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翻修膝关节置换术中的假体限制选择:一项评估限制程度对术后结果影响的随机对照试验研究方案

Constraint choice in revision knee arthroplasty: study protocol of a randomised controlled trial assessing the effect of level of constraint on postoperative outcome.

作者信息

Hommel Hagen, Wilke Kai, Kunze Daniel, Hommel Peggy, Fennema Peter

机构信息

Krankenhaus Märkisch Oderland GmbH BT Wriezen, Klinik für Orthopädie, Sportmedizin und Rehabilitation, Wriezen, Germany.

Lehrkrankenhaus der Medizinischen Hochschule Brandenburg (MHB) Theodor Fontane, Neuruppin, Germany.

出版信息

BMJ Open. 2017 Mar 27;7(3):e012964. doi: 10.1136/bmjopen-2016-012964.

Abstract

INTRODUCTION

The proper management of total knee arthroplasty (TKA) in patients with severe deformities regarding the preferable prosthetic design and the required amount of constraint is a controversial subject. In the absence of any high-level clinical evidence, we designed a randomised clinical trial to investigate if rotating hinged (RTH) and constrained condylar knee (CCK) designs yield similar outcomes.

METHODS AND ANALYSIS

This study is a multicentre, randomised clinical trial including two groups of 85 patients. Patients will be randomised to a CCK knee design group or an RTH knee design group. Patients will be followed for 2 years. The study will be designed as an equivalence trial. The primary study outcome will be the postoperative functional outcome as measured by the self-administered Knee Injury and Osteoarthritis Outcome Score. Secondary outcomes will be postoperative joint awareness during various activities of daily living as measured by the Forgotten Joint Score-12, the Knee Society Score, along with the incidence and location of radiolucent lines using the Knee Society TKA radiographic evaluation system.

ETHICS AND DISSEMINATION

This study is approved by the ethics committee of the Landesärztekammer Brandenburg ((S 10(a)/2013) from 27.08.2013, amended on 25.04.2016) and will be conducted according to the principles of the World Medical Association Declaration of Helsinki and the ISO14155:2011.

TRIAL REGISTRATION NUMBER

DRKS00010539.

摘要

引言

对于严重畸形患者的全膝关节置换术(TKA),在选择合适的假体设计和所需的限制程度方面进行恰当管理是一个有争议的话题。在缺乏任何高级别临床证据的情况下,我们设计了一项随机临床试验,以研究旋转铰链(RTH)和限制性髁膝关节(CCK)设计是否能产生相似的结果。

方法与分析

本研究是一项多中心随机临床试验,包括两组,每组85例患者。患者将被随机分配到CCK膝关节设计组或RTH膝关节设计组。患者将被随访2年。该研究将被设计为一项等效性试验。主要研究结果将是通过自我管理的膝关节损伤和骨关节炎结果评分来衡量的术后功能结果。次要结果将是通过遗忘关节评分 - 12、膝关节协会评分来衡量的术后在各种日常生活活动中的关节感知,以及使用膝关节协会TKA影像学评估系统评估的透亮线的发生率和位置。

伦理与传播

本研究已获得勃兰登堡州医师协会伦理委员会批准((S 10(a)/2013),自2013年8月27日起,于2016年4月25日修订),并将根据世界医学协会《赫尔辛基宣言》和ISO14155:2011的原则进行。

试验注册号

DRKS00010539。

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