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Evaluating Edema and Range of Motion Using Negative Pressure Therapy vs. Standard Surgical Dressing in Bilateral TKA (ENABLE)

Primary Purpose

Surgical Wound, Bilateral Total Knee Arthroplasty, Wounds and Injuries

Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Closed Incision Negative Pressure Therapy (ciNPT)
Standard Silver-containing Dressing
Sponsored by
3M
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Surgical Wound

Eligibility Criteria

22 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • is at least 22 years of age on the date of informed consent.
  • can independently provide informed consent.
  • requires and is scheduled to undergo a simultaneous, bilateral, primary TKA.
  • is willing and physically capable of undergoing a simultaneous, bilateral, primary TKA with or without replacement of the patella.
  • is willing and able to return for all scheduled study visits.

Exclusion Criteria:

  • is pregnant or lactating.
  • has signs of an infection in the area of either knee or has signs of a systemic infection at the time of surgery.
  • is a chronic opioid user, defined per the CDC guidelines as opioid use for >3 months, at the time of enrollment.
  • has a current diagnosis of lymphedema in either leg.
  • has signs, symptoms, or a current diagnosis of venous insufficiency in either leg, as determined by the investigator's review of the subject's medical history.
  • has a history of clotting disorder or prior history of deep vein thrombosis
  • will undergo a unilateral TKA.
  • will undergo a staged, bilateral TKA.
  • has had previous knee replacement surgery.
  • has received a corticosteroid injection into either knee within 30 days of surgery.
  • undergoes a simultaneous, bilateral TKA with a planned different incision type on each knee (eg, midline incision vs. medial parapatellar incision).
  • has known sensitivity to the study product components (drape and/or dressing materials in direct contact with the closed incision or skin).
  • has known sensitivity to silver.
  • is enrolled in another interventional clinical study.
  • has skin cancer localized at or in proximity to the incision site.
  • does not have access to an electronic device (smartphone, iPad, or computer) on a daily basis to complete online assessments.
  • has condition(s) that, in the opinion of the investigator, cause the subject to be an overall health risk that is unsuitable for the surgery.
  • has condition(s) that, in the opinion of the investigator, will impact study endpoints (eg, hemophilia or autoimmune disorders) or the ability to comply with study procedures.

Intra-Op Exclusion Criteria:

  • does not receive a "total" knee replacement for first knee. For example, a partial or uni-compartmental knee replacement is performed
  • has a surgical incision that would preclude placement of either dressing onto the knee
  • has a TKA resulting in a muscle flap

Sites / Locations

  • Anne Arundel Medical Center
  • Rubin Institute for Advanced Orthopedics
  • Johns Hopkins Orthopaedics
  • Northwell Health - Southside Hospital
  • Northwell Health - Lenox Hill Hospital
  • Northwell Health - Long Island Jewish Valley Stream

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Closed Incision Negative Pressure Therapy (ciNPT) Dressing

Standard Silver-containing Dressing

Arm Description

Prevena Restor Arthro-Form Dressing with Prevena Plus Therapy Unit

Outcomes

Primary Outcome Measures

Percent Change in Lower Limb Volume
Percent change in lower limb volume as calculated using manual circumference measurements

