Trial Outcomes & Findings for Traditional vs Oral Fluid Management in Total Knee Arthroplasty (NCT NCT03719378)

NCT ID: NCT03719378

Last Updated: 2021-03-16

Results Overview

Patient Weight will be monitored

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

150 participants

Primary outcome timeframe

Change is patients weight from baseline at pre op to two weeks post op.

Results posted on

2021-03-16

Participant Flow

Participant milestones

Participant milestones
Measure
Traditional Fluid
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Overall Study
STARTED
75
75
Overall Study
COMPLETED
65
65
Overall Study
NOT COMPLETED
10
10

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Traditional Fluid
n=75 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=75 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Total
n=150 Participants
Total of all reporting groups
Age, Continuous
61.2 Years
STANDARD_DEVIATION 7.5 • n=75 Participants
60.9 Years
STANDARD_DEVIATION 6.8 • n=75 Participants
61 Years
STANDARD_DEVIATION 7.2 • n=150 Participants
Sex: Female, Male
Female
44 Participants
n=75 Participants
42 Participants
n=75 Participants
86 Participants
n=150 Participants
Sex: Female, Male
Male
31 Participants
n=75 Participants
33 Participants
n=75 Participants
64 Participants
n=150 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Region of Enrollment
United States
75 participants
n=75 Participants
75 participants
n=75 Participants
150 participants
n=150 Participants
BMI
28.5 kg/m^2 (BMI)
STANDARD_DEVIATION 4.9 • n=75 Participants
28.1 kg/m^2 (BMI)
STANDARD_DEVIATION 4.2 • n=75 Participants
28.3 kg/m^2 (BMI)
STANDARD_DEVIATION 4.6 • n=150 Participants

PRIMARY outcome

Timeframe: Change is patients weight from baseline at pre op to two weeks post op.

Patient Weight will be monitored

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=64 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=64 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Body Weight
-1.9 pounds
Standard Deviation 4.4
-1.6 pounds
Standard Deviation 4.4

SECONDARY outcome

Timeframe: Post Op Day 1, 2 Weeks and 6 Weeks Post Op

Measurements will be done with a standard goniometer (Measurements below are shown as the difference from their pre operative base line measurement to the time points below)

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Knee Range of Motion
Post Op Day 1
-30.5 degrees
Standard Deviation 18.5
-26.7 degrees
Standard Deviation 16
Knee Range of Motion
2 Weeks Post Op
-27.9 degrees
Standard Deviation 17.5
-25.5 degrees
Standard Deviation 16.5
Knee Range of Motion
6 Weeks Post OP
-7.7 degrees
Standard Deviation 17
-4.8 degrees
Standard Deviation 13.2

SECONDARY outcome

Timeframe: Post op Day 1, 2 weeks and 6 weeks Post Op

measurements will be performed at 5 \& 10 cm suprapatellar, midpatella, and 10 cm infrapatellar with the use of a standard tape measure. measurements below show the difference from their pre operative base line measurement to the timepoints below.

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Leg Anthropometric (Girth) Measurements
(10 cm suprapatellar) Post Op day 1
2.5 inches
Standard Deviation 3.0
2.1 inches
Standard Deviation 3.1
Leg Anthropometric (Girth) Measurements
(10 cm suprapatellar) 2 weeks post op
0.9 inches
Standard Deviation 3.0
1.6 inches
Standard Deviation 4.0
Leg Anthropometric (Girth) Measurements
(10 cm suprapatellar) 6 weeks post op
0.00 inches
Standard Deviation 2.6
0.00 inches
Standard Deviation 3.3
Leg Anthropometric (Girth) Measurements
(5 cm suprapatellar) Post Op day 1
4.1 inches
Standard Deviation 2.4
4.0 inches
Standard Deviation 2.6
Leg Anthropometric (Girth) Measurements
(5 cm suprapatellar) 2 weeks post op
2.0 inches
Standard Deviation 2.3
2.8 inches
Standard Deviation 2.6
Leg Anthropometric (Girth) Measurements
(5 cm suprapatellar) 6 weeks post op
0.9 inches
Standard Deviation 1.9
1.0 inches
Standard Deviation 2.2
Leg Anthropometric (Girth) Measurements
(Midpatellar) Post Op day 1
4.6 inches
Standard Deviation 2.2
4.1 inches
Standard Deviation 2.6
Leg Anthropometric (Girth) Measurements
(Midpatellar) 2 weeks post op
2.2 inches
Standard Deviation 2.3
3.0 inches
Standard Deviation 2.0
Leg Anthropometric (Girth) Measurements
(Midpatellar) 6 weeks post op
1.3 inches
Standard Deviation 1.6
1.3 inches
Standard Deviation 2.0
Leg Anthropometric (Girth) Measurements
(10 cm inferior patella) Post Op day 1
2.7 inches
Standard Deviation 2.7
1.5 inches
Standard Deviation 4.6
Leg Anthropometric (Girth) Measurements
(10 cm inferior patella) 2 weeks post op
0.8 inches
Standard Deviation 2.1
0.9 inches
Standard Deviation 2.3
Leg Anthropometric (Girth) Measurements
(10 cm inferior patella) 6 weeks post op
-0.2 inches
Standard Deviation 1.3
0.1 inches
Standard Deviation 1.5

