Trial Outcomes & Findings for Safety of Total Knee Replacement Surgery Before and After the Implementation of Enhanced Recovery Program (NCT NCT05028426)

NCT ID: NCT05028426

Last Updated: 2022-07-07

Results Overview

Recorded complications were Bleeding, Deep periprosthetic joint infection, Implant fracture, Instability, Patellofemoral dislocation, Readmission, Reoperation, Revision, Stiffness, Thromboembolic disease, Tibiofemoral dislocation, Vascular injury, Wound complication.

Recruitment status

COMPLETED

Target enrollment

455 participants

Primary outcome timeframe

3 months after surgery

Results posted on

2022-07-07

Participant Flow

Participant milestones

Participant milestones
Measure
Traditional Method of Care
Patients managed according to the traditional care protocol without an enhanced recovery program
Some Elements of a Fast-track Program
operative and postoperative techniques were modified according to a fast-track program Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Full Enhanced Recovery Program
Patients were managed in an enhanced recovery program (elements of the previous fast-track program were modified and preoperative education was added) Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Overall Study
STARTED
214
132
109
Overall Study
COMPLETED
214
132
109
Overall Study
NOT COMPLETED
0
0
0

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 Method of Care
n=214 Participants
Patients managed according to the traditional care protocol without an enhanced recovery program
Some Elements of a Fast-track Program
n=132 Participants
operative and postoperative techniques were modified according to a fast-track program Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Full Enhanced Recovery Program
n=109 Participants
Patients were managed in an enhanced recovery program (elements of the previous fast-track program were modified and preoperative education was added) Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Total
n=455 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=214 Participants
0 Participants
n=132 Participants
0 Participants
n=109 Participants
0 Participants
n=455 Participants
Age, Categorical
Between 18 and 65 years
68 Participants
n=214 Participants
29 Participants
n=132 Participants
36 Participants
n=109 Participants
133 Participants
n=455 Participants
Age, Categorical
>=65 years
146 Participants
n=214 Participants
103 Participants
n=132 Participants
73 Participants
n=109 Participants
322 Participants
n=455 Participants
Age, Continuous
70 years
STANDARD_DEVIATION 9 • n=214 Participants
72 years
STANDARD_DEVIATION 8.9 • n=132 Participants
70 years
STANDARD_DEVIATION 8.5 • n=109 Participants
70 years
STANDARD_DEVIATION 8.9 • n=455 Participants
Sex: Female, Male
Female
130 Participants
n=214 Participants
77 Participants
n=132 Participants
66 Participants
n=109 Participants
273 Participants
n=455 Participants
Sex: Female, Male
Male
84 Participants
n=214 Participants
55 Participants
n=132 Participants
43 Participants
n=109 Participants
182 Participants
n=455 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Region of Enrollment
France
214 participants
n=214 Participants
132 participants
n=132 Participants
109 participants
n=109 Participants
455 participants
n=455 Participants
American Society of Anesthesiology (ASA) score
ASA score = 1
29 Participants
n=214 Participants
16 Participants
n=132 Participants
16 Participants
n=109 Participants
61 Participants
n=455 Participants
American Society of Anesthesiology (ASA) score
ASA score = 2
128 Participants
n=214 Participants
87 Participants
n=132 Participants
67 Participants
n=109 Participants
282 Participants
n=455 Participants
American Society of Anesthesiology (ASA) score
ASA score = 3
57 Participants
n=214 Participants
29 Participants
n=132 Participants
26 Participants
n=109 Participants
112 Participants
n=455 Participants

PRIMARY outcome

Timeframe: 3 months after surgery

Recorded complications were Bleeding, Deep periprosthetic joint infection, Implant fracture, Instability, Patellofemoral dislocation, Readmission, Reoperation, Revision, Stiffness, Thromboembolic disease, Tibiofemoral dislocation, Vascular injury, Wound complication.

Outcome measures

Outcome measures
Measure
Traditional Method of Care
n=214 Participants
Patients managed according to the traditional care protocol without an enhanced recovery program
Some Elements of a Fast-track Program
n=132 Participants
operative and postoperative techniques were modified according to a fast-track program Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Full Enhanced Recovery Program
n=109 Participants
Patients were managed in an enhanced recovery program (elements of the previous fast-track program were modified and preoperative education was added) Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Number of Patients With Early Complication
9 Participants
16 Participants
4 Participants

SECONDARY outcome

Timeframe: up to 28 months after surgery

Recorded complications were Bleeding, Deep periprosthetic joint infection, Implant fracture, Instability, Patellofemoral dislocation, Readmission, Reoperation, Revision, Stiffness, Thromboembolic disease, Tibiofemoral dislocation, Vascular injury, Wound complication.

