Kinematic Alignment vs Mechanical Alignment for Total Knee Arthroplasty (KA vs MA)
Primary Purpose
Knee Osteoarthritis, Knee Pain Chronic
Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Mechanical Alignment and Unrestricted Kinematic Alignment using Medacta GMK Sphere with MyKnee Custom guides
Mechanical Alignment and Restricted Kinematic Alignment using Medacta GMK Sphere with custom cutting guides
Sponsored by
About this trial
This is an interventional treatment trial for Knee Osteoarthritis
Eligibility Criteria
Inclusion Criteria:
Must be able to read, understand and provide written informed consent on the Institutional Review Board (IRB) approved Informed Consent Form (ICF).
- Ability to understand and provide written authorization for use and disclosure of personal health information.
- Subject who are able and willing to comply with the study protocol and follow-up visits.
- Must be 21 years or older to participate, and less than 80 years old.
- Subjects must have osteoarthritis knee disease in the affected knee compliant with the FDA-approved indications for use of GMK Sphere knee system and MyKnee cutting blocks.
- Patients who are candidates for Total Knee Arthroplasty and are determined to undergo a TKA using the Medacta GMK Sphere implant and MyKnee cutting blocks will be offered enrollment.
- Subjects must be able to return for the follow-up appointments, and have the mental capacity to cooperate and complete PRO questionnaires, physical exam and radiographs.
Exclusion Criteria:
• Cases of extreme bone loss requiring an augmented femoral or tibial implant and chronic ligamentous laxity requiring a constrained implant
- The patient has a fixed flexion deformity of ≥15°
- The patient has less than 90° of flexion
- Patient is morbidly obese (BMI ≥40)
- Patient with inflammatory arthritis
- History of prior deep knee infection
- History of alcoholism or drug abuse
- Currently on chemotherapy or radiation therapy for neoplastic disease
- Patient currently on immunosuppressive medications including steroids except when, (a) steroid use is less than 10mg daily, (b) other immunosuppressive medications are held for appropriate time, for example Adalimumab is held 2 weeks prior and 2 weeks after surgery
- History of known sensitivity or allergy to materials used in orthopedic implants, specifically Titanium and Cobalt-Chrome alloys
- Habitual use of narcotic pain medications prior to surgery (more than 2 doses daily and chronic use of a minimum 3 months)
- History of metabolic disorder affecting the skeletal system other than osteoarthritis or osteoporosis (e.g., Osteomalacia, Ricketts)
- History of chronic pain issues for reasons other than knee joint pain. If the type of pain affects activities of daily living, do not enroll. If the pain is intermittent and does not affect activities of daily living, it is OK to enroll. Fibromyalgia is exclusionary.
- Women who are pregnant
- Patient with unstable psychiatric illness or psychosis is excluded. (Patients with stable anxiety or depression can be enrolled if PI determines that the condition does not adversely affect study outcomes & requirements)
- Any patient, in the opinion of the investigator, is unable to fully comply with the surgical, rehabilitation, or follow-up aspects of this procedure.
- Prior surgery on the target knee other than arthroscopy and/or arthroscopically-assisted ligament reconstruction
- Prior high tibial osteotomy (HTO) or femoral osteotomy
- Malunion of fracture of a tibia or femur
- Patient with a neuromuscular or neurosensory deficiency
- Patient with history of knee fusion in the affected joint
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
Unrestricted Kinematic Alignment
Restricted Kinematic Alignment
Arm Description
Mechanical Alignment and Unrestricted Kinematic Alignment using Medacta GMK Sphere with custom cutting guides
Mechanical Alignment and restricted Kinematic Alignment using Medacta GMK Sphere with custom cutting guides
Outcomes
Primary Outcome Measures
Change from baseline in Forgotten Joint Score
Assessment of the improvement of joint specific outcomes following knee replacement surgery using the Knee Forgotten Joint Score
Secondary Outcome Measures
Change from baseline in Knee Osteoarthritis Outcome Score (KOOS)
Assessment of improvement of activity levels following knee replacement surgery using the KOOS
Change from baseline in Knee Society Score
Patient specific patient outcomes scoring
Change from baseline in Knee Society Score
Clinical Exam Range of Motion, Stability and Alignment
Change from baseline in PROMIS
Pain Intensity, Pain Interference, and physical function scoring
Change in Baseline in Knee Alignment
Determined by radiographic analysis measured by angle of degrees
Change from Baseline of Implant Position Fixation
Determined by radiographic analysis by measure radio lucent lines in millimeters
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT05461638
Brief Title
Kinematic Alignment vs Mechanical Alignment for Total Knee Arthroplasty
Acronym
KA vs MA
Official Title
A Prospective, Randomized, Single-Blinded, Multi-Center, Clinical Trial Comparing Kinematic Alignment vs. Mechanical Alignment Using Medially-Stabilized Knee (GMK Sphere) And Patient-Specific Cutting Guides (MyKnee) For Total Knee Arthroplasty
Study Type
Interventional
2. Study Status
Record Verification Date
July 2022
Overall Recruitment Status
Withdrawn
Why Stopped
No viable sites
Study Start Date
January 5, 2020 (Anticipated)
Primary Completion Date
April 5, 2022 (Actual)
Study Completion Date
April 5, 2022 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medacta USA
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is a prospective, randomized, single-blinded, multi-center trial comparing Kinematic Alignment vs Mechanical Alignment in TKA patients using patient reported outcomes, clinical and functional performance tests and radiographic analyses.
