Microcurrent Stimulation Reduces Post-Operative Swelling and Healing Time Following Knee Replacement Surgery
Primary Purpose
Osteoarthritis of Knee, Edema, Wounds and Injuries
Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
ODIN1
Standard Care
Diagnostic Device Testing
Sponsored by
About this trial
This is an interventional treatment trial for Osteoarthritis of Knee focused on measuring Inflammation, Edema, Arthroplasty, Rehabilitation, Replacement, Knee, Total Knee Replacement, Pain, Postoperative, Exercise Therapy, Therapeutics, Early Ambulation, Myofunctional Therapy, Electric Stimulation Therapy, Orthopedic Procedures, Wound Healing, Total Knee Arthroplasty
Eligibility Criteria
Inclusion Criteria:
- Patients must be scheduled for a primary total knee replacement surgery
- Age: 18 - 80 years old
- Males/Females all ethnicities
- Must have a minimum serum albumin of 4 and a minimum Hgb of 11
- Ability to mark appropriately the visual analog scales, keep a log of symptoms, medication use, and ODIN1® use
- Ability to understand all instructions and the informed consent document before signing it
Exclusion Criteria:
- Subject younger than 18 years of age
- Any patient with an electrically implanted device such as a pacemaker, neural stimulator, etc.
- Subject has any known neoplasms
- A demonstrated lack of compliance as determined by the Principal Investigator, nurse, or wound care specialist
- Current participation in another clinical study of an investigational device or drug.
- Any other condition or finding, which in the opinion of the investigator, would make the subject unsuitable for enrollment or could interfere with the subject participating in and completing the protocol
- Subject unwilling or unable to provide informed consent
- Subjects receiving any medication or having any condition that significantly interferes with the healing process such as a patient taking systemic steroids or immune suppressants or patient has diabetes mellitus with an HbA1c of greater than 7.5, etc.
- Any female who has experienced menstruation and is less than 5 years postmenopausal shall have a urine pregnancy test before the initial treatment. An additional test will be performed at 3 weeks from the initial treatment date. Any subject with a positive pregnancy test shall be excluded
- Subjects with significant peripheral extremity lymph edema
- Subjects with Stage III or IV peripheral vascular disease, as defined by the Fontaine stages
- Subjects with venous insufficiencies of Class III or greater, as defined by the Comprehensive Classification System for Chronic Venous Disorders (CEAP)
- Subjects with muscle skeletal disorders that are not related to the knee
- Subjects with uncontrolled Blood Pressure
- Subjects with neurological disease affecting locomotion
- Subjects with BMI > 35
- Subjects that are active smokers
- Subjects that live on the second floor or higher without elevator access
- Subjects must not have had a prior TKA. This study is for Primary TKA patients
Sites / Locations
- Nevada Orthopedic and Spine Center
- Centennial Hills Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Experimental
Control
Arm Description
This group will receive treatment from the ODIN1 device in conjunction with standard care and diagnostic device testing.
This group will receive the standard care and the diagnostic device testing.
Outcomes
Primary Outcome Measures
Rate of Reduction of post-operative edema
Determine the rate of reduction in edema by measuring the volume changes in the operated lower extremity over time
Decrease in time to heal
Determine the rate of healing by measuring the time elapsed from surgery to reach optimal function by measuring muscle strength, range of knee motion, standardized rehabilitation testing designed to quantitatively measure ambulation. When these measurements show no signs of improvement for a period of 30 days or greater, then the time elapsed after surgery until the beginning of this 30 day or greater period will be recorded and used as a measure of time to heal.
Secondary Outcome Measures
Reduction of pain
Record the degree of pain experienced by measuring the pain level on the universal pain scale of 1-10 over time elapsed since surgery.
Reduction of bacterial infections
Compare the incidence of TKA related infections in all participants. The measurement will be the number of recorded infections, related to the surgery, that has occurred within the first 60 days of that surgery in all participants. That number will be compared between the experimental and the control groups.
Increased healing of the surgical incision
Photograph and rate incision healing from 1st post-op day through day 60 comparing all participants.
