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ROSA Knee System vs Conventional Total Knee Arthroplasty (ROSA_RCT)

Primary Purpose

Knee Osteoarthritis

Status
Recruiting
Phase
Not Applicable
Locations
Netherlands
Study Type
Interventional
Intervention
Robotic-assisted total knee arthroplasty (raTKA)
conventional total knee arthroplasty
Sponsored by
Zuyderland Medisch Centrum
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Knee Osteoarthritis focused on measuring Robotic-assisted arthroplasty, Knee arthroplasty, Gait, Metabolic Syndrome, ROSA Knee System, Physical Activity, Cost-effectiveness

Eligibility Criteria

40 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Eligible for primary TKA age 40-90 years Body-Mass-Index 18.5-50.0 kg/m2 American Society of Anaesthesiologists Class I-III Willingness and capability to understand and follow protocol Exclusion Criteria: - Rheuma-/trauma-indicated knee arthroplasty

Sites / Locations

  • Zuyderland Medical CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Experimental

Arm Label

Conventional TKA

Robotic-assisted TKA

Arm Description

Conventional TKA, with no patient-specific instrumentation or robotic assistance

ROSA Knee System assisted TKA

Outcomes

Primary Outcome Measures

Oxford Knee Score
The Oxford Knee Score (OKS, best to worst 0-48) measures pain intensity and functional limitation of the knee during various activities. The questionnaire consists of 12 items. The maximum total score is 60 and corresponds with the highest pain intensity and functional limitation.
Oxford Knee Score
The Oxford Knee Score (OKS, best to worst 0-48) measures pain intensity and functional limitation of the knee during various activities. The questionnaire consists of 12 items. The maximum total score is 60 and corresponds with the highest pain intensity and functional limitation.

Secondary Outcome Measures

Quality of Life-Index
European Quality of Life-questionnaire-5-dimension-3-level (worst to best, -0.329 to 1.000)
Symptoms
Western Ontario and McMaster Universities Osteoarthritis Index (worst to best 0-100)
Pain Catastrophizing
Pain Catastrophizing Scale (best to worst, 0-52)
Pain Sensitivity
Pain Sensitivity Questionnaire (best to worst, 0-140)
Mobility
De Morten Mobility index (worst to best, 0-100)
Complications
Registered complications during hospitalization
Duration of surgery
Registered duration of surgery
Blood loss
Registered blood loss during hospitalization
Length of hospital stay
Duration from patient intake until discharge
Anesthesia
Type of anesthesia used
Stability of the knee
Ligament tension, assessed by the ROSA Knee System
Knee implant position
Resection, assessed by the ROSA Knee System
Mobility of the knee
Flexion, Extension of knee, assessed by the ROSA Knee System
Mechanical axis of the leg.
Hip-Knee-Alignment, by CT
Implant Survival
Duration until failure (required revision)
Patient Survival
Duration until death
Physical Activity
Steps per day, assessed for 7 continuous days using hip-worn accelerometer
Metabolic Syndrome
Metabolic Syndrome Severity Scale (no predefined range, higher scores indicate worse outcome)
Body composition
Fat mass, measured as % using bioimpedance analysis
Handgrip strength
handgrip strength using hand-held dynamometer
Physical condition
Completed distance in 2-minute walking
Physical strength
Completed sit-to-stand-transfers within 30 seconds
Physical mobility
Time to stand up, walk 3m back and forth and sit down again (timed-up-and-go test)
Cost of procedure, implants
Number implant sizes readily available, and used
Cost of procedure, personnel
Number of Personnel during surgery
Productivity
Institute for Medical Technology Assessment Productivity Cost Questionnaire (worst to best, 0-100)
Medical consumption
Institute for Medical Technology Assessment Medical Consumption Questionnaire (outcome in Euro)
Work Ability Index
Work Ability Index Questionnaire (worst to best, 0-100)
Work Productivity and Activity Impairment
Work Productivity and Activity Impairment-Questionnaire (worst to best, 0-100)

Full Information

First Posted
November 25, 2022
Last Updated
January 12, 2023
Sponsor
Zuyderland Medisch Centrum
Collaborators
Zimmer Biomet
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1. Study Identification

