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A Randomized, Study to Evaluate the Iovera° Device in Treating Pain Associated With Total Knee Arthroplasty

Primary Purpose

Arthritis of the Knee

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
iovera°
iovera° Sham
Sponsored by
Pacira CryoTech, Inc., a wholly owned subsidiary of Pacira BioSciences, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Arthritis of the Knee

Eligibility Criteria

22 Years - 79 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • 22 to 79 years of age
  • Scheduled to undergo primary unilateral TKA under spinal anesthesia for primary diagnosis of osteoarthritis
  • American Society of Anesthesiology (ASA) Physical Classification System classes I-III
  • Anticipation of discharge to home after inpatient acute post-op phase (age, co-morbidities, home environment, and social support are in favor of discharge to home in the opinion of the Investigator)
  • Subject is willing and able to give written informed consent.
  • Subject is fluent in verbal and written English.
  • Subject is willing and able to comply with study instructions and commit to all follow-up visits for the duration of the study.
  • Subject is in good general health and free of any systemic disease state or physical condition that might impair evaluation or which in the Investigator's opinion, exposes the Subject to an unacceptable risk by study participation.

Exclusion Criteria:Exclusion Criteria

  • Chronic opioid use (defined as daily or almost daily use of opioids for >3 months).
  • Concurrent painful physical condition, surgery, or musculoskeletal disease that requires or may require analgesic treatment during study follow-up that is not strictly related to the target knee being treated with iovera°, which have the potential to confound the postoperative assessments (e.g., significant pain from other joints, chronic neuropathic pain, concurrent or planned contralateral TKA, concurrent foot, neck, spine, hip, or other musculoskeletal disease, arthritis, or planned surgery, etc.).
  • Greater than 15° malalignment (varus or valgus) on pre-operative radiograph.
  • Previous myoscience FCT™ treatment.
  • Previous Partial or Total Knee Arthroplasty. Partial or Total Knee Arthroplasty of the contralateral knee is permitted if [surgery was completed at least twelve (12) months prior to screening].
  • Body Mass Index ≥ 40
  • Prior surgery in the treatment areas that may alter the anatomy of the infrapatellar branch of the saphenous nerve (ISN) or the anterior femoral cutaneous nerve (AFCN) or result in scar tissue in the treatment area.
  • Any clotting disorder and/or use of an anticoagulant (e.g. warfarin, clopidogrel, etc.) within seven (7) days prior to administration of the device. Low dose aspirin (81mg or less daily) for cardiac prophylaxis allowed.
  • Any local skin condition at the treatment sites that in the Investigator's opinion would adversely affect treatment or outcomes.
  • Open and/or infected wound in the treatment areas.
  • Allergy to lidocaine.
  • History of cryoglobulinemia
  • History of paroxysmal cold hemoglobinuria.
  • History of cold urticaria.
  • History of Raynaud's disease.
  • History of opioid or alcohol abuse.
  • Subject is pregnant or planning to become pregnant while enrolled in the study.
  • Current enrollment in any investigational drug or device study or participation within 30 days prior to screening.
  • Currently being treated for related knee injury under worker's compensation claim or equivalent (i.e. legal case).
  • Any chronic medical condition that in the Investigator's opinion would prevent adequate participation.
  • Any chronic medication use (prescription, over-the-counter, etc.) that in the Investigator's opinion would affect study participation or Subject safety.
  • For any reason, in the opinion of the Investigator, the Subject may not be a suitable candidate for study participation (i.e., history of noncompliance, drug dependency, etc.).

Sites / Locations

  • University of California San Diego
  • Colorado Orthopedic Consultants, P.C.
  • Holy Cross Hospital Orthopedic Research Institute
  • Phoenix Clinical Research, LLC
  • Cleveland Clinic Florida
  • LSUHSC - Department of Orthopaedics
  • Cleveland Clinic
  • Rothman Institute

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Sham Comparator

Arm Label

Treatment

Sham

Arm Description

Treatment with focused cold therapy.

