Preoperative CT Assisted Planning for Primary Total Knee Arthroplasty

NCT ID: NCT03628664

Last Updated: 2018-08-14

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

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-30

Study Completion Date

2020-12-31

Brief Summary

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Total knee arthroplasty is one of the most common management methods of knee osteoarthritis. Patellar complications are one of the important causes of revision total knee arthroplasty. Proper placement of the components in the best rotational and axial alignment would achieve better patellar tracking and the best functional outcomes. Preoperative CT scan can add information regarding the coronal and rotational alignment of the prosthesis components.

Detailed Description

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Total knee arthroplasty is the gold standard treatment for advanced knee osteoarthritis. In spite of the great advance in the prosthesis design, surgical techniques and rehabilitation programs, only 85% (75% to 92%) of patients with total knee arthroplasty are satisfied with their operations and 30% develops patellofemoral complications.

Femoral and tibial components malrotation is a crucial cause of postoperative knee pain, patellar instability, and may lead to revision. In measured resection technique the surgical epicondylar axis (SEA) is the center of rotation of the knee and the femoral component must be parallel to this axis. The surgical epicondylar axis is difficult to be determined intraoperative by palpation.

Commonly, surgeons routinely set the femoral posterior condyle resection at three degrees fixed from the posterior condylar line (PCL) because the PCL was found to be three degrees internally rotated from the (SEA).

The posterior condylar angle on a three-dimensional structure reconstruction of the CT scans in osteoarthritic knees has also been shown as 3.3° ± 1.5°, However, another study documented the posterior condylar angle (PCA) in osteoarthritic knees as 1.6° ± 1.9°. Also there is a two to three degree difference between the surgical epicondylar axis and the anatomical epicondylar axis. Therefore, a routine bone resection of three degrees from the PCL is not universal for all cases and may create malrotation of the femur.

CT scan can provide an adequate template with good but not excellent inter and intra observer reliability for exact determination of the surgical epicondylar axis and femoral component rotation.

2\. AIM/ OBJECTIVES

1. What is the mean of distal femoral rotation in Egyptian population?
2. What is the effect of osteoarthritis on femoral rotation?
3. How much is the accuracy of CT scan in detecting anatomical landmarks to choose the intraoperative femoral component rotation (correlation between radiological and intraoperative findings?
4. Is the relation between the anatomical epicondylar axis (AEA) in comparison to surgical epicondylar axis (SEA) a fixed ratio?
5. What is the relation between thde femoral component malrotation and the coronal alignment and flexion gap balance?
6. Can CT scan add a simple planning tool for accurate placement of femoral component and the reproducibility of the preoperative plan in surgery?

Conditions

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Knee Osteoarthritis

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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CT planned total knee arthroplasty

Surgeon will follow the CT plan

Group Type ACTIVE_COMPARATOR

CT scan

Intervention Type RADIATION

Assessment of the actual posterior condylar angle using the CT scan

Non CT planned total knee arthroplasty

Surgeon will not follow the CT plan

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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CT scan

Assessment of the actual posterior condylar angle using the CT scan

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Advanced knee osteoarthritis in which total knee arthroplasty is indicated

Exclusion Criteria

* Revision total knee arthroplasty
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ain Shams University

OTHER

Sponsor Role lead

Responsible Party

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Ahmed Saeed Younis

Clinical investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ahmed Saeed Younis, Dr.

Role: PRINCIPAL_INVESTIGATOR

Ain Shams University

Radwan Gamal Abdel Hamid, Dr.

Role: STUDY_DIRECTOR

Ain Shams University

Mohamed Awad, Dr.

Role: STUDY_DIRECTOR

Ain Shams University

Wael Samir Osman, professor

Role: STUDY_CHAIR

Ain Shams University

Tarek Mohammed Samy, Professor

Role: STUDY_CHAIR

Ain Shams University

Locations

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Ain Shams Univrsity

Cairo, , Egypt

Site Status

Countries

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Egypt

Central Contacts

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Ahmed Saeed Younis, Dr.

Role: CONTACT

201012370677

Radwan Gamal Abdel Hamid, Dr.

Role: CONTACT

201272221906

Other Identifiers

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44556677

Identifier Type: -

Identifier Source: org_study_id

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