One-stage Versus Two-stage Revision of the Infected Knee Arthroplasty

NCT ID: NCT03435679

Last Updated: 2024-12-11

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

97 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-03-01

Study Completion Date

2026-11-18

Brief Summary

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This study investigates functional outcome and safety after one-stage versus two-stage revision of the infected knee arthroplasty.

Half of participants are treated with a one-stage surgical procedure, while the other half is treated with a two-stage procedure.

The investigators hypothesize that the functional outcome and quality of life of the participants is superior after one-stage surgery compared to two-stage surgery.

Detailed Description

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A two-stage approach is the standard surgical procedure in the treatment of the chronically infected knee arthroplasty, but promising results have been reported after a one-stage approach from single-centre studies.

The potential benefits for the patients treated with a one-stage approach are many as they only have to go through surgery and rehabilitation once with shorter total length of hospital stay. However, no randomized controlled trials comparing outcome after the procedures have been performed so far.

Conditions

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Periprosthetic Knee Infection

Keywords

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infection knee arthroplasty surgical treatment one-stage two-stage outcome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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one-stage

one-stage surgical treatment of the infected knee arthroplasty

Group Type EXPERIMENTAL

one-stage

Intervention Type PROCEDURE

one-stage surgery

two-stage

two-stage surgical treatment of the infected knee arthroplasty with a interim period of 8-10 weeks between stages

Group Type ACTIVE_COMPARATOR

two-stage

Intervention Type PROCEDURE

two-stage surgery

Interventions

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one-stage

one-stage surgery

Intervention Type PROCEDURE

two-stage

two-stage surgery

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Clinical signs of periprosthetic knee infection
* \> 6 weeks from previous knee arthoplasty procedure (primary or total revision procedure)
* Speak and understand Danish and have given informed consent

Exclusion Criteria

* Soft tissue problems requiring plastic surgery
* major bone loss requiring mega/tumor-prosthesis
* acute surgery due to sepsis
* malignant disease with less than 2 years life expectancy
* re-infection with previous two-stage procedure
* bilateral knee infection
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Odense Patient Data Explorative Network

OTHER

Sponsor Role collaborator

Region of Southern Denmark

OTHER

Sponsor Role collaborator

Odense University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Martin Lindberg-Larsen

Orthopaedic Surgeon, MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Martin Lindberg-Larsen

Role: PRINCIPAL_INVESTIGATOR

Martin Lindberg-Larsen

Locations

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Aalborg University Hospital

Aalborg, , Denmark

Site Status

Bispebjerg Hospital

Copenhagen, , Denmark

Site Status

Gentofte Hospital

Copenhagen, , Denmark

Site Status

Hvidovre Hospital

Copenhagen, , Denmark

Site Status

Rigshospitalet

Copenhagen, , Denmark

Site Status

Horsens Hospital

Horsens, , Denmark

Site Status

Næstved Hospital

Næstved, , Denmark

Site Status

Odense Universitets Hospital

Odense, , Denmark

Site Status

Vejle Hospital

Vejle, , Denmark

Site Status

Countries

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Denmark

References

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Lindberg-Larsen M, Jorgensen CC, Bagger J, Schroder HM, Kehlet H. Revision of infected knee arthroplasties in Denmark. Acta Orthop. 2016 Aug;87(4):333-8. doi: 10.3109/17453674.2016.1148453. Epub 2016 Feb 22.

Reference Type BACKGROUND
PMID: 26900908 (View on PubMed)

Lindberg-Larsen M, Pitter FT, Voldstedlund M, Schroder HM, Bagger J. Microbiological diagnosis in revision of infected knee arthroplasties in Denmark. Infect Dis (Lond). 2017 Nov-Dec;49(11-12):824-830. doi: 10.1080/23744235.2017.1350878. Epub 2017 Jul 8.

Reference Type BACKGROUND
PMID: 28691647 (View on PubMed)

Masters JP, Smith NA, Foguet P, Reed M, Parsons H, Sprowson AP. A systematic review of the evidence for single stage and two stage revision of infected knee replacement. BMC Musculoskelet Disord. 2013 Jul 29;14:222. doi: 10.1186/1471-2474-14-222.

Reference Type BACKGROUND
PMID: 23895421 (View on PubMed)

Haddad FS, Sukeik M, Alazzawi S. Is single-stage revision according to a strict protocol effective in treatment of chronic knee arthroplasty infections? Clin Orthop Relat Res. 2015 Jan;473(1):8-14. doi: 10.1007/s11999-014-3721-8.

Reference Type BACKGROUND
PMID: 24923669 (View on PubMed)

Singer J, Merz A, Frommelt L, Fink B. High rate of infection control with one-stage revision of septic knee prostheses excluding MRSA and MRSE. Clin Orthop Relat Res. 2012 May;470(5):1461-71. doi: 10.1007/s11999-011-2174-6. Epub 2011 Nov 12.

Reference Type BACKGROUND
PMID: 22081299 (View on PubMed)

Baker P, Petheram TG, Kurtz S, Konttinen YT, Gregg P, Deehan D. Patient reported outcome measures after revision of the infected TKR: comparison of single versus two-stage revision. Knee Surg Sports Traumatol Arthrosc. 2013 Dec;21(12):2713-20. doi: 10.1007/s00167-012-2090-7. Epub 2012 Jun 13.

Reference Type BACKGROUND
PMID: 22692517 (View on PubMed)

Massin P, Delory T, Lhotellier L, Pasquier G, Roche O, Cazenave A, Estellat C, Jenny JY. Infection recurrence factors in one- and two-stage total knee prosthesis exchanges. Knee Surg Sports Traumatol Arthrosc. 2016 Oct;24(10):3131-3139. doi: 10.1007/s00167-015-3884-1. Epub 2015 Nov 26.

Reference Type BACKGROUND
PMID: 26611899 (View on PubMed)

Lindberg-Larsen M, Odgaard A, Fredborg C, Schroder HM; One-stage vs Two-stage Collaboration Group. One-stage versus two-stage revision of the infected knee arthroplasty - a randomized multicenter clinical trial study protocol. BMC Musculoskelet Disord. 2021 Feb 12;22(1):175. doi: 10.1186/s12891-021-04044-8.

Reference Type DERIVED
PMID: 33579256 (View on PubMed)

Other Identifiers

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MLL_02_2018

Identifier Type: -

Identifier Source: org_study_id