Trochlear Thickness and Its Effect on the Outcomes of Total Knee Arthroplasty

NCT ID: NCT06555055

Last Updated: 2024-08-15

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

Total Enrollment

87 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-09-30

Study Completion Date

2024-07-01

Brief Summary

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Total knee arthroplasty (TKA ) is the gold standard treatment for advanced knee osteoarthritis. only 85% (75% to 92%) of patients with total knee arthroplasty are satisfied with their operations and 30% develops patellofemoral complications.

Numerous biomechanical studies suggest that patellofemoral tracking is not always restored to physiological values, because the prosthetic trochlea may differ from the native trochlea. no study has been con-ducted to investigate the thickness of the trochlear groove and its effect on the outcome of Total knee replacement (TKR), So many people has different measurements of trochlear thickness which may affect Patellofemoral joint (PFJ) so knowing of native trochlear thickness in patients with KNEE Osteoarthritis (OA) can affect the outcomes of total knee arthroplasty.

Detailed Description

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Total knee arthroplasty is the gold standard treatment for advanced knee osteoarthritis. In spite of the great advance in the prosthesis design, surgical techniques and rehabilitation programs, only 85% (75% to 92%) of patients with total knee arthroplasty are satisfied with their operations and 30% develops patellofemoral complications. Patellofemoral complications after TKR are usually caused by multiple factors related to surgical technique (e.g., implant positioning and sizing, soft-tissue balancing, patellar resurfacing, etc.) and implant design (e.g., trochlear thickness, sagittal curvature, patellar component shape).

Numerous biomechanical studies suggest that patellofemoral tracking is not always restored to physiological values, because the prosthetic trochlea may differ from the native trochlea.

Theoretically decreasing of contact area distance of trochlea might increase the contact pressure in the patellofemoral joint. The increased contact pressure will elevate the stress in the subchondral bone of the patellofemoral joint, which is hypothesized to be a cause of patellofemoral pain.

A mechanical experiment was performed in an attempt to analyze the influence of thickening of the patella on the knee extension movement. The measurement show that anterior advancement of the extensor apparatus at the level of the patella gives a mechanical advantage, enabling the quadriceps to extend the knee with the use of less force. so increase thickness of patella affects the quadriceps function but no study has been shown the effect of trochlear thickness on quadriceps or patellofemoral joint.

Nonetheless, no study has been con-ducted to investigate the thickness of the trochlear groove and its effect on the outcome of TKR, So many people has different measurements of trochlear thickness which may affect PFJ so knowing of native trochlear thickness in patients with KNEE OA can affect the outcomes of total knee arthroplasty.

Preoperative and postoperative radiography (CT scan) can provide an adequate measurement of trochlear thickness which will help in understanding more about PFJ and its effect in the total knee replacement.

Conditions

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Knee Osteoarthritis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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trochlear thickness change

Radiological Assessment of trochlear thickness of PFJ in primary TKR by preoperative and postoperative CT scan. and observing Effects of Ct Different measures changes in trochlear thickness on short term TKR outcomes

CT trochlear thickness change

Intervention Type OTHER

Preoperative and postoperative CT scan measuring trochlear thickness of PFJ was defined as distance from deepest part of trochlea and line tangential to the anterior aspect of the femoral cortex. It was assessed on the sagittal cuts.

CT images will be viewed using Sante DICOM viewer version 5.4.2 and image fusion will be done using Overlay multiple image software.

Two observers will measure the angles and the intraobserver and interobserver reliabilities will be assessed for consistency by the intraclass correlation coefficient (ICC) and reliability coefficient using the SPSS software

Interventions

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CT trochlear thickness change

Preoperative and postoperative CT scan measuring trochlear thickness of PFJ was defined as distance from deepest part of trochlea and line tangential to the anterior aspect of the femoral cortex. It was assessed on the sagittal cuts.

CT images will be viewed using Sante DICOM viewer version 5.4.2 and image fusion will be done using Overlay multiple image software.

Two observers will measure the angles and the intraobserver and interobserver reliabilities will be assessed for consistency by the intraclass correlation coefficient (ICC) and reliability coefficient using the SPSS software

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Advanced knee osteoarthritis in which total knee arthroplasty is indicated

Exclusion Criteria

* Revision total knee arthroplasty
* Previous osteotomy around the knee
* Post traumatic knee arthritis
* Inflammatory knee arthritis
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ain Shams University

OTHER

Sponsor Role collaborator

Ibrahim barsoum

OTHER

Sponsor Role lead

Responsible Party

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Ibrahim barsoum

Ass. lecturer.

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Ibrahim B Anis, MS

Role: PRINCIPAL_INVESTIGATOR

Ain Shams University

Wael S Abd El Mageed, MD

Role: STUDY_DIRECTOR

Ain Shams University

Sherif M El Sayed, MD

Role: STUDY_DIRECTOR

Ain Shams University

Zeiad M Zakaria, MD

Role: STUDY_DIRECTOR

Ain Shams University

Mohmed E Awad, MD

Role: STUDY_DIRECTOR

Ain Shams University

Locations

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Ain Sahms University

Cairo, Abbasia, Egypt

Site Status

Countries

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Egypt

References

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Ranawat CS, Flynn WF Jr, Saddler S, Hansraj KK, Maynard MJ. Long-term results of the total condylar knee arthroplasty. A 15-year survivorship study. Clin Orthop Relat Res. 1993 Jan;(286):94-102.

Reference Type RESULT
PMID: 8425373 (View on PubMed)

Healy WL, Wasilewski SA, Takei R, Oberlander M. Patellofemoral complications following total knee arthroplasty. Correlation with implant design and patient risk factors. J Arthroplasty. 1995 Apr;10(2):197-201. doi: 10.1016/s0883-5403(05)80127-5.

Reference Type RESULT
PMID: 7798101 (View on PubMed)

Dejour H, Walch G, Neyret P, Adeleine P. [Dysplasia of the femoral trochlea]. Rev Chir Orthop Reparatrice Appar Mot. 1990;76(1):45-54. French.

Reference Type RESULT
PMID: 2140459 (View on PubMed)

Other Identifiers

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Trochlear thickness in TKA

Identifier Type: -

Identifier Source: org_study_id

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