient. The codes that document which group the set belongs to will be opened after all analysis is completed by an independent analyst.

Conditions

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Osteoarthritis of Knee Edema Wounds and Injuries

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Experimental

This group will receive treatment from the ODIN1 device in conjunction with standard care and diagnostic device testing.

Group Type EXPERIMENTAL

ODIN1

Intervention Type DEVICE

Shortly after surgery, electrodes will be applied to the lower extremity in such a way that the current will flow from the ankle through the knee replacement and pass through the thigh. The frequency of the treatments will vary over the period of time from post-op recovery to end of rehab.

All treatments are applying current that consists of different combinations of intensities within the micro to nano ampere ranges.

Standard Care

Intervention Type OTHER

Anti-thrombotic medication. Elevation and ice. Pain medications as needed. Dressings changes. Topical antibiotics. Progressive physical therapy.

Diagnostic Device Testing

Intervention Type DEVICE

Diagnostic interventions include: the Perometer which scans the lower extremity and determines its volume to a high degree of accuracy; the Impedimed Bioimpedance Spectroscopy (BIS) device that measures intra and intercellular fluid movement; the Microfet muscle force testing device that provides a digital output of the number of pounds exerted by the quadriceps upon extension; the Acumar digital digital Inclinometer that accurately measures the ROM of the knee; and the K.I.S.S. wound measuring system to measure rate of incision healing.

Control

This group will receive the standard care and the diagnostic device testing.

Group Type ACTIVE_COMPARATOR

Standard Care

Intervention Type OTHER

Anti-thrombotic medication. Elevation and ice. Pain medications as needed. Dressings changes. Topical antibiotics. Progressive physical therapy.

Diagnostic Device Testing

Intervention Type DEVICE

Diagnostic interventions include: the Perometer which scans the lower extremity and determines its volume to a high degree of accuracy; the Impedimed Bioimpedance Spectroscopy (BIS) device that measures intra and intercellular fluid movement; the Microfet muscle force testing device that provides a digital output of the number of pounds exerted by the quadriceps upon extension; the Acumar digital digital Inclinometer that accurately measures the ROM of the knee; and the K.I.S.S. wound measuring system to measure rate of incision healing.

Interventions

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ODIN1

Shortly after surgery, electrodes will be applied to the lower extremity in such a way that the current will flow from the ankle through the knee replacement and pass through the thigh. The frequency of the treatments will vary over the period of time from post-op recovery to end of rehab.

All treatments are applying current that consists of different combinations of intensities within the micro to nano ampere ranges.

Intervention Type DEVICE

Standard Care

Anti-thrombotic medication. Elevation and ice. Pain medications as needed. Dressings changes. Topical antibiotics. Progressive physical therapy.

Intervention Type OTHER

Diagnostic Device Testing

Diagnostic interventions include: the Perometer which scans the lower extremity and determines its volume to a high degree of accuracy; the Impedimed Bioimpedance Spectroscopy (BIS) device that measures intra and intercellular fluid movement; the Microfet muscle force testing device that provides a digital output of the number of pounds exerted by the quadriceps upon extension; the Acumar digital digital Inclinometer that accurately measures the ROM of the knee; and the K.I.S.S. wound measuring system to measure rate of incision healing.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Patients must be scheduled for a primary total knee replacement surgery
2. Age: 18 - 80 years old
3. Males/Females all ethnicities
4. Must have a minimum serum albumin of 4 and a minimum Hgb of 11
5. Ability to mark appropriately the visual analog scales, keep a log of symptoms, medication use, and ODIN1® use
6. Ability to understand all instructions and the informed consent document before signing it

Exclusion Criteria

1. Subject younger than 18 years of age
2. Any patient with an electrically implanted device such as a pacemaker, neural stimulator, etc.
3. Subject has any known neoplasms
4. A demonstrated lack of compliance as determined by the Principal Investigator, nurse, or wound care specialist
5. Current participation in another clinical study of an investigational device or drug.
6. Any other condition or finding, which in the opinion of the investigator, would make the subject unsuitable for enrollment or could interfere with the subject participating in and completing the protocol
7. Subject unwilling or unable to provide informed consent
8. Subjects receiving any medication or having any condition that significantly interferes with the healing process such as a patient taking systemic steroids or immune suppressants or patient has diabetes mellitus with an HbA1c of greater than 7.5, etc.
9. Any female who has experienced menstruation and is less than 5 years postmenopausal shall have a urine pregnancy test before the initial treatment. An additional test will be performed at 3 weeks from the initial treatment date. Any subject with a positive pregnancy test shall be excluded
10. Subjects with significant peripheral extremity lymph edema
11. Subjects with Stage III or IV peripheral vascular disease, as defined by the Fontaine stages
12. Subjects with venous insufficiencies of Class III or greater, as defined by the Comprehensive Classification System for Chronic Venous Disorders (CEAP)
13. Subjects with muscle skeletal disorders that are not related to the knee
14. Subjects with uncontrolled Blood Pressure
15. Subjects with neurological disease affecting locomotion
16. Subjects with BMI \> 35
17. Subjects that are active smokers
18. Subjects that live on the second floor or higher without elevator access
19. Subjects must not have had a prior TKA. This study is for Primary TKA patients
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Bioelectric Research Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ron Hillock, M.D.