Detailed Description
This is a prospective, randomized, single-blinded, multi-center trial comparing Kinematic Alignment vs Mechanical Alignment in TKA patients with Medacta GMK Sphere knee system using patient specific instrumentation Medacta MyKnee. Patients will be assessed a pre-operative, operative and interim post-operative visits, week 6, month 6 and 1,2,5 & 10 years. There will be a phone survey follow up at year 3,4,6,7,8,& 9.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Osteoarthritis, Knee Pain Chronic
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Unrestricted Kinematic Alignment
Arm Type
Active Comparator
Arm Description
Mechanical Alignment and Unrestricted Kinematic Alignment using Medacta GMK Sphere with custom cutting guides
Arm Title
Restricted Kinematic Alignment
Arm Type
Active Comparator
Arm Description
Mechanical Alignment and restricted Kinematic Alignment using Medacta GMK Sphere with custom cutting guides
Intervention Type
Procedure
Intervention Name(s)
Mechanical Alignment and Unrestricted Kinematic Alignment using Medacta GMK Sphere with MyKnee Custom guides
Intervention Description
MA places the implant in an average position for all patients based on pre-determined definition of acceptable knee alignment and has become the most common surgical approach for TKA and Unrestricted KA places the implant in a custom position for each patient, completely matching individual anatomy and restoring natural alignment to that of the prearthritic knee.
Intervention Type
Procedure
Intervention Name(s)
Mechanical Alignment and Restricted Kinematic Alignment using Medacta GMK Sphere with custom cutting guides
Intervention Description
MA places the implant in an average position for all patients based on pre-determined definition of acceptable knee alignment and has become the most common surgical approach for TKA and Restricted KA places the implant in a custom position for each patient, closely matching with anatomy and natural alignment of the individual's knee.
Primary Outcome Measure Information:
Title
Change from baseline in Forgotten Joint Score
Description
Assessment of the improvement of joint specific outcomes following knee replacement surgery using the Knee Forgotten Joint Score
Time Frame
Post operative 4-132 months
Secondary Outcome Measure Information:
Title
Change from baseline in Knee Osteoarthritis Outcome Score (KOOS)
Description
Assessment of improvement of activity levels following knee replacement surgery using the KOOS
Time Frame
Baseline to Post operative 4-132 months
Title
Change from baseline in Knee Society Score
Description
Patient specific patient outcomes scoring
Time Frame
Baseline to Post operative 4-132 months
Title
Change from baseline in Knee Society Score
Description
Clinical Exam Range of Motion, Stability and Alignment
Time Frame
Baseline to Post operative 4-132 months
Title
Change from baseline in PROMIS
Description
Pain Intensity, Pain Interference, and physical function scoring
Time Frame
Baseline to Post operative 4-132 months
Title
Change in Baseline in Knee Alignment
Description
Determined by radiographic analysis measured by angle of degrees
Time Frame
Baseline to Post operative 4-132 months
Title
Change from Baseline of Implant Position Fixation
Description
Determined by radiographic analysis by measure radio lucent lines in millimeters
Time Frame
Baseline to Post operative 4-132 months
Other Pre-specified Outcome Measures:
Title
Number of implant failures, implant survival status
Description
Re-operations, revisions, removals, and device related adverse events
Time Frame
Post operative 4-132 months
Title
Age of patient
Description
Date of birth
Time Frame
Baseline
Title
Number of male or female patients
Description
Gender description male or female
Time Frame
Baseline
Title
Demographics
Description
Height in inches, weight in pounds to determine BMI
Time Frame
Baseline
Title
Occurrence of prior medical and surgical history
Description
Medical and surgical history of patient prior to knee surgery
Time Frame
Baseline
Title
Pain medication associated with study knee
Description
Pain medication and use of narcotics for the study knee
Time Frame
Baseline to Post operative 4-132 months
Title
Return to Work/Activity questionnaire
Description
Assessment of ability to return to work or other activities following surgery
Time Frame
Baseline to Post operative 4-132 months
Title
Anesthetic
Description
type of anesthesia used during surgery
Time Frame
day of surgery
Title
Estimated Blood Loss
Description