Sham treatment with focused cold therapy device

Outcomes

Primary Outcome Measures

Cumulative Consumption of Opioids Total Daily Morphine Equivalent (TME) (mg/Day)
The cumulative morphine equivalent was divided by the number of days to provide a Total Daily Morphine Equivalent (TME) for each Subject.

Secondary Outcome Measures

Change in Pain From Baseline to Six Weeks
The Numeric Rating Scale for Pain (NRS for Pain) is a measure of pain intensity which is assessed on a scale from 0 to 10 with 0 being no pain at all and 10 being the worst pain imaginable. The Subject provides a self-reported score based on their pain in the target knee at the time the questionnaire is administered (labeled 'now' in the tables below) as well as their pain in the past 7 days (labeled "past 7" in the tables below).
Change in WOMAC Scores at 6 Weeks After Surgery
The Western Ontario and McMaster Universities Arthritis Index (WOMAC) is a tri-dimensional, disease-specific, Subject-reported outcome measure. It consists of 24 questions with 5 questions regarding pain, 2 questions regarding stiffness and 17 questions regarding function in Subjects with osteoarthritis of the hip and/or knee. Each question is answered on a scale of 0 (none)-10 (extreme). Higher scores are associated with worse outcomes.
Length of Hospital Stay
Change in Active Range of Motion From Baseline to 2 Weeks After Surgery
Range of motion measures the physical function of the replaced knee during active flexion at the specified timepoints.
40 Meter Walk Test
The 40 Meter Walk Test measured the average speed in meters per second a Subject could walk 40 meters.
30 Second Chair Test
The 30 Second Chair Test evaluates physical function during recovery by measuring the number of times a subject could go from seated in a chair to standing over the course of 30 seconds.
Change 36-Item Short Form Health Survey (SF-36) From Baseline to 6 Weeks
The 36-question survey captures the Subject's perception of their general health by sorting them into multi-item scales that assess eight health concepts rather than a single total score. The survey used ten components to assess the health concepts: Physical, Mental, Physical Functioning, Role- Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, and Health Transition. Subject responses to the SF-36 survey were recorded. Scores can range from 0 to 100. Higher scores indicate better health status, and a mean score of 50 has been articulated as a normative value for all scales.
Change in Patient Reported Outcomes Measurement Information System (PROMIS) From Baseline to Week 6
8 domains assessing physical, mental and social health while also covering important areas of self-reported health: pain, fatigue, depression, anxiety, sleep, and physical function. A high PROMIS domain sub-score indicates more of that concept being measured. PROMIS scores have a mean of 50 and standard deviation (SD) of 10 in a referent population. The referent population is usually the US General Population. lower scores are less favorable, and higher scores are more favorable.

Full Information

First Posted
November 3, 2014
Last Updated
July 25, 2023
Sponsor
Pacira CryoTech, Inc., a wholly owned subsidiary of Pacira BioSciences, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02284113
Brief Title
A Randomized, Study to Evaluate the Iovera° Device in Treating Pain Associated With Total Knee Arthroplasty
Official Title
A Post-Market, Multi-Center, Prospective, Double-Blind, Randomized, Controlled Study to Evaluate the Iovera° Device in Treating Pain Associated With Total Knee Arthroplasty
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
December 2014 (undefined)
Primary Completion Date
May 2016 (Actual)
Study Completion Date
June 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pacira CryoTech, Inc., a wholly owned subsidiary of Pacira BioSciences, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will evaluate the iovera° device in treating pain associated with total knee arthroplasty (TKA). This study will also assess if overall pain medication is reduced following TKA and will investigate the relationship between patients treated with the iovera° device and length of hospital stay, pain, patient satisfaction and improved rehabilitation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Arthritis of the Knee

