Total Knee Arthroplasty
Conditions
Keywords
knee surgery, total knee arthroplasty, total knee replacement, ropivacaine, femoral nerve block
Brief summary
Total knee replacement is a frequent procedure in Québec's hospitals and the muscular strength of the quadriceps is the best indicator of the patient's functional recovery post surgery. Thus, the importance of the patient's recovery leads to the evaluation of the influence of the femoral nerve block on the muscle strength. The purpose of the study is to compare the short term and long term recuperation of the quadriceps' motor strength of after a total knee arthroplasty using different types of analgesics such as the continuous femoral nerve block, the single dose femoral nerve block and the systemic analgesic, a patient controlled analgesic pump.
Interventions
DRUG48-hour ropivacaine infusions
Patients receive 20 ml of ropivacaine 0.5 % pre-operation through femoral block catheter, followed by ropivacaine infusions from 0.1 % to 0.1 ml/kg/hour for 48 hours.
Patients receive 20 ml of ropivacaine 0.5% pre-operation
DRUGPatient controlled analgesics
Patient controlled analgesics alone, no femoral block
Sponsors
Sanofi
Hopital de l'Enfant-Jesus
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* \> 18 years old * men or women needing an elective total knee replacement surgery
Exclusion criteria
* unicompartmental arthroplasty * revision surgery for knee arthroplasty * previous surgery on same knee * previous fracture of femur/patella with functional after-effects * allergies or contraindication to any medication used during study or to local anaesthesia technique * preexisting neurological deficit * severe anomaly of intracardiac conduction * previous vascular surgery near the site of introduction of the catheter * pregnancy or breastfeeding * ASA IV or V14 class * Men or women \> 18 years old unfit to consent * \< 18 years old * Refusal to sign consent form
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Quadriceps strength measurement with Cybex machine | 6 weeks after surgery | Evidence of the influence of the different types of analgesics on the strength of the quadriceps post surgery. Quadriceps strength will be evaluated in open chain and closed chain with the help of the Cybex machine. |
| Quadriceps strength measurements with Cybex machine | 12 months after surgery | Evidence of the influence of the different types of analgesics on the strength of the quadriceps post surgery. Quadriceps strength will be evaluated in open chain and closed chain with the help of the Cybex machine. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall functional recovery | 6 weeks after surgery | The overall functional recovery of the patient will be evaluated considering the analgesic type using SF-36 and WOMAC questionnaires. |
| Pain score on Visual Analog Scale (VAS) | every 6 hour for the 48 hours following surgery | Evaluation of the effectiveness of the analgesics on pain with VAS . |
| Hospital stay length | 4 to 7 days after surgery | Evaluation of the hospital stay length after total knee replacement taking into account the different types of analgesics. |
Countries
Canada
Outcome results
None listed