Secondary Outcome Measures

Percent Change in Lower Limb Volume
Percent change in lower limb volume as calculated using manual circumference measurements
Percent Change in Lower Limb Volume
Percent change in lower limb volume as calculated using manual circumference measurements
Percent Change in Lower Limb Volume
Percent change in lower limb volume as calculated using manual circumference measurements
Percent Change in Lower Limb Circumference
Percent change in circumferences measured at 10 cm above the center of the patella, at the center of patella, 10cm below the center of the patella and 1cm above medial malleolus of ankle
Percent Change in Lower Limb Circumference
Percent change in circumferences measured at 10 cm above the center of the patella, at the center of patella, 10cm below the center of the patella and 1cm above medial malleolus of ankle
Percent Change in Lower Limb Circumference
Percent change in circumferences measured at 10 cm above the center of the patella, at the center of patella, 10cm below the center of the patella and 1cm above medial malleolus of ankle
Percent Change in Lower Limb Circumference
Percent change in circumferences measured at 10 cm above the center of the patella, at the center of patella, 10cm below the center of the patella and 1cm above medial malleolus of ankle
Change in Knee Flexion Angle
Change in knee flexion angle
Change in Knee Flexion Angle
Change in knee flexion angle
Change in Knee Flexion Angle
Change in knee flexion angle
Change in Knee Flexion Angle
Change in knee flexion angle
Change in Knee Extension Angle
Change in knee extension angle
Change in Knee Extension Angle
Change in knee extension angle
Change in Knee Extension Angle
Change in knee extension angle
Change in Knee Extension Angle
Change in knee extension angle
Change of Total Range of Motion in Degrees
Change of total ROM degrees, defined as the flexion angle minus the extension angle
Change of Total Range of Motion in Degrees
Change of total ROM degrees, defined as the flexion angle minus the extension angle
Change of Total Range of Motion in Degrees
Change of total ROM degrees, defined as the flexion angle minus the extension angle
Change of Total Range of Motion in Degrees
Change of total ROM degrees, defined as the flexion angle minus the extension angle
Incidence of Surgical Site Complications (SSCs)
Incidence of surgical site complications defined as: Superficial Surgical Site Infection (SSI) Deep SSI Full thickness skin dehiscence Seroma or hematoma requiring drainage or surgery Skin necrosis Continued drainage at the time of dressing removal
Incidence of Surgical Site Complications (SSCs)
Incidence of surgical site complications defined as: Superficial Surgical Site Infection (SSI) Deep SSI Full thickness skin dehiscence Seroma or hematoma requiring drainage or surgery Skin necrosis Continued drainage at the time of dressing removal
Scar assessment
Evaluation of wound and scar using scar cosmesis assessment
Scar assessment
Evaluation of wound and scar using scar cosmesis assessment
Scar assessment
Evaluation of wound and scar using scar cosmesis assessment
Scar assessment
Evaluation of wound and scar using scar cosmesis assessment
Average pain rating on 0-10 scale
Average pain in each leg using NPRS rating scale
Worst pain rating on 0-10 scale
Worst pain in last 24 hours for each leg using NPRS rating scale

Full Information

First Posted
January 14, 2021
Last Updated
November 7, 2022
Sponsor
3M
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1. Study Identification

Unique Protocol Identification Number
NCT04712019
Brief Title
Evaluating Edema and Range of Motion Using Negative Pressure Therapy vs. Standard Surgical Dressing in Bilateral TKA
Acronym
ENABLE
Official Title
A Randomized Controlled Trial Evaluating Edema and ROM Using Negative Pressure Therapy Over Closed Incisions and Surrounding Soft Tissue Versus Standard Surgical Dressings in Bilateral Total Knee Arthroplasty: A Pilot Study
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Terminated
Why Stopped
Lack of Enrollment
Study Start Date
November 6, 2020 (Actual)
Primary Completion Date
August 26, 2022 (Actual)
Study Completion Date
August 26, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
3M

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
This study will compare the effects of closed incision negative pressure dressing vs. standard of care silver dressing on lower limb swelling after bilateral primary total knee arthroplasty.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Surgical Wound, Bilateral Total Knee Arthroplasty, Wounds and Injuries, Joint Diseases, Musculoskeletal Diseases, Edema Leg, Joint Pain, Arthritis Knee

