Evaluation of Walking Analysis After a Total Knee Arthroplasty With Kinematic Alignment Versus Mechanical Alignment

NCT ID: NCT04226339

Last Updated: 2022-08-23

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

RECRUITING

Clinical Phase

NA

Total Enrollment

104 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-07

Study Completion Date

2029-03-07

Brief Summary

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Total knee arthroplasty (TKA) is a treatment for advanced femoro-tibial osteoarthritis. This surgery is justified in case of significant discomfort and failure of medical treatment.

The functional results of TKA are good with a recovery of 6 months - 1 year. Nevertheless, very few patients forget their prostheses. A United Kingdom study assessed patient satisfaction in a cohort of 10,000 patients more than one year after TKA: nearly 20% were not satisfied with their TKA.

The knee is indeed a complex articulation that works differently in the three space plans. Current knee prostheses are trying to replicate this biomechanics and get as close as possible to the anatomy of a native knee.

Bellemans et al. found in 250 asymptomatic patients 32% of men with a constitutional varus greater than 3 ° and 17% of women. Restoration of normal knee function can also be achieved by restoring a moderate constitutional deformity present preoperatively. The objective of the femorotibial alignment was dogmatically fixed at 180° (mechanical femorotibial alignment). In recent years, some surgical teams have attempted to reproduce the preoperative constitutional deformity in varus or valgus with the prosthesis. This femorotibial alignment is called kinematic alignment. This kinematic alignment has already been studied in several randomized studies and has demonstrated improved functional scores. However, these studies focused on specific TKA, which are posterior cruciate TKA, and the assessment was subjective through functional scores. In addition, these TKA were often made with patient specific instrumentation (PSI). Some studies have evaluated walking kinematics after TKA with kinematic alignment. But it was again TKA retaining the posterior cruciate ligament.

The investigators would like to prospectively evaluate the restoration of the medially stabilized TKA walking kinematics (medial-stable TKA or ball in socket stability) implanted with a kinematic alignment compared to a mechanical alignment.

Detailed Description

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Conditions

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Knee Arthroplasty, Total

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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total knee arthroplasty with a kinetic alignment

Group Type EXPERIMENTAL

total knee arthroplasty with a kinetic alignment

Intervention Type PROCEDURE

During surgery, a SPHERE prosthesis will replace the knee and the femorotibial alignment.

it will be set to reproduce the preoperative constitutional deformity in varus or valgus as it was measured before surgery

total knee arthroplasty with a mechanical alignment

Group Type ACTIVE_COMPARATOR

total knee arthroplasty with a mechanical alignment

Intervention Type PROCEDURE

During surgery, a SPHERE prosthesis will replace the knee and the femorotibial alignment.

It will be set to 180° as defined for a mechanical femorotibial alignment

Interventions

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total knee arthroplasty with a kinetic alignment

During surgery, a SPHERE prosthesis will replace the knee and the femorotibial alignment.

it will be set to reproduce the preoperative constitutional deformity in varus or valgus as it was measured before surgery

Intervention Type PROCEDURE

total knee arthroplasty with a mechanical alignment

During surgery, a SPHERE prosthesis will replace the knee and the femorotibial alignment.

It will be set to 180° as defined for a mechanical femorotibial alignment

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Both sex
* Adults between 55 and 80 years
* Diagnosis of internal or global disabling femorotibial gonarthrosis Indication of total first knee arthroplasty (unilateral), using a Sphere type prosthesis (Medacta)
* Constitutional deformity in varus between 3 ° and 10 °
* Fulfilling the pass conditions of a KneeKG walking test: Unipodal support possible for 1 minute, run for 5 min at a speed of at least 0.8 km / h
* Affiliated to a social security system
* Patients able to understand and fulfill the requirement of the study

Exclusion Criteria

* TKA bilateral
* TKA to change an Uni-compartmental prosthesis
* History of femoral or tibial fracture
* History of femoral or tibial osteotomy
* Associated gesture at the same time (allograft, osteotomy)
* External femorotibial gonarthrosis
* Angle Hip Knee Ankle \> 178 °
* Constitutional distortion\> 10 °
* Refusal to participate in the study
* Persons deprived of their liberty by a judicial or administrative decision, persons under psychiatric care, persons admitted to a health or social institution for purposes other than research
* Adults subject to a legal protection measure
* breastfeeding or pregnant women
* Patient already participating to another clinical trial that might jeopardize the current trial
Minimum Eligible Age

55 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospices Civils de Lyon

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sebastien Lustig, Pr

Role: PRINCIPAL_INVESTIGATOR

Hospices Civils de Lyon

Locations

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Hôpital de la Croix Rousse

Lyon, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Sebastien Lustig, Pr

Role: CONTACT

4 26 10 92 98 ext. +33

Julien Berthiller

Role: CONTACT

4 72 11 80 67 ext. +33

Facility Contacts

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Sebastien Lustig, Pr

Role: primary

4 26 10 92 98 ext. +33

Other Identifiers

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2019-A02288-49

Identifier Type: OTHER

Identifier Source: secondary_id

69HCL19_0497

Identifier Type: -

Identifier Source: org_study_id

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