SECONDARY outcome

Timeframe: intra operative, Post Op Day #1 or #2

Post Operative/Intra Operative Transfusions

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Number of Participants With Requiring Transfusions
0 Participants
1 Participants

SECONDARY outcome

Timeframe: Up to 6 weeks Post OP

incidence of wound infection and wound drainage will be assessed and recorded

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Number of Participants With Off Wound Complications Post Operative
0 Participants
0 Participants

SECONDARY outcome

Timeframe: Post Opeartive until the 6 week follow up appointment

The incidence of thromboembolic events will be recorded.

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Number of Participants With Thromboembolic Disease
1 Participants
0 Participants

SECONDARY outcome

Timeframe: Post Op day 1, 2 Week and 6 Week Post OP

The strength testing will be calculated using a handheld dynamometer

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Quadriceps Strength Measure With a Handheld Dynamometer
Change from Preop to Post Op Day1
-10.4 KG
Standard Deviation 7.6
-11.2 KG
Standard Deviation 7.1
Quadriceps Strength Measure With a Handheld Dynamometer
Change from Preop to 2 weeks post op
-9.0 KG
Standard Deviation 6.5
-9.6 KG
Standard Deviation 7.2
Quadriceps Strength Measure With a Handheld Dynamometer
Change from Preop to 6 weeks post op
-3.2 KG
Standard Deviation 5.8
-3.8 KG
Standard Deviation 6.5

SECONDARY outcome

Timeframe: preoperative appointment and once again at their 2 and 6 weeks postoperatively

timed up and go (TUG)

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Time up and GO
Change from Preop to 2 weeks Post op
4.4 Seconds
Standard Deviation 4.8
3.3 Seconds
Standard Deviation 3.7
Time up and GO
Change from Preop to 6 weeks Post op
-4.7 Seconds
Standard Deviation 3.5
-4.0 Seconds
Standard Deviation 3.9

SECONDARY outcome

Timeframe: preoperative appointment and once again at their 2 and 6 weeks postoperatively

30 second sit-to-stand tests

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
30 Second STS Test
Change from Preop to 2 weeks Post op
-5.3 sit-to-stand events
Standard Deviation 4.0
-4.4 sit-to-stand events
Standard Deviation 4.6
30 Second STS Test
Change from Preop to 6 weeks Post op
-0.4 sit-to-stand events
Standard Deviation 4.1
0.3 sit-to-stand events
Standard Deviation 3.0

SECONDARY outcome

Timeframe: Daily up to 2 days while hospitalized

Length of time the patient is Hospitalized after their total knee replacement.

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Length of the Hospitalization
1 Day
56 Participants
63 Participants
Length of the Hospitalization
2 Days
9 Participants
2 Participants

SECONDARY outcome

Timeframe: up to 6 weeks post op

Number of patients re-admitted post TKA

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Number of Patients Re-admitted Post TKA
1 Participants
0 Participants

SECONDARY outcome

Timeframe: Every 4 hours, averaged daily, reported at Post op day 1 and 2 (while in the hospital), weeks 1, 2, 3, and 4 (3 times a day)

Population: Some of the patients did not complete their pain log for the study, which is why the numbers are different below.

Pain will be assessed using a pain Visual Analog scale(VAS), the scale is from 1 to 10, the higher the score the worse the pain.

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Postoperative Pain Assessment Using Visual Analog Scale
Average Post Op Day 1
2.6 units on a scale
Standard Deviation 1.4
2.3 units on a scale
Standard Deviation 1.4
Postoperative Pain Assessment Using Visual Analog Scale
Average Post Op Day 2
4.4 units on a scale
Standard Deviation 1.5
4.5 units on a scale
Standard Deviation 1.6
Postoperative Pain Assessment Using Visual Analog Scale
Average Week 1
4.3 units on a scale
Standard Deviation 1.6
4.1 units on a scale
Standard Deviation 1.6
Postoperative Pain Assessment Using Visual Analog Scale
Average Week 2
3.6 units on a scale
Standard Deviation 1.8
3.4 units on a scale
Standard Deviation 1.5
Postoperative Pain Assessment Using Visual Analog Scale
Average Week 3
3.0 units on a scale
Standard Deviation 1.7
3.2 units on a scale
Standard Deviation 1.7
Postoperative Pain Assessment Using Visual Analog Scale
Average Week 4
2.7 units on a scale
Standard Deviation 1.6
2.6 units on a scale
Standard Deviation 1.4

