Kinematic Alignment in Total Knee Arthroplasty - a Double-blind Randomised Controlled Trial Between Robotic and Caliper-based Techniques

NCT ID: NCT06709703

Last Updated: 2024-11-29

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-28

Study Completion Date

2028-09-30

Brief Summary

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Knee replacement surgery is a surgery designed to treat severe arthritis of the knee. However, as many as 20% of patients are not satisfied with the results of their surgery. To place the knee replacement in correct position, the kinematic alignment method, which tries to reproduce the patient normal anatomy, has shown promise in improving the satisfaction after knee replacement surgery. It is not known if using a robotic arm to assist in surgery is better than the traditional method when trying to recreate kinematic alignment.

The goal of this study is to learn if robotic assisted surgery is better than traditional method for knee replacement done using kinematic alignment. The main questions the study tries to answer are:

1. Do the radiographs of kinematic knee replacement surgeries done with robotic assistance show better alignment than radiographs of kinematic knee replacements done with the traditional method?
2. Does robotic assisted kinematic knee replacement give better function to patients than traditional knee replacement done with kinematic alignment?
3. Does robotic assisted kinematic knee replacement decrease pain, improve knee movement and improve knee stability better than traditional knee replacement done with kinematic alignment?
4. Are there more complications with robotic assisted kinematic knee replacement in comparison to traditional kinematic knee replacement?
5. How long long does it take a surgeon to become good a performing a kinematic knee replacement using robotic assistance? Researchers will compare knee replacements done using a robotic to make the bone cuts, and compare it to the usual method using guides and manual instruments. All the knee replacements will be done using the kinematic alignment and with the same type of knee replacement prothesis.

Participants will:

* Have a knee replacement done with the kinematic alignment technique by an experienced surgeon, with or without robotic assistance during the surgery.
* Visit the clinic before surgery, six weeks after surgery, three months, six months, twelve months and twenty-four months after the surgery.
* Fill questionnaire, have their knee examined and have radiographs of their knee done at each visit.

Detailed Description

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Conditions

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Arthritis Arthritis (Knee) Osteoarthritis Osteoarthritis Knee Pain OA OA Knee OA Knee Pain Osteoarthritis of Knee Gonarthrosis; Primary

Keywords

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osteoarthritis arthritis knee osteoarthritis knee OA knee arthritis total knee replacement robotic kinematic alignment patient-specific surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Double-blind randomized controlled-trial
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
Statistician will be blinded to the intervention

Study Groups

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Kinematic knee replacement with traditional instruments

Patients will undergo kinematic aligned knee replacement done using traditional instruments and cut guides

Group Type ACTIVE_COMPARATOR

Kinematic aligned total knee replacement

Intervention Type PROCEDURE

Replacement of worn knee cartilage using a prosthesis. The alignment is determined according to the patient's anatomy and ligament balance.

Robotic-assisted kinematic knee replacement

Patients will undergo kinematic aligned knee replacement done using robotic assistance

Group Type EXPERIMENTAL

Kinematic aligned total knee replacement

Intervention Type PROCEDURE

Replacement of worn knee cartilage using a prosthesis. The alignment is determined according to the patient's anatomy and ligament balance.

Interventions

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Kinematic aligned total knee replacement

Replacement of worn knee cartilage using a prosthesis. The alignment is determined according to the patient's anatomy and ligament balance.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patient aged 18 or above
* Patient being consented for a primary total knee arthroplasty (TKA)
* The primary TKA is planned to be done with kinematic alignment
* All pre-operative alignments are included

Exclusion Criteria

* Revision TKA (including revision of unicompartimental knee arthroplasty into total knee arthroplasty with primary components). TKA being done in the setting of previous femur or tibia fracture or osteotomy are however included.
* No available adequate pre-operative imaging
* Patient who does want to be randomized of the two groups
* At the discretion of the surgeon, if the patient's pathology or particular anatomy precludes the use of kinematic alignment technique, robotic surgery, or traditional instrument TKA.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hopital Charles Lemoyne

OTHER

Sponsor Role collaborator

Université de Sherbrooke

OTHER

Sponsor Role lead

Responsible Party

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Samuel Larrivée

Orthopaedic Surgeon

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Samuel Larrivée, MD, MSc, FRCSC

Role: CONTACT

Phone: 450-466-4333

Email: [email protected]

References

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Zhang J, Ndou WS, Ng N, Gaston P, Simpson PM, Macpherson GJ, Patton JT, Clement ND. Robotic-arm assisted total knee arthroplasty is associated with improved accuracy and patient reported outcomes: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2022 Aug;30(8):2677-2695. doi: 10.1007/s00167-021-06464-4. Epub 2021 Feb 6.

Reference Type BACKGROUND
PMID: 33547914 (View on PubMed)

Agarwal N, To K, McDonnell S, Khan W. Clinical and Radiological Outcomes in Robotic-Assisted Total Knee Arthroplasty: A Systematic Review and Meta-Analysis. J Arthroplasty. 2020 Nov;35(11):3393-3409.e2. doi: 10.1016/j.arth.2020.03.005. Epub 2020 Mar 11.

Reference Type BACKGROUND
PMID: 32234326 (View on PubMed)

Van Essen J, Stevens J, Dowsey MM, Choong PF, Babazadeh S. Kinematic alignment results in clinically similar outcomes to mechanical alignment: Systematic review and meta-analysis. Knee. 2023 Jan;40:24-41. doi: 10.1016/j.knee.2022.11.001. Epub 2022 Nov 17.

Reference Type BACKGROUND
PMID: 36403396 (View on PubMed)

Dossett HG, Estrada NA, Swartz GJ, LeFevre GW, Kwasman BG. A randomised controlled trial of kinematically and mechanically aligned total knee replacements: two-year clinical results. Bone Joint J. 2014 Jul;96-B(7):907-13. doi: 10.1302/0301-620X.96B7.32812.

Reference Type BACKGROUND
PMID: 24986944 (View on PubMed)

Turan K, Camurcu Y, Kezer M, Uysal Y, Kizilay YO, Ucpunar H, Temiz A. A comparison of robotic-assisted and manual techniques in restricted kinematically aligned total knee arthroplasty: coronal alignment improvement with no significant clinical differences. Knee Surg Sports Traumatol Arthrosc. 2023 Nov;31(11):4673-4679. doi: 10.1007/s00167-023-07426-8. Epub 2023 May 10.

Reference Type BACKGROUND
PMID: 37165209 (View on PubMed)

Other Identifiers

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2025-958

Identifier Type: -

Identifier Source: org_study_id