A Study to Compare Different Ways of Steroid Administration After Total Knee Implantation

NCT ID: NCT04432012

Last Updated: 2025-08-06

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

PHASE4

Total Enrollment

159 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-07-01

Study Completion Date

2033-04-30

Brief Summary

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We are going to evaluate the difference between perioperative intravenous steroid supplementation, perioperative periarticular steroid supplementation, and standard anaesthesia protocols. We'll evaluate the outcome of patients with knee osteoarthritis who are undergoing Total Knee Arthroplasty to understand which of the three treatments give more benefits to the patient.

Detailed Description

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A total of 159 patients will be needed (53 patients per arm, 3 arms in total). Dexamethasone (brand name: Mephameson) is the steroid drug that we perioperative administer in two different ways: intra-venous (IV) dexamethasone (9mg) in arm-A, intra-articular (IA) dexamethasone (9mg) in arm-B. No steroid supplementation will be provided in the control group (arm-C).

The primary objective of the study is to compare the effect on post-operative pain of I.V. and I.A. perioperative dexamethasone supplementation for total knee arthroplasty (TKA).

The secondary objectives of the studies will be the comparison between I.V. and I.A. peri-operative dexamethasone supplementation in terms of post-operative pain and function, opioids and analgesic drugs consumption, knee range of motion, systemic inflammatory response, time to mobilisation, length of stay, and patient satisfaction.

Moreover, both I.V. and I.A. steroid supplementation protocols will be compared to routine analgesia protocol (no steroid supplementation group) in order to document their advantages over the absence of steroid supplementation.

The safety of I.V. and I.A. peri-operative dexamethasone will be evaluated and compared recording all the steroid supplementation related complications. In particular, the risk of hyperglycaemia-related complications and post-operative infections will be documented. The safety of both I.V. and I.A. steroid supplementation protocols will be verified comparing them to the no-treatment group in terms of incidence of complications.

Overall study duration will be 12 years: 2 years to enroll all the patients and 10 years to complete the last follow-up. Primary data analysis is planned after the completion of the 1-year follow-up visits.

Conditions

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Total Knee Replacement

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
The present study will be double blinded: both participants and assessor will be blinded to the assigned treatment. Only the surgeons and the anaesthetists taking part to surgery will be aware of the group to which the patient was assigned but they will not take part to the follow-up visits.

Study Groups

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arm-A Intra-venous dexamethasone

9 mg of Intra-venous dexamethasone

Group Type EXPERIMENTAL

Dexamethasone Sodium Phosphate 4 mg/ml intravenous

Intervention Type DRUG

Perioperative intravenous injection of 3 ml of solution (9mg of dexamethasone)

arm-B intra-articular dexamethasone

9 mg of intra-articular dexamethasone

Group Type EXPERIMENTAL

Dexamethasone Sodium Phosphate 4 mg/ml intra-articular

Intervention Type DRUG

Perioperative intra-articular injection of 3 ml of solution (9mg of dexamethasone)

arm-C routine

No steroid supplementation or other drugs will be added to the routinely performed anaesthesia protocol in the control group

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Dexamethasone Sodium Phosphate 4 mg/ml intravenous

Perioperative intravenous injection of 3 ml of solution (9mg of dexamethasone)

Intervention Type DRUG

Dexamethasone Sodium Phosphate 4 mg/ml intra-articular

Perioperative intra-articular injection of 3 ml of solution (9mg of dexamethasone)

Intervention Type DRUG

Other Intervention Names

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Mephameson Mephameson

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing unilateral primary TKA at the Ospedale Regionale di Lugano.
* Patients with a BMI \>18.5 and \<35.
* Patients able to provide informed consent and follow all the study procedures as indicated by the protocol.
* Informed Consent as documented by signature (Appendix Informed Consent Form).

Exclusion Criteria

* Contraindications to steroids.
* Revision TKA.
* Active steroid therapy.
* Women who are pregnant or breast feeding.
* Presence of other clinically significant concomitant disease states (ASA IV).
* Uncontrolled diabetes mellitus
* Known or suspected non-compliance, drug or alcohol abuse.
* Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant.
* Participation in another study with investigational drug within the 30 days preceding and during the present study.
* Previous enrolment into the current study.
* Enrolment of the investigator, his/her family members, employees and other dependent persons.
Minimum Eligible Age

50 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Christian Candrian

OTHER

Sponsor Role lead

Responsible Party

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Christian Candrian

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Christian Candrian, MD, Prof.

Role: PRINCIPAL_INVESTIGATOR

EOC

Locations

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Ospedale Regionale di Lugano Civico e Italiano

Lugano, , Switzerland

Site Status RECRUITING

Countries

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Switzerland

Central Contacts

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Christian Candrian, MD, Prof

Role: CONTACT

+41 (0) 91 811 61 23

Marco Delcogliano, MD

Role: CONTACT

+41 (0)91 811 66 56

Facility Contacts

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Christian Candrian, MD, Prof

Role: primary

+41 (0)91 811 7029

Other Identifiers

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ORL-ORT-013

Identifier Type: -

Identifier Source: org_study_id

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