Unique Protocol Identification Number
NCT05685693
Brief Title
ROSA Knee System vs Conventional Total Knee Arthroplasty
Acronym
ROSA_RCT
Official Title
The Effect of ROSA®-Assisted Knee Arthroplasty on Clinical Outcomes
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Recruiting
Study Start Date
December 16, 2022 (Actual)
Primary Completion Date
December 2025 (Anticipated)
Study Completion Date
December 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Zuyderland Medisch Centrum
Collaborators
Zimmer Biomet

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a randomized clinical study, in which 150 patients with end-stage osteoarthritis will be enrolled to ROSA®-assisted knee arthroplasty or conventional knee arthroplasty. Patients are recruited at Zuyderland Medical Center, enrolled pre-operatively and followed up for 12 months post-surgery. In- and exclusion criteria are stated below. After recruitment, participants will be invited for a pre-operative visit. During this pre-operative visit Informed Consent is signed and completion of patient-reported outcome measures (PROMs) is checked. Additionally, measurements regarding body composition, strength and fitness and metabolic outcomes are performed. Participants will have a blood sample taken. Scans, adverse event and medication use will be confirmed. Participants will receive a ActiGraph for collecting data from physical activity. Of all patients, 72 will undergo additional measurements (gait, proprioception). During surgery ROSA- and surgery-data will be collected. Post-operative participants will have a 6-weeks, 3-month and 12-month visit. During these visits pre-operative measurements are repeated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Osteoarthritis
Keywords
Robotic-assisted arthroplasty, Knee arthroplasty, Gait, Metabolic Syndrome, ROSA Knee System, Physical Activity, Cost-effectiveness