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
150 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment
Arm Type
Experimental
Arm Description
Treatment with focused cold therapy.
Arm Title
Sham
Arm Type
Sham Comparator
Arm Description
Sham treatment with focused cold therapy device
Intervention Type
Device
Intervention Name(s)
iovera°
Intervention Description
Use of iovera° device to administer treatment Focused Cold Therapy
Intervention Type
Device
Intervention Name(s)
iovera° Sham
Intervention Description
iovera° device used for sham treatment
Primary Outcome Measure Information:
Title
Cumulative Consumption of Opioids Total Daily Morphine Equivalent (TME) (mg/Day)
Description
The cumulative morphine equivalent was divided by the number of days to provide a Total Daily Morphine Equivalent (TME) for each Subject.
Time Frame
hospital discharge to 6 Weeks post-TKA surgery
Secondary Outcome Measure Information:
Title
Change in Pain From Baseline to Six Weeks
Description
The Numeric Rating Scale for Pain (NRS for Pain) is a measure of pain intensity which is assessed on a scale from 0 to 10 with 0 being no pain at all and 10 being the worst pain imaginable. The Subject provides a self-reported score based on their pain in the target knee at the time the questionnaire is administered (labeled 'now' in the tables below) as well as their pain in the past 7 days (labeled "past 7" in the tables below).
Time Frame
Baseline to 6 Weeks
Title
Change in WOMAC Scores at 6 Weeks After Surgery
Description
The Western Ontario and McMaster Universities Arthritis Index (WOMAC) is a tri-dimensional, disease-specific, Subject-reported outcome measure. It consists of 24 questions with 5 questions regarding pain, 2 questions regarding stiffness and 17 questions regarding function in Subjects with osteoarthritis of the hip and/or knee. Each question is answered on a scale of 0 (none)-10 (extreme). Higher scores are associated with worse outcomes.
Time Frame
Baseline to 6 weeks after surgery
Title
Length of Hospital Stay
Time Frame
treatment to hospital discharge
Title
Change in Active Range of Motion From Baseline to 2 Weeks After Surgery
Description
Range of motion measures the physical function of the replaced knee during active flexion at the specified timepoints.
Time Frame
baseline to 2 weeks after surgery
Title
40 Meter Walk Test
Description
The 40 Meter Walk Test measured the average speed in meters per second a Subject could walk 40 meters.
Time Frame
Baseline, 2,4,6,12 weeks
Title
30 Second Chair Test
Description
The 30 Second Chair Test evaluates physical function during recovery by measuring the number of times a subject could go from seated in a chair to standing over the course of 30 seconds.
Time Frame
Baseline, 2,4,6,12 weeks after surgery
Title
Change 36-Item Short Form Health Survey (SF-36) From Baseline to 6 Weeks
Description
The 36-question survey captures the Subject's perception of their general health by sorting them into multi-item scales that assess eight health concepts rather than a single total score. The survey used ten components to assess the health concepts: Physical, Mental, Physical Functioning, Role- Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, and Health Transition. Subject responses to the SF-36 survey were recorded. Scores can range from 0 to 100. Higher scores indicate better health status, and a mean score of 50 has been articulated as a normative value for all scales.
Time Frame
Baseline to Week 6
Title
Change in Patient Reported Outcomes Measurement Information System (PROMIS) From Baseline to Week 6
Description
8 domains assessing physical, mental and social health while also covering important areas of self-reported health: pain, fatigue, depression, anxiety, sleep, and physical function. A high PROMIS domain sub-score indicates more of that concept being measured. PROMIS scores have a mean of 50 and standard deviation (SD) of 10 in a referent population. The referent population is usually the US General Population. lower scores are less favorable, and higher scores are more favorable.
Time Frame
Baseline to 6 weeks after surgery