Reduction of Pain Medication Usage
Record the consumption of all pain medications consumed to mitigate post-operative pain. A total dosage will be calculated in terms of morphine equivalent strengths and compared between the groups.
Full Information
NCT ID
NCT02623660
First Posted
December 1, 2015
Last Updated
January 8, 2016
Sponsor
Bioelectric Research Corporation
1. Study Identification
Unique Protocol Identification Number
NCT02623660
Brief Title
Microcurrent Stimulation Reduces Post-Operative Swelling and Healing Time Following Knee Replacement Surgery
Official Title
Accelerated Reduction of Post-operative Edema and Early Return to Function Following Total Knee Arthroplasty (TKA)
Study Type
Interventional
2. Study Status
Record Verification Date
January 2016
Overall Recruitment Status
Unknown status
Study Start Date
January 2016 (undefined)
Primary Completion Date
October 2016 (Anticipated)
Study Completion Date
October 2016 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bioelectric Research Corporation
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to determine if patients undergoing a total knee arthroplasty (TKA) experience a clinically significant reduction in healing time when treated post operatively with a specific form of micro and nano-ampere current. The results of this trial will provide a basis for generalizing its outcomes to apply to other joint replacements and revisions by reducing edema and inflammation and therefore will result in a shorter time to heal.
The study will compare electrically treated and non electrically treated patients by using digitally based measurements to determine objective reductions of lower extremity edema including intra and inter cellular shifts in fluid distribution, increased range of motion (ROM) and muscle strength, and improved functional tests of ambulation.
Detailed Description
This study is intended to assess the efficiency and efficacy of the ODIN1® microcurrent generating device to reduce post-operative edema, shorten the time to heal and regain maximum function in total knee replacement patients. Changes in swelling will be documented by utilizing a 3D scanning device (Perometer) and a Bio-Impedance Spectroscopy (BIS) device (Impedimed SFB7). These instruments quantitate limb volume and inter and intra-cellular fluid respectively with a high degree of accuracy. Measurements will be made from the first post-operative day until the completion of rehabilitation therapy several months later.
Edema volume and fluid distribution data collected from both control and experimental groups will be compared to determine the statistical significance of the difference between these groups. An additional analysis will be performed on data collected from the non-operated lower limb of each patient.
The second primary objective is to determine the time to complete post-op rehabilitation. Completion will be determined by the ability of the patient to experience an optimal outcome by utilizing performance based measurements of knee function including quadriceps strength and range of motion. The time from surgery to optimal post-op rehabilitation will be recorded.
The determinations of statistical significance between the electrically treated and non-electrically treated groups will be made by analysts on a blind basis. They will not know whether a sample data set is from an experimental or control patient. The codes that document which group the set belongs to will be opened after all analysis is completed by an independent analyst.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis of Knee, Edema, Wounds and Injuries
Keywords
Inflammation, Edema, Arthroplasty, Rehabilitation, Replacement, Knee, Total Knee Replacement, Pain, Postoperative, Exercise Therapy, Therapeutics, Early Ambulation, Myofunctional Therapy, Electric Stimulation Therapy, Orthopedic Procedures, Wound Healing, Total Knee Arthroplasty
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
40 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Experimental
Arm Type
Experimental
Arm Description
This group will receive treatment from the ODIN1 device in conjunction with standard care and diagnostic device testing.
Arm Title
Control
Arm Type
Active Comparator
Arm Description
This group will receive the standard care and the diagnostic device testing.
Intervention Type
Device
Intervention Name(s)
ODIN1
Intervention Description
Shortly after surgery, electrodes will be applied to the lower extremity in such a way that the current will flow from the ankle through the knee replacement and pass through the thigh. The frequency of the treatments will vary over the period of time from post-op recovery to end of rehab.
All treatments are applying current that consists of different combinations of intensities within the micro to nano ampere ranges.
Intervention Type
Other
Intervention Name(s)
Standard Care
Intervention Description
Anti-thrombotic medication. Elevation and ice. Pain medications as needed. Dressings changes. Topical antibiotics. Progressive physical therapy.
