A Study to Compare Different Ways of Steroid Administration After Total Knee Implantation

  • STATUS
    Recruiting
  • End date
    Sep 1, 2032
  • participants needed
    159
  • sponsor
    Christian Candrian
Updated on 19 February 2024
anesthesia
osteoarthritis
total knee replacement
dexamethasone
dexamethasone sodium phosphate

Summary

We are going to evaluate the difference between perioperative intravenous steroid supplementation, perioperative periarticular steroid supplementation, and standard anaesthesia protocols. We'll evaluate the outcome of patients with knee osteoarthritis who are undergoing Total Knee Arthroplasty to understand which of the three treatments give more benefits to the patient.

Description

A total of 159 patients will be needed (53 patients per arm, 3 arms in total). Dexamethasone (brand name: Mephameson) is the steroid drug that we perioperative administer in two different ways: intra-venous (IV) dexamethasone (9mg) in arm-A, intra-articular (IA) dexamethasone (9mg) in arm-B. No steroid supplementation will be provided in the control group (arm-C).

The primary objective of the study is to compare the effect on post-operative pain of I.V. and I.A. perioperative dexamethasone supplementation for total knee arthroplasty (TKA).

The secondary objectives of the studies will be the comparison between I.V. and I.A. peri-operative dexamethasone supplementation in terms of post-operative pain and function, opioids and analgesic drugs consumption, knee range of motion, systemic inflammatory response, time to mobilisation, length of stay, and patient satisfaction.

Moreover, both I.V. and I.A. steroid supplementation protocols will be compared to routine analgesia protocol (no steroid supplementation group) in order to document their advantages over the absence of steroid supplementation.

The safety of I.V. and I.A. peri-operative dexamethasone will be evaluated and compared recording all the steroid supplementation related complications. In particular, the risk of hyperglycaemia-related complications and post-operative infections will be documented. The safety of both I.V. and I.A. steroid supplementation protocols will be verified comparing them to the no-treatment group in terms of incidence of complications.

Overall study duration will be 12 years: 2 years to enroll all the patients and 10 years to complete the last follow-up. Primary data analysis is planned after the completion of the 1-year follow-up visits.

Details
Condition Repair of knee joint, knee surgery, knee surgery
Age 50-85 years
Treatment Dexamethasone Sodium Phosphate 4 mg/ml intravenous, Dexamethasone Sodium Phosphate 4 mg/ml intra-articular
Clinical Study IdentifierNCT04432012
SponsorChristian Candrian
Last Modified on19 February 2024

Eligibility

Yes No Not Sure

Inclusion Criteria

Patients undergoing unilateral primary TKA at the Ospedale Regionale di Lugano
Patients with a BMI >18.5 and <35\
Patients able to provide informed consent and follow all the study procedures as indicated by the protocol
Informed Consent as documented by signature (Appendix Informed Consent Form)

Exclusion Criteria

Contraindications to steroids
Revision TKA
Active steroid therapy
Women who are pregnant or breast feeding
Presence of other clinically significant concomitant disease states (ASA IV)
Uncontrolled diabetes mellitus
Known or suspected non-compliance, drug or alcohol abuse
Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant
Participation in another study with investigational drug within the 30 days preceding and during the present study
Previous enrolment into the current study
Enrolment of the investigator, his/her family members, employees and other dependent persons
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