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
150 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Conventional TKA
Arm Type
Active Comparator
Arm Description
Conventional TKA, with no patient-specific instrumentation or robotic assistance
Arm Title
Robotic-assisted TKA
Arm Type
Experimental
Arm Description
ROSA Knee System assisted TKA
Intervention Type
Procedure
Intervention Name(s)
Robotic-assisted total knee arthroplasty (raTKA)
Intervention Description
Robotic-assisted total knee arthroplasty is an orthopaedic surgery that involves replacing the articular surfaces (femoral condyles and tibial plateau) of the knee joint with smooth metal and highly cross-linked polyethylene plastic. The robot (ROSA Knee System, Zimmer Biomet, US) assists in planning and placement of the implants and resection sites.
Intervention Type
Procedure
Intervention Name(s)
conventional total knee arthroplasty
Intervention Description
total knee arthroplasty is an orthopaedic surgery that involves replacing the articular surfaces (femoral condyles and tibial plateau) of the knee joint with smooth metal and highly cross-linked polyethylene plastic. In conventional TKAs, no patient-specific instrumentation or robotic assistance is provided.
Primary Outcome Measure Information:
Title
Oxford Knee Score
Description
The Oxford Knee Score (OKS, best to worst 0-48) measures pain intensity and functional limitation of the knee during various activities. The questionnaire consists of 12 items. The maximum total score is 60 and corresponds with the highest pain intensity and functional limitation.
Time Frame
3-months post-operative
Title
Oxford Knee Score
Description
The Oxford Knee Score (OKS, best to worst 0-48) measures pain intensity and functional limitation of the knee during various activities. The questionnaire consists of 12 items. The maximum total score is 60 and corresponds with the highest pain intensity and functional limitation.
Time Frame
12-months post-operative
Secondary Outcome Measure Information:
Title
Quality of Life-Index
Description
European Quality of Life-questionnaire-5-dimension-3-level (worst to best, -0.329 to 1.000)
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Symptoms
Description
Western Ontario and McMaster Universities Osteoarthritis Index (worst to best 0-100)
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Pain Catastrophizing
Description
Pain Catastrophizing Scale (best to worst, 0-52)
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Pain Sensitivity
Description
Pain Sensitivity Questionnaire (best to worst, 0-140)
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Mobility
Description
De Morten Mobility index (worst to best, 0-100)
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Complications
Description
Registered complications during hospitalization
Time Frame
During in-patient stay for indicated surgery (up to 5 days)
Title
Duration of surgery
Description
Registered duration of surgery
Time Frame
During surgery
Title
Blood loss
Description
Registered blood loss during hospitalization
Time Frame
During surgery
Title
Length of hospital stay
Description
Duration from patient intake until discharge
Time Frame
During in-patient stay for indicated surgery (up to 5 days)
Title
Anesthesia
Description
Type of anesthesia used
Time Frame
During surgery
Title
Stability of the knee
Description
Ligament tension, assessed by the ROSA Knee System
Time Frame
Immediately after the surgery
Title
Knee implant position
Description
Resection, assessed by the ROSA Knee System
Time Frame
Immediately after the surgery
Title
Mobility of the knee
Description
Flexion, Extension of knee, assessed by the ROSA Knee System
Time Frame
During and immediately after the surgery
Title
Mechanical axis of the leg.
Description
Hip-Knee-Alignment, by CT
Time Frame
3-months post-surgery
Title
Implant Survival
Description
Duration until failure (required revision)
Time Frame
90-day and 1-year
Title
Patient Survival
Description
Duration until death
Time Frame
90-day and 1-year
Title
Physical Activity
Description
Steps per day, assessed for 7 continuous days using hip-worn accelerometer
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Metabolic Syndrome
Description
Metabolic Syndrome Severity Scale (no predefined range, higher scores indicate worse outcome)
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Body composition
Description
Fat mass, measured as % using bioimpedance analysis
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Handgrip strength
Description
handgrip strength using hand-held dynamometer
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Physical condition
Description
Completed distance in 2-minute walking
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Physical strength
Description
Completed sit-to-stand-transfers within 30 seconds
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Physical mobility
Description
Time to stand up, walk 3m back and forth and sit down again (timed-up-and-go test)
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Cost of procedure, implants
Description
Number implant sizes readily available, and used
Time Frame
During Surgery
Title
Cost of procedure, personnel
Description
Number of Personnel during surgery
Time Frame
During Surgery
Title
Productivity
Description
Institute for Medical Technology Assessment Productivity Cost Questionnaire (worst to best, 0-100)
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Medical consumption
Description
Institute for Medical Technology Assessment Medical Consumption Questionnaire (outcome in Euro)
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Work Ability Index
Description
Work Ability Index Questionnaire (worst to best, 0-100)
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Title
Work Productivity and Activity Impairment
Description
Work Productivity and Activity Impairment-Questionnaire (worst to best, 0-100)
Time Frame
Pre-operative, 3-months and 12-months post-operative.
Other Pre-specified Outcome Measures:
Title
Gait, walking
Description
comfortable walking speed
Time Frame
Pre-operative, 12-months post-operative
Title
Gait, sit-to-stand
Description
ground reaction force difference between left and right foot during sit-to-stand-transfer
Time Frame
Pre-operative, 12-months post-operative
Title
Gait, single-leg-stance
Description
standard deviation in center of mass and pressure during single-leg-stance
Time Frame
Pre-operative, 12-months post-operative
Title
Proprioception, reaction time
Description
Proprioception of the knee will be measured in a motorized carriage. Patients will lay on a hospital bed where their leg is fixed in the motorized carriage. This sled will passively extend and flex the knee. When patients get the sensation of movement, they have to push a button. The reaction time and the angle to sense the movement will be measured digitally.
Time Frame
Pre-operative, 12-months post-operative
Title
Proprioception, angle at movement
Description
Proprioception of the knee will be measured in a motorized carriage. Patients will lay on a hospital bed where their leg is fixed in the motorized carriage. This sled will passively extend and flex the knee. When patients get the sensation of movement, they have to push a button. The reaction time and the angle to sense the movement will be measured digitally.
Time Frame
Pre-operative, 12-months post-operative

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Eligible for primary TKA age 40-90 years Body-Mass-Index 18.5-50.0 kg/m2 American Society of Anaesthesiologists Class I-III Willingness and capability to understand and follow protocol Exclusion Criteria: - Rheuma-/trauma-indicated knee arthroplasty
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jasper Most, PhD
Phone
+31(0)625159747
Email
j.most@zuyderland.nl
First Name & Middle Initial & Last Name or Official Title & Degree
Henriëtte Eijking
Phone
+31(0)657068904
Email
h.eijking@zuyderland.nl
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jasper Most, PhD
Organizational Affiliation
Zuyderland Medical Center
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Bert Boonen, PhD
Organizational Affiliation
Zuyderland Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Zuyderland Medical Center
City
Sittard
State/Province
Limburg
ZIP/Postal Code
6162 BG
Country
Netherlands
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jasper Most
Phone
+31(0)625159747
Email
j.most@zuyderland.nl

12. IPD Sharing Statement

Plan to Share IPD
No

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ROSA Knee System vs Conventional Total Knee Arthroplasty

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