Role: PRINCIPAL_INVESTIGATOR

Centennial Hills Hospital & University of Nevada School of Medicine

Locations

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Nevada Orthopedic and Spine Center

Las Vegas, Nevada, United States

Site Status

Centennial Hills Hospital

Las Vegas, Nevada, United States

Site Status

Countries

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United States

References

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Shi R, Borgens RB. Three-dimensional gradients of voltage during development of the nervous system as invisible coordinates for the establishment of embryonic pattern. Dev Dyn. 1995 Feb;202(2):101-14. doi: 10.1002/aja.1002020202.

Reference Type BACKGROUND
PMID: 7734729 (View on PubMed)

Hotary KB, Robinson KR. Endogenous electrical currents and voltage gradients in Xenopus embryos and the consequences of their disruption. Dev Biol. 1994 Dec;166(2):789-800. doi: 10.1006/dbio.1994.1357.

Reference Type BACKGROUND
PMID: 7813796 (View on PubMed)

Soong HK, Parkinson WC, Bafna S, Sulik GL, Huang SC. Movements of cultured corneal epithelial cells and stromal fibroblasts in electric fields. Invest Ophthalmol Vis Sci. 1990 Nov;31(11):2278-82.

Reference Type BACKGROUND
PMID: 2242993 (View on PubMed)

Zhao M, Dick A, Forrester JV, McCaig CD. Electric field-directed cell motility involves up-regulated expression and asymmetric redistribution of the epidermal growth factor receptors and is enhanced by fibronectin and laminin. Mol Biol Cell. 1999 Apr;10(4):1259-76. doi: 10.1091/mbc.10.4.1259.

Reference Type BACKGROUND
PMID: 10198071 (View on PubMed)

Lin F, Baldessari F, Gyenge CC, Sato T, Chambers RD, Santiago JG, Butcher EC. Lymphocyte electrotaxis in vitro and in vivo. J Immunol. 2008 Aug 15;181(4):2465-71. doi: 10.4049/jimmunol.181.4.2465.

Reference Type BACKGROUND
PMID: 18684937 (View on PubMed)

McCaig CD, Rajnicek AM, Song B, Zhao M. Controlling cell behavior electrically: current views and future potential. Physiol Rev. 2005 Jul;85(3):943-78. doi: 10.1152/physrev.00020.2004.

Reference Type BACKGROUND
PMID: 15987799 (View on PubMed)

Sato MJ, Kuwayama H, van Egmond WN, Takayama AL, Takagi H, van Haastert PJ, Yanagida T, Ueda M. Switching direction in electric-signal-induced cell migration by cyclic guanosine monophosphate and phosphatidylinositol signaling. Proc Natl Acad Sci U S A. 2009 Apr 21;106(16):6667-72. doi: 10.1073/pnas.0809974106. Epub 2009 Apr 3.

Reference Type BACKGROUND
PMID: 19346484 (View on PubMed)

Li L, Gu W, Du J, Reid B, Deng X, Liu Z, Zong Z, Wang H, Yao B, Yang C, Yan J, Zeng L, Chalmers L, Zhao M, Jiang J. Electric fields guide migration of epidermal stem cells and promote skin wound healing. Wound Repair Regen. 2012 Nov-Dec;20(6):840-51. doi: 10.1111/j.1524-475X.2012.00829.x. Epub 2012 Oct 19.

Reference Type BACKGROUND
PMID: 23082865 (View on PubMed)

Man IO, Markland KL, Morrissey MC. The validity and reliability of the Perometer in evaluating human knee volume. Clin Physiol Funct Imaging. 2004 Nov;24(6):352-8. doi: 10.1111/j.1475-097X.2004.00577.x.

Reference Type BACKGROUND
PMID: 15522044 (View on PubMed)

Pichonnaz C, Bassin JP, Currat D, Martin E, Jolles BM. Bioimpedance for oedema evaluation after total knee arthroplasty. Physiother Res Int. 2013 Sep;18(3):140-7. doi: 10.1002/pri.1540. Epub 2012 Nov 27.

Reference Type BACKGROUND
PMID: 23188719 (View on PubMed)

Other Identifiers

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BRC-001

Identifier Type: -

Identifier Source: org_study_id

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