Outcome measures

Outcome measures
Measure
Traditional Method of Care
n=214 Participants
Patients managed according to the traditional care protocol without an enhanced recovery program
Some Elements of a Fast-track Program
n=132 Participants
operative and postoperative techniques were modified according to a fast-track program Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Full Enhanced Recovery Program
n=109 Participants
Patients were managed in an enhanced recovery program (elements of the previous fast-track program were modified and preoperative education was added) Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Number of Patients With Late Complication
0 Participants
5 Participants
1 Participants

SECONDARY outcome

Timeframe: up to 1 month after surgery

the time between admission for an operation and discharge from the hospital

Outcome measures

Outcome measures
Measure
Traditional Method of Care
n=214 Participants
Patients managed according to the traditional care protocol without an enhanced recovery program
Some Elements of a Fast-track Program
n=132 Participants
operative and postoperative techniques were modified according to a fast-track program Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Full Enhanced Recovery Program
n=109 Participants
Patients were managed in an enhanced recovery program (elements of the previous fast-track program were modified and preoperative education was added) Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Length of Hospital Stay
9.5 days
Standard Deviation 2.7
5.6 days
Standard Deviation 2.4
4.9 days
Standard Deviation 2.1

SECONDARY outcome

Timeframe: up to 1 month before surgery

Measure in degree of how much the knee straightens during consultation with surgeon

Outcome measures

Outcome measures
Measure
Traditional Method of Care
n=214 Participants
Patients managed according to the traditional care protocol without an enhanced recovery program
Some Elements of a Fast-track Program
n=132 Participants
operative and postoperative techniques were modified according to a fast-track program Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Full Enhanced Recovery Program
n=109 Participants
Patients were managed in an enhanced recovery program (elements of the previous fast-track program were modified and preoperative education was added) Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Preoperative Knee Extension
5 degree
Standard Deviation 8.2
7.4 degree
Standard Deviation 7.4
4.8 degree
Standard Deviation 8.0

SECONDARY outcome

Timeframe: At 3 months after surgery

Measure in degree of how much the knee straightens during consultation with surgeon

Outcome measures

Outcome measures
Measure
Traditional Method of Care
n=214 Participants
Patients managed according to the traditional care protocol without an enhanced recovery program
Some Elements of a Fast-track Program
n=132 Participants
operative and postoperative techniques were modified according to a fast-track program Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Full Enhanced Recovery Program
n=109 Participants
Patients were managed in an enhanced recovery program (elements of the previous fast-track program were modified and preoperative education was added) Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Postoperative Knee Extension
0.5 degree
Standard Deviation 2.1
0.7 degree
Standard Deviation 2.8
0.8 degree
Standard Deviation 3.6

SECONDARY outcome

Timeframe: up to 1 month before surgery

Measure in degree of how much the knee bends during consultation with surgeon

Outcome measures

Outcome measures
Measure
Traditional Method of Care
n=214 Participants
Patients managed according to the traditional care protocol without an enhanced recovery program
Some Elements of a Fast-track Program
n=132 Participants
operative and postoperative techniques were modified according to a fast-track program Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Full Enhanced Recovery Program
n=109 Participants
Patients were managed in an enhanced recovery program (elements of the previous fast-track program were modified and preoperative education was added) Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Preoperative Knee Flexion
106.5 degree
Standard Deviation 13.3
107.0 degree
Standard Deviation 16.9
108.3 degree
Standard Deviation 15.7

SECONDARY outcome

Timeframe: At 3 months after surgery

Measure in degree of how much the knee bends during consultation with surgeon

Outcome measures

Outcome measures
Measure
Traditional Method of Care
n=214 Participants
Patients managed according to the traditional care protocol without an enhanced recovery program
Some Elements of a Fast-track Program
n=132 Participants
operative and postoperative techniques were modified according to a fast-track program Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Full Enhanced Recovery Program
n=109 Participants
Patients were managed in an enhanced recovery program (elements of the previous fast-track program were modified and preoperative education was added) Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Postoperative Knee Flexion
114.5 degree
Standard Deviation 14.9
116.6 degree
Standard Deviation 14.4
112.9 degree
Standard Deviation 16.1