Volume of blood loss during surgery
Time Frame
day of surgery
Title
Implant demographics
Description
Implant femoral and tibial size and poly thickness
Time Frame
day of surgery
Title
Type of Surgical Technique
Description
Mechanical, Restricted Kinematic, Unrestricted Kinematic and tendon release
Time Frame
day of surgery
Title
Length of Surgery
Description
Time in minutes skin to skin
Time Frame
day of surgery
Title
Length of Hospital Stay
Description
Length of stay in hours
Time Frame
day of surgery
Title
Tourniquet Time
Description
Tourniquet time in minutes
Time Frame
day of surgery
Title
Frequency of Facility type used for knee surgery
Description
Type of facility used for knee surgery
Time Frame
day of surgery
Title
Complications
Description
Assess adverse events and Serious Adverse Events
Time Frame
Baseline to Post operative 4-132 months
Title
Assisted device usage
Description
Cessation of assisted device usage by date
Time Frame
Post operative 4-14 months
Title
Pain, Satisfaction, Narcotics and Function expectations
Description
Custom Health Survey
Time Frame
36-108 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Must be able to read, understand and provide written informed consent on the Institutional Review Board (IRB) approved Informed Consent Form (ICF).
Ability to understand and provide written authorization for use and disclosure of personal health information.
Subject who are able and willing to comply with the study protocol and follow-up visits.
Must be 21 years or older to participate, and less than 80 years old.
Subjects must have osteoarthritis knee disease in the affected knee compliant with the FDA-approved indications for use of GMK Sphere knee system and MyKnee cutting blocks.
Patients who are candidates for Total Knee Arthroplasty and are determined to undergo a TKA using the Medacta GMK Sphere implant and MyKnee cutting blocks will be offered enrollment.
Subjects must be able to return for the follow-up appointments, and have the mental capacity to cooperate and complete PRO questionnaires, physical exam and radiographs.
Exclusion Criteria:
• Cases of extreme bone loss requiring an augmented femoral or tibial implant and chronic ligamentous laxity requiring a constrained implant
The patient has a fixed flexion deformity of ≥15°
The patient has less than 90° of flexion
Patient is morbidly obese (BMI ≥40)
Patient with inflammatory arthritis
History of prior deep knee infection
History of alcoholism or drug abuse
Currently on chemotherapy or radiation therapy for neoplastic disease
Patient currently on immunosuppressive medications including steroids except when, (a) steroid use is less than 10mg daily, (b) other immunosuppressive medications are held for appropriate time, for example Adalimumab is held 2 weeks prior and 2 weeks after surgery
History of known sensitivity or allergy to materials used in orthopedic implants, specifically Titanium and Cobalt-Chrome alloys
Habitual use of narcotic pain medications prior to surgery (more than 2 doses daily and chronic use of a minimum 3 months)
History of metabolic disorder affecting the skeletal system other than osteoarthritis or osteoporosis (e.g., Osteomalacia, Ricketts)
History of chronic pain issues for reasons other than knee joint pain. If the type of pain affects activities of daily living, do not enroll. If the pain is intermittent and does not affect activities of daily living, it is OK to enroll. Fibromyalgia is exclusionary.
Women who are pregnant
Patient with unstable psychiatric illness or psychosis is excluded. (Patients with stable anxiety or depression can be enrolled if PI determines that the condition does not adversely affect study outcomes & requirements)
Any patient, in the opinion of the investigator, is unable to fully comply with the surgical, rehabilitation, or follow-up aspects of this procedure.
Prior surgery on the target knee other than arthroscopy and/or arthroscopically-assisted ligament reconstruction
Prior high tibial osteotomy (HTO) or femoral osteotomy
Malunion of fracture of a tibia or femur
Patient with a neuromuscular or neurosensory deficiency
Patient with history of knee fusion in the affected joint
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rena Mandino
Organizational Affiliation
Associate Director, Clinical Research Medacta USA
Official's Role
Study Director
12. IPD Sharing Statement
Learn more about this trial
Kinematic Alignment vs Mechanical Alignment for Total Knee Arthroplasty
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