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
One leg receives ciNPT and the other leg receives standard silver containing dressing.
Masking
None (Open Label)
Allocation
Randomized
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Closed Incision Negative Pressure Therapy (ciNPT) Dressing
Arm Type
Experimental
Arm Description
Prevena Restor Arthro-Form Dressing with Prevena Plus Therapy Unit
Arm Title
Standard Silver-containing Dressing
Arm Type
Active Comparator
Intervention Type
Device
Intervention Name(s)
Closed Incision Negative Pressure Therapy (ciNPT)
Other Intervention Name(s)
Prevena Restor ArthroForm, Prevena Plus 125 Therapy Unit
Intervention Description
Closed Incision Negative Pressure Therapy applied through a foam bolster with a wicking interface fabric at 125mmHg of continuous negative pressure on a closed surgical incision
Intervention Type
Device
Intervention Name(s)
Standard Silver-containing Dressing
Intervention Description
A standard silver-containing dressing applied to a closed surgical incision
Primary Outcome Measure Information:
Title
Percent Change in Lower Limb Volume
Description
Percent change in lower limb volume as calculated using manual circumference measurements
Time Frame
5-7 days after bilateral TKA procedure
Secondary Outcome Measure Information:
Title
Percent Change in Lower Limb Volume
Description
Percent change in lower limb volume as calculated using manual circumference measurements
Time Frame
12-14 days after bilateral TKA procedure
Title
Percent Change in Lower Limb Volume
Description
Percent change in lower limb volume as calculated using manual circumference measurements
Time Frame
35-49 days after bilateral TKA procedure
Title
Percent Change in Lower Limb Volume
Description
Percent change in lower limb volume as calculated using manual circumference measurements
Time Frame
77-91 days after bilateral TKA procedure
Title
Percent Change in Lower Limb Circumference
Description
Percent change in circumferences measured at 10 cm above the center of the patella, at the center of patella, 10cm below the center of the patella and 1cm above medial malleolus of ankle
Time Frame
5-7 days after bilateral TKA procedure
Title
Percent Change in Lower Limb Circumference
Description
Percent change in circumferences measured at 10 cm above the center of the patella, at the center of patella, 10cm below the center of the patella and 1cm above medial malleolus of ankle
Time Frame
12-14 days after bilateral TKA procedure
Title
Percent Change in Lower Limb Circumference
Description
Percent change in circumferences measured at 10 cm above the center of the patella, at the center of patella, 10cm below the center of the patella and 1cm above medial malleolus of ankle
Time Frame
35-49 days after bilateral TKA procedure
Title
Percent Change in Lower Limb Circumference
Description
Percent change in circumferences measured at 10 cm above the center of the patella, at the center of patella, 10cm below the center of the patella and 1cm above medial malleolus of ankle
Time Frame
77-91 days after bilateral TKA procedure
Title
Change in Knee Flexion Angle
Description
Change in knee flexion angle
Time Frame
5-7 days after bilateral TKA procedure
Title
Change in Knee Flexion Angle
Description
Change in knee flexion angle
Time Frame
12-14 days after bilateral TKA procedure
Title
Change in Knee Flexion Angle
Description
Change in knee flexion angle
Time Frame
35-49 days after bilateral TKA procedure
Title
Change in Knee Flexion Angle
Description
Change in knee flexion angle
Time Frame
77-91 days after bilateral TKA procedure
Title
Change in Knee Extension Angle
Description
Change in knee extension angle
Time Frame
5-7 days after bilateral TKA procedure
Title
Change in Knee Extension Angle
Description
Change in knee extension angle
Time Frame
12-14 days after bilateral TKA procedure
Title
Change in Knee Extension Angle
Description
Change in knee extension angle
Time Frame
35-49 days after bilateral TKA procedure
Title
Change in Knee Extension Angle
Description
Change in knee extension angle
Time Frame
77-91 days after bilateral TKA procedure
Title
Change of Total Range of Motion in Degrees
Description
Change of total ROM degrees, defined as the flexion angle minus the extension angle
Time Frame
5-7 days after bilateral TKA procedure
Title
Change of Total Range of Motion in Degrees
Description
Change of total ROM degrees, defined as the flexion angle minus the extension angle
Time Frame
12-14 days after bilateral TKA procedure
Title
Change of Total Range of Motion in Degrees
Description
Change of total ROM degrees, defined as the flexion angle minus the extension angle
Time Frame
35-49 days after bilateral TKA procedure
Title
Change of Total Range of Motion in Degrees
Description
Change of total ROM degrees, defined as the flexion angle minus the extension angle
Time Frame
77-91 days after bilateral TKA procedure
Title
Incidence of Surgical Site Complications (SSCs)
Description