Adverse Events

Traditional Method of Care

Serious events: 9 serious events
Other events: 7 other events
Deaths: 6 deaths

Some Elements of a Fast-track Program

Serious events: 21 serious events
Other events: 7 other events
Deaths: 1 deaths

Full Enhanced Recovery Program

Serious events: 5 serious events
Other events: 6 other events
Deaths: 2 deaths

Serious adverse events

Serious adverse events
Measure
Traditional Method of Care
n=214 participants at risk
Patients managed according to the traditional care protocol without an enhanced recovery program
Some Elements of a Fast-track Program
n=132 participants at risk
operative and postoperative techniques were modified according to a fast-track program Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Full Enhanced Recovery Program
n=109 participants at risk
Patients were managed in an enhanced recovery program (elements of the previous fast-track program were modified and preoperative education was added) Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Surgical and medical procedures
Bleeding
0.00%
0/214 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.76%
1/132 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/109 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Surgical and medical procedures
joint infection
1.4%
3/214 • Number of events 3 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
6.1%
8/132 • Number of events 8 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.92%
1/109 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Surgical and medical procedures
Fracture
0.00%
0/214 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.76%
1/132 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/109 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Surgical and medical procedures
Joint instability
0.00%
0/214 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.76%
1/132 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/109 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Surgical and medical procedures
Joint dislocation
0.47%
1/214 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/132 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.92%
1/109 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Surgical and medical procedures
Hospitalisation
0.93%
2/214 • Number of events 2 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
5.3%
7/132 • Number of events 7 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
2.8%
3/109 • Number of events 3 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Surgical and medical procedures
Stiffness
0.00%
0/214 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.76%
1/132 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/109 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Surgical and medical procedures
Thromboembolic event
0.00%
0/214 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.76%
1/132 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/109 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Surgical and medical procedures
Vascular injury
0.93%
2/214 • Number of events 2 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/132 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/109 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Surgical and medical procedures
Wound complication
0.47%
1/214 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.76%
1/132 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/109 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.

Other adverse events

Other adverse events
Measure
Traditional Method of Care
n=214 participants at risk
Patients managed according to the traditional care protocol without an enhanced recovery program
Some Elements of a Fast-track Program
n=132 participants at risk
operative and postoperative techniques were modified according to a fast-track program Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Full Enhanced Recovery Program
n=109 participants at risk
Patients were managed in an enhanced recovery program (elements of the previous fast-track program were modified and preoperative education was added) Enhanced recovery program: Enhanced recovery programs are a multimodal approach to optimize patients' physiological and psychological states in the preoperative, intraoperative and postoperative care domains.
Surgical and medical procedures
Joint prosthesis loosening
0.47%
1/214 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/132 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/109 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Skin and subcutaneous tissue disorders
Necrosis
0.00%
0/214 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.76%
1/132 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/109 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Musculoskeletal and connective tissue disorders
Osteopenia
0.00%
0/214 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.76%
1/132 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/109 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
General disorders
Pain
2.3%
5/214 • Number of events 5 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
1.5%
2/132 • Number of events 2 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
1.8%
2/109 • Number of events 2 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Surgical and medical procedures
Haematoma
0.00%
0/214 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
1.5%
2/132 • Number of events 2 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.92%
1/109 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Respiratory, thoracic and mediastinal disorders
Respiratory distress
0.00%
0/214 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/132 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.92%
1/109 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
General disorders
Fall
0.47%
1/214 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/132 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.92%
1/109 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
Surgical and medical procedures
Hip surgery
0.00%
0/214 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.76%
1/132 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/109 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
General disorders
Hyperthermia
0.00%
0/214 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.00%
0/132 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.
0.92%
1/109 • Number of events 1 • The post-surgery follow-up consultation took place 1 month after the operation. Depending on the clinical situation, further follow-up consultations took place up to 28 months after surgery.

Additional Information

Dr. Vivien Fontaine

Groupe Hospitalier de la Rochelle Ré Aunis

Phone: +33546455050

Results disclosure agreements

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