Intervention Type
Device
Intervention Name(s)
Diagnostic Device Testing
Intervention Description
Diagnostic interventions include: the Perometer which scans the lower extremity and determines its volume to a high degree of accuracy; the Impedimed Bioimpedance Spectroscopy (BIS) device that measures intra and intercellular fluid movement; the Microfet muscle force testing device that provides a digital output of the number of pounds exerted by the quadriceps upon extension; the Acumar digital digital Inclinometer that accurately measures the ROM of the knee; and the K.I.S.S. wound measuring system to measure rate of incision healing.
Primary Outcome Measure Information:
Title
Rate of Reduction of post-operative edema
Description
Determine the rate of reduction in edema by measuring the volume changes in the operated lower extremity over time
Time Frame
120 days
Title
Decrease in time to heal
Description
Determine the rate of healing by measuring the time elapsed from surgery to reach optimal function by measuring muscle strength, range of knee motion, standardized rehabilitation testing designed to quantitatively measure ambulation. When these measurements show no signs of improvement for a period of 30 days or greater, then the time elapsed after surgery until the beginning of this 30 day or greater period will be recorded and used as a measure of time to heal.
Time Frame
120 Days
Secondary Outcome Measure Information:
Title
Reduction of pain
Description
Record the degree of pain experienced by measuring the pain level on the universal pain scale of 1-10 over time elapsed since surgery.
Time Frame
90 days
Title
Reduction of bacterial infections
Description
Compare the incidence of TKA related infections in all participants. The measurement will be the number of recorded infections, related to the surgery, that has occurred within the first 60 days of that surgery in all participants. That number will be compared between the experimental and the control groups.
Time Frame
60 Days
Title
Increased healing of the surgical incision
Description
Photograph and rate incision healing from 1st post-op day through day 60 comparing all participants.
Time Frame
From the 1st post-op day until 60 Days post-op
Title
Reduction of Pain Medication Usage
Description
Record the consumption of all pain medications consumed to mitigate post-operative pain. A total dosage will be calculated in terms of morphine equivalent strengths and compared between the groups.
Time Frame
90 days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Patients must be scheduled for a primary total knee replacement surgery
Age: 18 - 80 years old
Males/Females all ethnicities
Must have a minimum serum albumin of 4 and a minimum Hgb of 11
Ability to mark appropriately the visual analog scales, keep a log of symptoms, medication use, and ODIN1® use
Ability to understand all instructions and the informed consent document before signing it
Exclusion Criteria:
Subject younger than 18 years of age
Any patient with an electrically implanted device such as a pacemaker, neural stimulator, etc.
Subject has any known neoplasms
A demonstrated lack of compliance as determined by the Principal Investigator, nurse, or wound care specialist
Current participation in another clinical study of an investigational device or drug.
Any other condition or finding, which in the opinion of the investigator, would make the subject unsuitable for enrollment or could interfere with the subject participating in and completing the protocol
Subject unwilling or unable to provide informed consent
Subjects receiving any medication or having any condition that significantly interferes with the healing process such as a patient taking systemic steroids or immune suppressants or patient has diabetes mellitus with an HbA1c of greater than 7.5, etc.
Any female who has experienced menstruation and is less than 5 years postmenopausal shall have a urine pregnancy test before the initial treatment. An additional test will be performed at 3 weeks from the initial treatment date. Any subject with a positive pregnancy test shall be excluded
Subjects with significant peripheral extremity lymph edema
Subjects with Stage III or IV peripheral vascular disease, as defined by the Fontaine stages
Subjects with venous insufficiencies of Class III or greater, as defined by the Comprehensive Classification System for Chronic Venous Disorders (CEAP)
Subjects with muscle skeletal disorders that are not related to the knee
Subjects with uncontrolled Blood Pressure
Subjects with neurological disease affecting locomotion
Subjects with BMI > 35
Subjects that are active smokers
Subjects that live on the second floor or higher without elevator access
Subjects must not have had a prior TKA. This study is for Primary TKA patients
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ron Hillock, M.D.