Incidence of surgical site complications defined as: Superficial Surgical Site Infection (SSI) Deep SSI Full thickness skin dehiscence Seroma or hematoma requiring drainage or surgery Skin necrosis Continued drainage at the time of dressing removal
Time Frame
within 49 days of bilateral TKA procedure
Title
Incidence of Surgical Site Complications (SSCs)
Description
Incidence of surgical site complications defined as: Superficial Surgical Site Infection (SSI) Deep SSI Full thickness skin dehiscence Seroma or hematoma requiring drainage or surgery Skin necrosis Continued drainage at the time of dressing removal
Time Frame
within 91 days of bilateral TKA procedure
Title
Scar assessment
Description
Evaluation of wound and scar using scar cosmesis assessment
Time Frame
5-7 days after bilateral TKA procedure
Title
Scar assessment
Description
Evaluation of wound and scar using scar cosmesis assessment
Time Frame
12-14 days after bilateral TKA procedure
Title
Scar assessment
Description
Evaluation of wound and scar using scar cosmesis assessment
Time Frame
35-49 days after bilateral TKA procedure
Title
Scar assessment
Description
Evaluation of wound and scar using scar cosmesis assessment
Time Frame
77-91 days after bilateral TKA procedure
Title
Average pain rating on 0-10 scale
Description
Average pain in each leg using NPRS rating scale
Time Frame
Daily for 4 weeks post-surgery, then weekly for weeks 5-12
Title
Worst pain rating on 0-10 scale
Description
Worst pain in last 24 hours for each leg using NPRS rating scale
Time Frame
Daily for 4 weeks post-surgery, then weekly for weeks 5-12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: is at least 22 years of age on the date of informed consent. can independently provide informed consent. requires and is scheduled to undergo a simultaneous, bilateral, primary TKA. is willing and physically capable of undergoing a simultaneous, bilateral, primary TKA with or without replacement of the patella. is willing and able to return for all scheduled study visits. Exclusion Criteria: is pregnant or lactating. has signs of an infection in the area of either knee or has signs of a systemic infection at the time of surgery. is a chronic opioid user, defined per the CDC guidelines as opioid use for >3 months, at the time of enrollment. has a current diagnosis of lymphedema in either leg. has signs, symptoms, or a current diagnosis of venous insufficiency in either leg, as determined by the investigator's review of the subject's medical history. has a history of clotting disorder or prior history of deep vein thrombosis will undergo a unilateral TKA. will undergo a staged, bilateral TKA. has had previous knee replacement surgery. has received a corticosteroid injection into either knee within 30 days of surgery. undergoes a simultaneous, bilateral TKA with a planned different incision type on each knee (eg, midline incision vs. medial parapatellar incision). has known sensitivity to the study product components (drape and/or dressing materials in direct contact with the closed incision or skin). has known sensitivity to silver. is enrolled in another interventional clinical study. has skin cancer localized at or in proximity to the incision site. does not have access to an electronic device (smartphone, iPad, or computer) on a daily basis to complete online assessments. has condition(s) that, in the opinion of the investigator, cause the subject to be an overall health risk that is unsuitable for the surgery. has condition(s) that, in the opinion of the investigator, will impact study endpoints (eg, hemophilia or autoimmune disorders) or the ability to comply with study procedures. Intra-Op Exclusion Criteria: does not receive a "total" knee replacement for first knee. For example, a partial or uni-compartmental knee replacement is performed has a surgical incision that would preclude placement of either dressing onto the knee has a TKA resulting in a muscle flap
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Fred Cushner, MD
Organizational Affiliation
Hospital for Special Surgery, New York
Official's Role
Principal Investigator
Facility Information:
Facility Name
Anne Arundel Medical Center
City
Annapolis
State/Province
Maryland
ZIP/Postal Code
21401
Country
United States
Facility Name
Rubin Institute for Advanced Orthopedics
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21215
Country
United States
Facility Name
Johns Hopkins Orthopaedics
City
Columbia
State/Province
Maryland
ZIP/Postal Code
21044
Country
United States
Facility Name
Northwell Health - Southside Hospital
City
Bay Shore
State/Province
New York
ZIP/Postal Code
11706
Country
United States
Facility Name
Northwell Health - Lenox Hill Hospital
City
New York
State/Province
New York
ZIP/Postal Code
10075
Country
United States
Facility Name
Northwell Health - Long Island Jewish Valley Stream
City
Valley Stream
State/Province
New York
ZIP/Postal Code
11580
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Evaluating Edema and Range of Motion Using Negative Pressure Therapy vs. Standard Surgical Dressing in Bilateral TKA

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