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The purpose of this prospective study is to evaluate Zimmer® iASSIST™ with respect to radiographic, clinical and economic outcomes and compared to conventional instrumentation in primary total knee arthroplasty (NexGen or Persona knee implants).
The study design is a prospective, multicenter, comparative outcome study. The study requires each site to obtain IRB (Institutional Review Board) approval prior to study enrollment. All potential study subjects will be required to participate in the Informed Consent Process.
All study subjects will undergo preoperative clinical evaluations prior to their total knee arthroplasty. Investigators will collect clinical data for 12 months. Follow-up clinical visits include 3 and 12 months post-operatively.
The primary endpoint of this study is defined as component alignment as determined using long leg X-Rays. The secondary endpoint will be to evaluate the Knee Society Score, EQ-5D (EuroQol-5Dimensions) scoring system, operating room time, blood loss and complications
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| iAssist group | Other | patients will have primary total knee arthroplasty with the iAssist. The iAssist Knee System is a computer assisted stereotaxic surgical instrument system to assist the surgeon in the positioning of orthopedic implant system components intra-operatively. It involves surgical instruments and position sensors to determine alignment axes in relation to anatomical landmarks and to precisely position alignment instruments and implant components relative to these axes. |
|
| conventional instrumentation | Other | patients will have primary total knee arthroplasty with the conventional instrumentation. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| total knee arthroplasty | Procedure | surgical procedure in which damaged parts of the knee joint are replaced with an implant. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Component Alignment | Assess the differences in component alignment, measured by the mean of radiographs, between iASSISTâ„¢ and conventional instrumentation in primary total knee arthroplasty (TKA) procedures. | 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Knee Society Score Assessment | Assess the differences in Knee Society Score between iASSISTâ„¢ and conventional instrumentation in primary TKA procedures. Higher (and better) score value: 100, lower value: 0. Score 80-100 = Excellent Score 70-79 = Good Score 60-69 = Fair Score below 60 = Poor | 1 year |
| Knee Society Score Function |
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Inclusion Criteria:
Patient is male or female
Patient needs a primary total knee replacement using the NexGen LPS Flex or Persona knee implant
Patient is diagnosed with non-inflammatory degenerative joint disease (e.g., osteoarthritis, post-traumatic arthritis, avascular necrosis, etc.)
Patient is over 18 years old
Patient is able to:
Patient meets an acceptable preoperative medical clearance and is free of or treated for cardiac, pulmonary, hematological or other conditions that would pose excessive operative risk.
Patient has a presence of varus or valgus deformity of 15 degrees or less.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Paola Vivoda, Ass.Direct | Zimmer Biomet | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital El Angel, S.A. | Málaga | 29007 | Spain | |||
| Hospital Unviersitario Son Espases |
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75 patients were intended to be enrolled according to the protocol but only 72 were finally enrolled.
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| ID | Title | Description |
|---|---|---|
| FG000 | iAssist Group | 45 iASSIST cases have been enrolled in 3 sites between April 2014 and August 2017. |
| FG001 | Conventional Instrumentation Group | 27 conventional instrumentation cases have been enrolled in 3 sites between April 2014 and August 2017. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | iAssist Group | 45 iASSIST cases have been enrolled in 3 sites between April 2014 and August 2017. |
| BG001 | Conventional Instrumentation Group | 27 conventional cases have been enrolled in 3 sites between April 2014 and August 2017. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Component Alignment | Assess the differences in component alignment, measured by the mean of radiographs, between iASSISTâ„¢ and conventional instrumentation in primary total knee arthroplasty (TKA) procedures. | Available data of enrolled patients were used for analysis. | Posted | Mean | Standard Deviation | degree | 1 year |
|
The adverse events were collected preoperatively, intraoperatively and postoperatively (at 3 months ±2 weeks and 12 months ±1 month postoperative).
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | iAssist Group | 45 iASSIST cases have been enrolled in 3 sites between April 2014 and August 2017. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Poor alignment in tibia component | Surgical and medical procedures | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Allergic reaction after eating nuts | General disorders | Systematic Assessment |
Since the first follow-up visits were performed according to the standard of care of each site, they did not occur at the same time point.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Emilie Rohmer, Clinical Operations Manager | Zimmer Biomet | +41 58 85 48210 | Emilie.Rohmer@zimmerbiomet.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Aug 12, 2016 | Oct 7, 2020 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D010020 | Osteonecrosis |
| D010003 | Osteoarthritis |
| D020370 | Osteoarthritis, Knee |
| ID | Term |
|---|---|
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D009336 | Necrosis |
| D010335 | Pathologic Processes |
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| ID | Term |
|---|---|
| D019645 | Arthroplasty, Replacement, Knee |
| ID | Term |
|---|---|
| D019643 | Arthroplasty, Replacement |
| D001178 | Arthroplasty |
| D019637 | Orthopedic Procedures |
| D013514 | Surgical Procedures, Operative |
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2 groups of patients: 1 will have the knee prosthesis implanted with iAssist and the other with conventional instrumentation.