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Maximum Age & Unit of Time
79 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: 22 to 79 years of age Scheduled to undergo primary unilateral TKA under spinal anesthesia for primary diagnosis of osteoarthritis American Society of Anesthesiology (ASA) Physical Classification System classes I-III Anticipation of discharge to home after inpatient acute post-op phase (age, co-morbidities, home environment, and social support are in favor of discharge to home in the opinion of the Investigator) Subject is willing and able to give written informed consent. Subject is fluent in verbal and written English. Subject is willing and able to comply with study instructions and commit to all follow-up visits for the duration of the study. Subject is in good general health and free of any systemic disease state or physical condition that might impair evaluation or which in the Investigator's opinion, exposes the Subject to an unacceptable risk by study participation. Exclusion Criteria:Exclusion Criteria Chronic opioid use (defined as daily or almost daily use of opioids for >3 months). Concurrent painful physical condition, surgery, or musculoskeletal disease that requires or may require analgesic treatment during study follow-up that is not strictly related to the target knee being treated with iovera°, which have the potential to confound the postoperative assessments (e.g., significant pain from other joints, chronic neuropathic pain, concurrent or planned contralateral TKA, concurrent foot, neck, spine, hip, or other musculoskeletal disease, arthritis, or planned surgery, etc.). Greater than 15° malalignment (varus or valgus) on pre-operative radiograph. Previous myoscience FCT™ treatment. Previous Partial or Total Knee Arthroplasty. Partial or Total Knee Arthroplasty of the contralateral knee is permitted if [surgery was completed at least twelve (12) months prior to screening]. Body Mass Index ≥ 40 Prior surgery in the treatment areas that may alter the anatomy of the infrapatellar branch of the saphenous nerve (ISN) or the anterior femoral cutaneous nerve (AFCN) or result in scar tissue in the treatment area. Any clotting disorder and/or use of an anticoagulant (e.g. warfarin, clopidogrel, etc.) within seven (7) days prior to administration of the device. Low dose aspirin (81mg or less daily) for cardiac prophylaxis allowed. Any local skin condition at the treatment sites that in the Investigator's opinion would adversely affect treatment or outcomes. Open and/or infected wound in the treatment areas. Allergy to lidocaine. History of cryoglobulinemia History of paroxysmal cold hemoglobinuria. History of cold urticaria. History of Raynaud's disease. History of opioid or alcohol abuse. Subject is pregnant or planning to become pregnant while enrolled in the study. Current enrollment in any investigational drug or device study or participation within 30 days prior to screening. Currently being treated for related knee injury under worker's compensation claim or equivalent (i.e. legal case). Any chronic medical condition that in the Investigator's opinion would prevent adequate participation. Any chronic medication use (prescription, over-the-counter, etc.) that in the Investigator's opinion would affect study participation or Subject safety. For any reason, in the opinion of the Investigator, the Subject may not be a suitable candidate for study participation (i.e., history of noncompliance, drug dependency, etc.).
Facility Information:
Facility Name
University of California San Diego
City
San Diego
State/Province
California
ZIP/Postal Code
92130
Country
United States
Facility Name
Colorado Orthopedic Consultants, P.C.
City
Englewood
State/Province
Colorado
ZIP/Postal Code
80110
Country
United States
Facility Name
Holy Cross Hospital Orthopedic Research Institute
City
Fort Lauderdale
State/Province
Florida
ZIP/Postal Code
33334
Country
United States
Facility Name
Phoenix Clinical Research, LLC
City
Tamarac
State/Province
Florida
ZIP/Postal Code
33321
Country
United States
Facility Name
Cleveland Clinic Florida
City
Weston
State/Province
Florida
ZIP/Postal Code
33331
Country
United States
Facility Name
LSUHSC - Department of Orthopaedics
City
New Orleans
State/Province
Louisiana
ZIP/Postal Code
70112
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Rothman Institute
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States

12. IPD Sharing Statement

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A Randomized, Study to Evaluate the Iovera° Device in Treating Pain Associated With Total Knee Arthroplasty

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