Organizational Affiliation
Centennial Hills Hospital & University of Nevada School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Nevada Orthopedic and Spine Center
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89128
Country
United States
Facility Name
Centennial Hills Hospital
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89149
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
7734729
Citation
Shi R, Borgens RB. Three-dimensional gradients of voltage during development of the nervous system as invisible coordinates for the establishment of embryonic pattern. Dev Dyn. 1995 Feb;202(2):101-14. doi: 10.1002/aja.1002020202.
Results Reference
background
PubMed Identifier
7813796
Citation
Hotary KB, Robinson KR. Endogenous electrical currents and voltage gradients in Xenopus embryos and the consequences of their disruption. Dev Biol. 1994 Dec;166(2):789-800. doi: 10.1006/dbio.1994.1357.
Results Reference
background
PubMed Identifier
2242993
Citation
Soong HK, Parkinson WC, Bafna S, Sulik GL, Huang SC. Movements of cultured corneal epithelial cells and stromal fibroblasts in electric fields. Invest Ophthalmol Vis Sci. 1990 Nov;31(11):2278-82.
Results Reference
background
PubMed Identifier
10198071
Citation
Zhao M, Dick A, Forrester JV, McCaig CD. Electric field-directed cell motility involves up-regulated expression and asymmetric redistribution of the epidermal growth factor receptors and is enhanced by fibronectin and laminin. Mol Biol Cell. 1999 Apr;10(4):1259-76. doi: 10.1091/mbc.10.4.1259.
Results Reference
background
PubMed Identifier
18684937
Citation
Lin F, Baldessari F, Gyenge CC, Sato T, Chambers RD, Santiago JG, Butcher EC. Lymphocyte electrotaxis in vitro and in vivo. J Immunol. 2008 Aug 15;181(4):2465-71. doi: 10.4049/jimmunol.181.4.2465.
Results Reference
background
PubMed Identifier
15987799
Citation
McCaig CD, Rajnicek AM, Song B, Zhao M. Controlling cell behavior electrically: current views and future potential. Physiol Rev. 2005 Jul;85(3):943-78. doi: 10.1152/physrev.00020.2004.
Results Reference
background
PubMed Identifier
19346484
Citation
Sato MJ, Kuwayama H, van Egmond WN, Takayama AL, Takagi H, van Haastert PJ, Yanagida T, Ueda M. Switching direction in electric-signal-induced cell migration by cyclic guanosine monophosphate and phosphatidylinositol signaling. Proc Natl Acad Sci U S A. 2009 Apr 21;106(16):6667-72. doi: 10.1073/pnas.0809974106. Epub 2009 Apr 3.
Results Reference
background
PubMed Identifier
23082865
Citation
Li L, Gu W, Du J, Reid B, Deng X, Liu Z, Zong Z, Wang H, Yao B, Yang C, Yan J, Zeng L, Chalmers L, Zhao M, Jiang J. Electric fields guide migration of epidermal stem cells and promote skin wound healing. Wound Repair Regen. 2012 Nov-Dec;20(6):840-51. doi: 10.1111/j.1524-475X.2012.00829.x. Epub 2012 Oct 19.
Results Reference
background
PubMed Identifier
15522044
Citation
Man IO, Markland KL, Morrissey MC. The validity and reliability of the Perometer in evaluating human knee volume. Clin Physiol Funct Imaging. 2004 Nov;24(6):352-8. doi: 10.1111/j.1475-097X.2004.00577.x.
Results Reference
background
PubMed Identifier
23188719
Citation
Pichonnaz C, Bassin JP, Currat D, Martin E, Jolles BM. Bioimpedance for oedema evaluation after total knee arthroplasty. Physiother Res Int. 2013 Sep;18(3):140-7. doi: 10.1002/pri.1540. Epub 2012 Nov 27.
Results Reference
background
Links:
URL
http://www.jisrf.org
Description
Joint Implant Surgery & Research Foundation
Learn more about this trial
Microcurrent Stimulation Reduces Post-Operative Swelling and Healing Time Following Knee Replacement Surgery
We'll reach out to this number within 24 hrs