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Study patients will not know if their knee prosthesis will be implanted with iAssist or with conventional instrumentation
Knee Society Score function asses 12 months postoperatively between iASSISTâ„¢ and conventional instrumentation in primary TKA procedures. Higher (and better) score value: 100, lower value: 0. Score 80-100 = Excellent Score 70-79 = Good Score 60-69 = Fair Score below 60 = Poor |
| 1 year |
| EQ-5D Questionnaire | Assess the differences in EQ-5D between iASSISTâ„¢ and conventional instrumentation in primary TKA procedures at 12 months postoperatively. Comparison of the derived EQ-5D scale and health state between the 2 groups. The EQ-5D questionnaire includes five dimensions (5D): mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. EQ-5D values range from -0.2 to 1 where the negative values correspond to bad health states (states worse than death), and 1.0 corresponds to perfect health. | 1 year |
| Palma de Mallorca |
| 07010 |
| Spain |
| Universitätsklinik Balgrist | Zurich | 8008 | Switzerland |
| BG002 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
|
| Weight kg | Mean | Standard Deviation | kg |
|
| Body Mass Index (BMI) kg/m^2 | Mean | Standard Deviation | kg/m^2 |
|
| Height cm | Mean | Standard Deviation | cm |
|
| Units | Counts |
|---|---|
| Participants |
|
|
|
| Secondary | Knee Society Score Assessment | Assess the differences in Knee Society Score between iASSISTâ„¢ and conventional instrumentation in primary TKA procedures. Higher (and better) score value: 100, lower value: 0. Score 80-100 = Excellent Score 70-79 = Good Score 60-69 = Fair Score below 60 = Poor | Available data of enrolled patients were used for analysis. | Posted | Mean | Standard Deviation | score on a scale | 1 year |
|
|
|
|
| Secondary | Knee Society Score Function | Knee Society Score function asses 12 months postoperatively between iASSISTâ„¢ and conventional instrumentation in primary TKA procedures. Higher (and better) score value: 100, lower value: 0. Score 80-100 = Excellent Score 70-79 = Good Score 60-69 = Fair Score below 60 = Poor | Available data of enrolled patients were used for analysis. | Posted | Mean | Standard Deviation | score on a scale | 1 year |
|
|
|
|
| Secondary | EQ-5D Questionnaire | Assess the differences in EQ-5D between iASSISTâ„¢ and conventional instrumentation in primary TKA procedures at 12 months postoperatively. Comparison of the derived EQ-5D scale and health state between the 2 groups. The EQ-5D questionnaire includes five dimensions (5D): mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. EQ-5D values range from -0.2 to 1 where the negative values correspond to bad health states (states worse than death), and 1.0 corresponds to perfect health. | Available data of enrolled patients were used for analysis. | Posted | Mean | Standard Deviation | score on a scale | 1 year |
|
|
|
|
| 0 |
| 45 |
| 2 |
| 45 |
| 7 |
| 45 |
| EG001 | Conventional Instrumentation Group | 27 conventional cases have been enrolled in 3 sites between April 2014 and August 2017. | 0 | 27 | 4 | 27 | 3 | 27 |
| Sepsis in bronchial asthma, infection exacerbation | Infections and infestations | Systematic Assessment | treated with antibiotics and cortisone |
|
| Implant failure | Surgical and medical procedures | Systematic Assessment | treated by total knee revision. |
|
| Pulmonary embolism | Vascular disorders | Systematic Assessment | treated with Anticoagulation |
|
| Lump in the neck: metastasis,as well as in the lungs | General disorders | Systematic Assessment | treated by removal and irradiation. |
|
| Patella transverse fracture+dislocation of the prosthesis+tibia shaft fracture+infe | Surgical and medical procedures | Systematic Assessment | adverse events occured in the opposite side (left side). |
|
| Allergic reaction unclear cause (itching, dyspnea, rash) | General disorders | Systematic Assessment |
|
| Radius fracture | Surgical and medical procedures | Systematic Assessment | treated by surgery |
|
| Flexion Contracture | General disorders | Systematic Assessment |
|
| Allergic reaction (Dafalgan) | General disorders | Systematic Assessment | treated by stopping the drugs and giving zavegyl/zantic |
|
| Foot fracture | Surgical and medical procedures | Systematic Assessment | treated by surgery 1 year later |
|
| Delayed Wound Healing | Surgical and medical procedures | Systematic Assessment | treated by wound revision and surgery |
|
| Fall from the bed | Social circumstances | Systematic Assessment | Patient and the knee were ok. |
|
| Pain in the calf (deep vein thrombosis) | Vascular disorders | Systematic Assessment | treated with xarelto 10mg/day for 3 month |
|
| patient felt on the floor, he wanted to stand up alone | Social circumstances | Systematic Assessment |
|
| Patient still had a joint effusion 6 months after surgery | Surgical and medical procedures | Systematic Assessment | treated by joint puncture |
|
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| D013568 |
| Pathological Conditions, Signs and Symptoms |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D012216 | Rheumatic Diseases |
| D019651 | Plastic Surgery Procedures |
| D019919 | Prosthesis Implantation |