Chronic Postoperative Pain, Chronic Post-Procedural Pain, Injury; Nerve, Peripheral, Multiple, Knee Injuries, Knee Pain Chronic, Postoperative Pain, Surgery, Total Knee Arthroplasty
Conditions
Keywords
Chronic Pain Following Left Total Knee Arthroplasty, Chronic Pain Following Right Total Knee Arthroplasty
Brief summary
SPRINT PNS System will be offered to patients with postoperative knee pain following primary unilateral total knee arthroplasty (TKA) who meet eligibility criteria and consistent with established coverage policy. SPRINT PNS System will be implanted for 60 days. At the discretion of the physician, the first lead may be placed to stimulate the nerve innervating the region of greatest pain. If pain is not adequately addressed by the first lead when assessed at 10 days, a second lead may be placed approximately 2 weeks following the initial lead placement.
Interventions
Same as Arm Description.
Sponsors
Study design
Intervention model description
Case series of 15 subjects with chronic post-surgical pain (CPSP). Subjects will be recruited over 6 months (on average 1 subject per week)
Eligibility
Inclusion criteria
* At least 21 years old * Underwent a primary or revision unilateral TKA * Completed all CHOIR questionnaires before and after TKA surgery * Persistent postsurgical knee pain ≥ 5 of 10 during ambulation as demonstrated on the CHOIR assessment. * Must meet the definition of chronic pain. 1. Pain that continues or is expected to continue for longer than 3 months from its initial onset or 2. Persistent pain that at the discretion of the physician has not resolved within the normal time course of healing or 3. Pain requiring opioid use beyond 30 days.
Exclusion criteria
* Patients with a pre-operative history of moderate to high dose use of opioids (≥ 50 morphine milligram equivalents (MME) average per day) * Patients taking opioids for reasons other than pain in knee that underwent TKA * Patients with arthrofibrosis or indicated for manipulation under anesthesia * BMI \>35 * Uncontrolled Diabetes Mellitus Types I or II, indicated by an HbA1c \>7.0% within the last 3 months * Vulnerable population (e.g. pregnant women, prisoners, minors, or employees) * Deep brain stimulation (DBS) system, an implanted active cardiac implant, or any other implantable neurostimulator whose stimulus current pathway may overlap the SPRINT stimulator's current pathway. * Any other condition that may interfere with the ability to participate in a clinical trial (e.g., anatomy that may interfere with lead placement, nerve damage in affected leg, pain caused by knee implant requiring revision, compromised immune system) as determined by the Investigator * Workers Compensation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Pain Intensity from Baseline to 12 Months | Collected at baseline, 10, 30, 60, and 90 days post lead placement; and 6 months following TKA | The primary outcome is Pain Intensity using Numerical Rating Scale (NRS) from 0-10 with the higher number (10) being worse pain and (0) being no pain. Incidence of chronic post-surgical pain (CPSP) through Pain Intensity will be looked at for patients throughout the study along with usage of the Peripheral Nerve Stimulation (PNS) device (hours/day). A collection of surveys already approved for patients following total knee arthroplasty from Stanford's Collaborative Health Outcomes Information Registry (CHOIR) will also be sent to patients. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Opioid Use | Collected at baseline, 10, 30, 60, and 90 days post lead placement; and 6 months following TKA | Opioid use as documented in the medical records and patient-reported. Will note the increase, decrease, or no change in opioid associated with implantation of the study device. |
Countries
United States