Aseptic Loosening of Prosthetic Joint, Femoral Revision Indicated, Instability of Prosthetic Joint, Reimplantation for Periprosthetic Joint Infection, Tibial Component Revision
Conditions
Keywords
revision total knee replacement, cck, ps, coronal instability, sagittal instability
Brief summary
This study aims to compare the clinical impact of Constrained Condylar versus Posterior Stabilized Knee (PS) bearings on patient satisfaction and surgical outcomes including mid-term survivorship among patients undergoing revision total knee arthroplasty.
Detailed description
The primary purpose of this study is to determine whether a difference exists in clinical patient reported outcomes between CCK or PS bearings following rTKA. A secondary goal of the study is to compare both bearings in survivorship free of revision surgery as well as other surgical complications including instability, in early to mid-term follow-up.
Interventions
DEVICEConstrained Condylar bearing
Patients in this intervention will receive a CCK bearing component
DEVICEposterior stabilized bearing
Patients in this intervention will receive a PS bearing component
Sponsors
Rush University Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
only the patient is blinded ahead of time
Intervention model description
Randomized controlled trial with two groups: constrained condylar (CCK) vs posterior stabilized (PS) articulating bearings. These are standard bearings used in revision knees, comparing two types.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients between 18-80 years of age * Patients who are undergoing both femoral and tibial component revisions, or isolated femoral component revisions with a retained tibial component that is compatible with PS or CCK bearings * Patients who are at least 6-weeks out from primary TKA surgery, with complete pre-operative and post-operative knee radiographs obtained at standard of care perioperative visits (AP/lateral and patellar views) * Patients undergoing rTKA for indications including aseptic component loosening, flexion or extension coronal or sagittal instability, component malalignment, arthrofibrosis, patellar maltracking, reimplantation following single or two-stage exchange revision for prosthetic joint infection or bearing surface wear when femoral or tibial component revision is indicated. * The use of revision total knee arthroplasty systems which have PS and CCK bearing options including different degree options of coronal and rotational constraint (to be individually randomized per constrained option): * Zimmer Biomet Persona, NexGen, or Vanguard * Smith and Nephew Legion * DJO / Enovis Empowr * Stryker Triathlon * Link SymphoKnee * Depuy Attune sion Criteria:
Exclusion criteria
Patients undergoing rTKA with a hinged implant, or pre-operatively determined to require CCK bearing rTKA, \> 80 years of age, or those requiring rTKA less than 6-weeks from the primary TKA, Patients undergoing rTKA for bearing exchange only rTKA, isolated tibial component rTKA Patients with pre-operative diagnosis of extensor mechanism disruption or collateral ligament incompetence or with a compromised soft tissue envelope requiring pre-pre-operative plastic surgery evaluation and planned soft tissue coverage. \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical patient reported outcomes | 6 weeks post op | patients will be asked pre and post operatively to completed standard of care patient reported outcomes to compare over time. The clinical patient reported outcomes of a revision total knee replacement to detect a 6-point difference in knee society score (KSS) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical reported outcomes (Koos Jr) | 6 weeks to 20 years post op | patients will be asked pre and post operatively to completed standard of care patient reported outcomes to compare over time |
| Range of motion over time | pre op to 20 years pots op | Patients will have their knee range of motion (ROM) checked prior to revision surgery and at multiple timepoints after surgery |
| Clinical reported outcomes ( VR-12) | 6 weeks, 1 year, 2 years, 5 years, 10 years, 15 years, 20 years post op | patients will be asked pre and post operatively to completed standard of care patient reported outcomes to compare over time |
| Clinical reported outcomes ( Forgotten Joint Score) | 6 weeks to 20 years post op | patients will be asked pre and post operatively to completed standard of care patient reported outcomes to compare over time |
| Clinical reported outcomes (EQ-5D-3L) | 6 weeks, 1 year, 2 years, 5 years, 10 years, 15 years, 20 years post op | patients will be asked pre and post operatively to completed standard of care patient reported outcomes to compare over time |
Countries
United States
Contacts
Primary ContactOmary Behery, MD
Backup ContactAnne DeBenedetti, MSc
Outcome results
None listed