SECONDARY outcome

Timeframe: Daily up to 2 days while hospitalized

patients will be asked about Nausea: None, Mild, Moderate or Severe

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
PONV (Post-operative Nausea and Vomiting)
None
51 Participants
46 Participants
PONV (Post-operative Nausea and Vomiting)
Mild
9 Participants
12 Participants
PONV (Post-operative Nausea and Vomiting)
Moderat
3 Participants
3 Participants
PONV (Post-operative Nausea and Vomiting)
Severe
2 Participants
4 Participants

SECONDARY outcome

Timeframe: 2 week and 6 week follow up appointments

Patient Reported Outcomes- Veterans Rand(VR-12), there is an algorithm to calculate this score, not a specific range. The higher the number the more positive the output. The score has two components a mental score (MCS) and Physical Score (PCS). Higher values represent a better outcome. MCS Scale 35.089613 to 46.341715 PCS Scale 14.957554 to 63.235672

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Veterans Rand -12
Change from Preop - 2 Weeks Post Op Mental Score
-4.7 score on a scale
Standard Deviation 12.2
-1.2 score on a scale
Standard Deviation 10.4
Veterans Rand -12
Change from Preop - 2 Weeks PostOp Physical Score
-8.3 score on a scale
Standard Deviation 10
-4.5 score on a scale
Standard Deviation 11.2
Veterans Rand -12
Change from Pre op - 6 Weeks Post Op Mental Score
-2.5 score on a scale
Standard Deviation 11.5
-3.2 score on a scale
Standard Deviation 11.4
Veterans Rand -12
Change from Preop - 6 Weeks PostOp Physical Score
-0.5 score on a scale
Standard Deviation 10.6
2.2 score on a scale
Standard Deviation 12.2

SECONDARY outcome

Timeframe: pre-operatively as well as at their 2 week and 6 week follow up appointments

Knee injury and Osteoarthritis Outcome Score (KOOS), the scale is 0 to 100, 100 being the best score possible.

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Patient Reported Outcomes - Knee Injury and Osteoarthritis Outcome Score (KOOS)
Change is score from pre op to 2 weeks
-1.6 score on a scale
Standard Deviation 16.2
3.1 score on a scale
Standard Deviation 13.8
Patient Reported Outcomes - Knee Injury and Osteoarthritis Outcome Score (KOOS)
Change is score from pre op to 6 weeks
9.4 score on a scale
Standard Deviation 14.5
12.3 score on a scale
Standard Deviation 14.1

SECONDARY outcome

Timeframe: pre-operatively as well as at their 2 week and 6 week follow up appointments

Knee Society Score(KSS), the total scores range from 0 - 200, 200 being the best.

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Patient Reported Outcomes - Knee Society Score(KSS)
Change from Preop to 2 weeks Post op
-14.6 score on a scale
Standard Deviation 39.9
-0.2 score on a scale
Standard Deviation 36.2
Patient Reported Outcomes - Knee Society Score(KSS)
Change from pre op to 6 weeks
31.9 score on a scale
Standard Deviation 36.3
40.5 score on a scale
Standard Deviation 35.4

SECONDARY outcome

Timeframe: Duration of IV intervention, up to 2 days

Total amount of IV fluids that the patients received while in the hospital

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Total IV Fluids Received
3895 ML
Interval 1500.0 to 5322.0
350 ML
Interval 177.0 to 1466.0

SECONDARY outcome

Timeframe: pre-op visit, Post Op Day #1 as well as their 2 week and 6 week visit

body composition before and after surgery to measure swelling. Lower numbers represent more swelling.

