Inflammation Knees, Osteoarthritis, Knee
Conditions
Brief summary
This study compares two total knee replacement implants to asses muscle function and quality, and the immune response to the implants. 30 patients will receive the Smith and Nephew Journey II implant, while 30 patients will receive the Zimmer NexGen LPS-flex implant. 15 healthy controls will also be recruited and compared.
Detailed description
Patients will undergo biomechanics testing while they complete sit-to-stand, stand-to-sit, lateral step down, level walking, and single leg balance tasks up to 1 month before surgery, and 6 and 12 months after surgery. They will also undergo MRI imaging up to 1 month before surgery and 12 months after surgery to assess muscle quality. A secondary outcome will also be to analyze the immunological response in the patients who received femoral components made of oxidized zirconium versus contemporary components made of cobalt chrome. Fifteen healthy controls will also participate in the study and will undergo the biomechanical, MRI and blood draws at a single visit.
Interventions
DEVICEZimmer NexGen LPS-Flex
Patients will be randomly assigned to 1 of 2 devices
DEVICESmith & Nephew Journey II
Patients will be randomly assigned to 1 of 2 devices
Sponsors
University of Ottawa
Ottawa Hospital Research Institute
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
45 Years to 75 Years
Healthy volunteers
Yes
Inclusion criteria
* The participants receiving a knee implant must requiring a total knee replacement
Exclusion criteria
* Any degenerative conditions (other than osteoarthritis at the affected knee) impacting joints of the lower extremities * bilateral knee replacements * previous joint replacement at the affected knee * any other past or present conditions that may impact gait * any active infection and any diagnosed conditions that may affect the local and systemic immune response (e.g., rheumatoid arthritis, HIV infection, lupus, pregnancy, and thrombocytosis) * BMI and waist circumference (WC) will be another exclusion criterion since both BMI and WC are associated with health problems and gait abnormalities. Any patient with both BMI \> 35 kg/m2 and a WC \> 102 cm in men or \> 88 cm in women will be excluded from the study. Healthy Controls Inclusion * controls must not suffer from lower extremity injuries or joint conditions that might alter gait dynamics Exclusion * BMI and waist circumference (WC) will be another exclusion criterion since both BMI and WC are associated with health problems and gait abnormalities. Any patient with both BMI \> 35 kg/m2 and a WC \> 102 cm in men or \> 88 cm in women will be excluded from the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline knee extension moment at 6 and 12 months during gait | Baseline (within 1 month of surgery), 6 months post-surgery, and 12 months post-surgery; and versus healthy controls | Peak knee extension moment will be measured by combining three-dimensional images of movement with time, the knee extension will be calculated in degrees while the participant walks at their normal walking speed. |
| Change from baseline muscle quality assessed via MRI at 12 months | Baseline (within 1 month of surgery), 12 months post-surgery; and versus healthy controls | Proton density fat fraction of the quadriceps and hamstrings muscles will be measured via MRI |
| Change from baseline quadriceps muscle activation at 6 and 12 months during gait | Baseline (within 1 month of surgery), 6 months post-surgery, and 12 months post-surgery; and versus healthy controls | Peak muscle activation of the quadriceps muscle will be measured with electromyography while the participant walks at their normal walking speed |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in trace metal concentrations from baseline, 12 months, and 24 months | Baseline (within 1 month of surgery), 12 months post-surgery, 24 months post-surgery; and versus healthy controls | Peripheral blood will be collected prior to surgery and at 12 months post-surgery; for symptomatic patients, a third blood draw will occur at 24 months post-surgery. Concentrations of cobalt, chromium, and Nickle will be measured by inductively coupled plasma-mass spectrometry. |
Countries
Canada
Contacts
Primary ContactWade Gofton, MD FRCSC
Backup ContactMeaghan Dufresne
Outcome results
None listed