Effect of Peri-operative Glucocorticoids on Short-term Functional Outcome After THA

NCT ID: NCT04317872

Last Updated: 2025-04-15

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

COMPLETED

Clinical Phase

NA

Total Enrollment

71 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-07-01

Study Completion Date

2024-05-03

Brief Summary

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This randomized, single surgeon, placebo controlled, double blind study will be conducted in order to investigate whether or not peri-operative high doses of intravenous glucocorticoids improve short-term functional outcome after direct anterior total hip arthroplasty. So far, it has been proven that high dose glucocorticoids reduce immediate post-operative pain and nausea, but no data exists on functional outcome during the first 6 weeks. Our hypothesis is that patients in the intervention group will follow a so-called "get ahead, stay ahead" principle and that glucocorticoids can be considered an important tool (adjuvant treatment) in the enhanced recovery pathway after THA with significant socio-economic implications.

Detailed Description

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Patients listed for a direct anterior total hip arthroplasty by a single surgeon will be recruited for this study and allocated to one of two groups:

1. intervention group: 25 grams of iv dexamethasone at induction followed by 10 mg of iv dexamethasone 12 hours later
2. control group: 5 grams of iv dexamethasone at induction followed by placebo 12 hours later Both patients and surgeons will be blinded. Primary outcome measure will be number of steps during the first 6 weeks as measured by a pedometer. Secondary outcome measures will be side effects, complications, Patient Reported Outcome Measures, pain, nausea, stiffness, achievement of clinical milestones and use of analgesia/anti-emetics. This data will be collected using a tailor made application for a smartphone or tablet and data collecting will start one week before surgery until 6 weeks after surgery.

Based on a power analysis both groups will consist of 35 patients each.

Conditions

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Coxarthrosis Avascular Necrosis of Hip

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A randomized, single surgeon, placebo controlled, double blind study using two parallel study groups
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Caregivers
An anesthetist or study nurse not involved in further care of the patient nor in the study will prepare the medication to administered based on the allocated group. The first syringe with either 5 or 25 mg of Aacidexam will be administered during induction. The second syringe will go with the patient to the ward and will be administered 12 hours after the surgery by the (blinded) ward nurse. The patient will not be made aware of what has been administered.

Study Groups

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Current protocol

"Current protocol": patients will receive a single shot of 25mg of aacidexam iv (5cc) at induction. After 12 hours these patients will another shot of 10mg of aacidexam iv (2cc) on the ward.

Group Type EXPERIMENTAL

High dose of peri-operative intravenous dexamethasone

Intervention Type DRUG

25mg aacidexam is administered during induction followed by 10mg on the ward after 12 hours

Old protocol

"Old protocol": patients will receive a single shot of 5mg of aacidexam iv at induction (5cc). After arrival 12 hours these patients will receive a placebo, i.e. a shot of 2 cc of NaCl 0.9% iv (Mini-Plasco van B. Braun).

Group Type ACTIVE_COMPARATOR

Low dose of peri-operative intravenous dexamethasone

Intervention Type DRUG

10mg aacidexam is administered during induction followed by placebo on the ward after 12 hours

Interventions

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High dose of peri-operative intravenous dexamethasone

25mg aacidexam is administered during induction followed by 10mg on the ward after 12 hours

Intervention Type DRUG

Low dose of peri-operative intravenous dexamethasone

10mg aacidexam is administered during induction followed by placebo on the ward after 12 hours

Intervention Type DRUG

Other Intervention Names

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Aacidexam Aacidexam

Eligibility Criteria

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Inclusion Criteria

* All patients undergoing unilateral uncemented THA for primary OA or AVN of the hip under general anesthesia (GA)
* Aged 18 years and above (including women of child bearing age)
* Able to provide informed consent

Exclusion Criteria

* Younger than 18 years
* Known alcohol or drug abuse
* Known allergy for glucocorticoids
* Administration of any glucocorticoids in the last three months
* Usage of strong analgesia (such as lyrica or oxycodone) as regular medication
* Usage of medication with anticipated interactions with glucocorticoids
* Known gastric ulcer
* Insulin dependent diabetes mellitus
* Severe heart disease (NYHA \> 2)
* Liver or renal failure
* Systemic rheumatoid diseases
* Insufficient understanding of the Dutch language
* Unable to provide informed consent
* Pre-operative use of walking aids
* Gross anatomical deformities
* Significant intra-operative complications such as periprosthetic fracture
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Universitaire Ziekenhuizen KU Leuven

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stijn Ghijselings, MD

Role: PRINCIPAL_INVESTIGATOR

Universitaire Ziekenhuizen KU Leuven

Locations

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University Hospitals of Leuven

Leuven, , Belgium

Site Status

Countries

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Belgium

References

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Other Identifiers

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S63584

Identifier Type: -

Identifier Source: org_study_id

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