Perioperative Vitamin C to Reduce Persistent Pain After Total Knee Arthroplasty

NCT ID: NCT06123715

Last Updated: 2025-04-25

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

PHASE2

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-16

Study Completion Date

2026-12-31

Brief Summary

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Phase II Multicentre, pilot, parallel-group, blinded, 1:1 randomized controlled trial to determine the feasibility of conducting a larger definitive trail of using vitamin C to reduce persistent pain in patients undergoing total knee arthroplasty surgery.

Detailed Description

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PROVISION is a multicentre, pilot, parallel-group, blinded, randomized controlled trial of 300 patients undergoing total knee arthroplasty surgery. Consented eligible patients will be randomized to receive vitamin C: 2000 mg taken orally within 4 hours of the start of surgery, followed by 500 mg of vitamin C taken twice daily from post-operative day 1 to day 56 (8 weeks). Patient in the control group will receive placebo lactose monohydrate capsules. Study medications will be prepared to look similar and labelled as per regulatory requirements. Patients will follow up on post-operative days 1-3, weeks 2,4,6, and 8 post-operatively, and at 3- and 12-months post-operatively to report on pain, opioid and analgesic consumption, medication adherence, adverse events, functional, mood, and quality of life outcomes.

Conditions

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Chronic Pain Knee Pain Chronic Post Operative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Intervention

Preoperative Vitamin C capsules

Group Type EXPERIMENTAL

Vitamin C

Intervention Type DRUG

Drug: Patients in the intervention group will receive 2g Vitamin C orally within 4 hours of the start of the surgery followed by 500 mg of Vitamin C to be taken orally twice a day from post-op day1 to day 56.

Placebo

Preoperative placebo capsules

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Drug: Patients in the placebo group will receive identical placebo capsules taken orally within 4 hours of the start of the surgery followed by placebo capsules taken orally twice a day from post-op day 1 to day 56.

Interventions

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Vitamin C

Drug: Patients in the intervention group will receive 2g Vitamin C orally within 4 hours of the start of the surgery followed by 500 mg of Vitamin C to be taken orally twice a day from post-op day1 to day 56.

Intervention Type DRUG

Placebo

Drug: Patients in the placebo group will receive identical placebo capsules taken orally within 4 hours of the start of the surgery followed by placebo capsules taken orally twice a day from post-op day 1 to day 56.

Intervention Type DRUG

Other Intervention Names

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Ascorbic Acid Lactose (Monohydrate)

Eligibility Criteria

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Inclusion Criteria

* Patients \>18 years old
* Undergoing a unilateral or bilateral primary total knee arthroplasty for advanced osteoarthritis of the knee

Exclusion Criteria

* TKA for infection (septic joint), fracture, ankylosing spondylitis, lupus, or psoriatic arthritis
* History of kidney stones, acute or chronic renal failure, hemochromatosis, or glucose-6-phosphate deficiency
* Unlikely to comply with follow-up (e.g., no fixed address, plans to move out of town)
* Language difficulties that would impede valid completion of questionnaires
* Planned staged bilateral TKA
* Treating surgeon deems patient inappropriate for inclusion in trial
* Any allergy or sensitivity to milk
* Pregnant or planning to become pregnant during the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Canadian Institutes of Health Research (CIHR)

OTHER_GOV

Sponsor Role collaborator

The Arthritis Society, Canada

OTHER

Sponsor Role collaborator

University Health Network, Toronto

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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James Khan, MD

Role: PRINCIPAL_INVESTIGATOR

University Health Network; Department of Anesthesia and Pain Medicine

Raman Mundi, MD

Role: PRINCIPAL_INVESTIGATOR

Holland Orthopedic and Arthritic Centre

Harman Chaudhry, MD

Role: PRINCIPAL_INVESTIGATOR

Holland Orthopedic and Arthritic Centre

Jesse Wolfstadt, MD

Role: PRINCIPAL_INVESTIGATOR

Mount Sinai Hospital; Department of Surgery

Locations

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Sunnybrook - Holland Centre

Toronto, Ontario, Canada

Site Status RECRUITING

Mount Sinai Hospital

Toronto, Ontario, Canada

Site Status RECRUITING

Toronto Western Hospital

Toronto, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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James Khan, MD

Role: CONTACT

416-340-4800 ext. 3243

Nour Ayach

Role: CONTACT

(416) 340 4800 ext. 4221

Facility Contacts

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Raman Mundi, MD

Role: primary

James Khan, MD

Role: primary

Anuj Bhatia, MD

Role: primary

Other Identifiers

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23-5642

Identifier Type: -

Identifier Source: org_study_id

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