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Bioimpedence
Change from Preop to Post Op Day1
-17.8 ohms
Standard Deviation 30.3
4.2 ohms
Standard Deviation 29.7
Bioimpedence
Change from Preop to 2 weeks post op
-41.4 ohms
Standard Deviation 34.2
-38.5 ohms
Standard Deviation 45.7
Bioimpedence
Change from Preop to 6 weeks post op
-30.9 ohms
Standard Deviation 25.6
-31.0 ohms
Standard Deviation 31.4

OTHER_PRE_SPECIFIED outcome

Timeframe: While in hospital until the 6 week follow up appointment

episodes such as symptomatic hypotension (light-headedness, syncope), emesis, the need the IV fluid boluses, and other hospital and post-discharge events will be recorded

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Number of Participants With Adverse Events
3 Participants
2 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Daily up to 2 days while hospitalized

Blood Pressure (Diastolic/ Systolic)

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Blood Pressure
Change in mmHg Pre Op to Recovery Room (Systolic)
21.5 Change in mmHg
Standard Deviation 15.9
26.0 Change in mmHg
Standard Deviation 16.7
Blood Pressure
Change in mmHg Pre Op to Recovery Room (Diastolic)
18.4 Change in mmHg
Standard Deviation 12.2
17.2 Change in mmHg
Standard Deviation 11.9
Blood Pressure
Change in mmHg Pre Op to Arrival on 4th floor (Systolic)
10.6 Change in mmHg
Standard Deviation 12.8
19.4 Change in mmHg
Standard Deviation 13.5
Blood Pressure
Change in mmHg Pre Op to Arrival on 4th floor (Diastolic)
10.5 Change in mmHg
Standard Deviation 10.3
9.3 Change in mmHg
Standard Deviation 10.8
Blood Pressure
Change in mmHg Pre Op to 08:00 on floor (Systolic)
17.0 Change in mmHg
Standard Deviation 12.9
23.4 Change in mmHg
Standard Deviation 13.3
Blood Pressure
Change in mmHg Pre Op to 08:00 on floor (Diastolic)
16.5 Change in mmHg
Standard Deviation 9.3
16.0 Change in mmHg
Standard Deviation 9.6
Blood Pressure
Change in mmHg Pre Op to 16:00 on floor (Systolic)
20.9 Change in mmHg
Standard Deviation 14.0
25.8 Change in mmHg
Standard Deviation 13.8
Blood Pressure
Change in mmHg Pre Op to 16:00 on floor (Diastolic)
16.3 Change in mmHg
Standard Deviation 11.2
18.7 Change in mmHg
Standard Deviation 11.8
Blood Pressure
Change in mmHg Pre Op to 24:00 on floor (Systolic)
12.5 Change in mmHg
Standard Deviation 14.7
12.5 Change in mmHg
Standard Deviation 12.9
Blood Pressure
Change in mmHg Pre Op to 24:00 on floor (Diastolic)
14.6 Change in mmHg
Standard Deviation 9.9
11.1 Change in mmHg
Standard Deviation 10.2

OTHER_PRE_SPECIFIED outcome

Timeframe: Up to Day 1 Post op

total amount of any pressor drugs given intraoperatively (e.g. Ephedrine and Phenylephrine)

Outcome measures

Outcome measures
Measure
Traditional Fluid
n=65 Participants
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 Participants
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Total Number of Patients That Received Any Pressor Drugs
Yes
23 Participants
22 Participants
Total Number of Patients That Received Any Pressor Drugs
No
42 Participants
43 Participants

Adverse Events

Traditional Fluid

Serious events: 1 serious events
Other events: 0 other events
Deaths: 0 deaths

Oral Fluid

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Traditional Fluid
n=65 participants at risk
* NPO Clears and Food after midnight. * 2 Liters of lactated ringers administered by anesthesia intraoperatively. * Postoperatively - 2 Liters of Crystalloid while in PACU and Inpatient Room for a Total of 4 Liters of Crystalloid within 24 hours. (Patient will receive 500 milliliters while in PACU and 1500 milliliters while in their Inpatient Room, for a total of 2 Liters). * Normal diet postoperatively.
Oral Fluid
n=65 participants at risk
* Pre Operative Oral Fluids (Patients encouraged to drink a minimum of 60 ounces of clear liquid per day for the 3 days prior to procedure.) * NPO Food/Milk: none beginning 8 hours prior to procedure time. * Pre Operative Oral Fluids (Patients are asked to drink 10 ounces of clear liquid 4 hours prior to their scheduled procedure time.) * Preoperative holding area, IV is started in the patient with Lactated Ringers IV fluid at a rate of 75ml/hr. IV fluids will be stopped and hep-locked in the PACU when the patient is taking PO fluid; the total amount of IV fluids is not to exceed 500ml total. * PO fluid protocol: a minimum of 60 ounces of liquid per day for 3 days. Pre Operative Oral Fluids: Patients will be self hydrating prior to their total knee replacement.
Respiratory, thoracic and mediastinal disorders
acute pulmonary embolism
1.5%
1/65 • Number of events 1 • 6 Weeks Post Operatively
0.00%
0/65 • 6 Weeks Post Operatively

Other adverse events

Adverse event data not reported

Additional Information

Rose Johnson, CCRP Research Lead

Colorado Joint Replacement

Phone: 3032602940

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place