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This study compares and evaluates differences in movement analysis, patient-reported outcome between patients undergoing total knee arthroplasty with use of either Zimmer Biomet NexGen with posterior stabilization and Bioimplanti K-Mod cruciate-retaining with dynamic congruence
The aim of this study is to assess and compare kinematic and time-space gait parameters in patients after total knee arthroplasty, who will undergo the surgery with the use of either posterior-stabilized (PS) or dynamic congruence (DC) implants.
Materials and methods To this study 56 consecutive patients undergoing total knee arthroplasty will be recruited. Study protocol is designed as a prospective, blinded, parallel-group, superiority trial, with balanced randomization [1:1]. All participants will be operated in single clinical orthopedic department, by single high-volume surgeon, who performed more than 3000 total knee arthroplasties in his professional career.
Before the surgery patients will fulfill the author's questionnaire concerning their age, height and body mass, level of activity and VAS (Visual Analogue Scale).
After the surgery 1 to 3 years postoperatively three-dimensional gait analysis will performed with use of BTS SMART device. This device uses passive markers technology and registers the movement by six cameras. To perform full gait analysis several data concerning patients anthropometry will be collected (lower limb length, knee and ankle joint width, width and depth of the pelvis). Whole gait analysis will be performed by experienced single clinical biomechanist accordingly to the Davis protocol. Markers will be installed on the patients' limbs on the following points: base of sacral bone, greater trochanter of the femur, lateral femoral condyle, head of the fibula, lateral malleoli, head of the V metatarsal bone).
Participants will walk barefoot for 10 meters quadruple times. Following time-space and kinematic parameters will be assessed:
Time-space parameters Single stance time (T1) [%] Swing time (T2) [%] Double-stance time (T3) [%] Step length (SL) [m] Mean gait velocity (Vm) [m/s] Cadence (C) [number of steps/min]
Kinematic parameters:
Operated knee range of flexion during swing phase [°]
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NexGen | Active Comparator | Patients undergoing total knee replacement for treatment of primary knee ostearthritis with use of Zimmer Biomet NexGen prosthesis |
|
| K-Mod | Active Comparator | Patients undergoing total knee replacement for treatment of primary knee ostearthritis with use of Bioimplanti K-MOD prosthesis |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Total knee replacement | Procedure | Participant will undergo total knee replacement performed via anterior parapatellar approach with either Posterior-stabilized or retaining cruciate-retaining with dynamic congruence implant |
| Measure | Description | Time Frame |
|---|---|---|
| Time of swing phase | Change from baseline part of swing phase time during gait, measured in percentage Change from baseline part of swing phase time during gait, measured in percentage | Time Frame: 1-3 years after surgery |
| Time of stance phase | Change from baseline part of stance phase time during gait, measured in percentage | Time Frame: 1-3 years after surgery |
| Time of double-stance phase | Change from baseline part of double-stance phase time during gait, measured in percentage | Time Frame: 1-3 years after surgery |
| Stride length | Change from baseline length of stride during gait, measured in meters | Time Frame: 1-3 years after surgery |
| Cadence | Change from baseline number of strides per minute of walking | Time Frame: 1-3 years after surgery |
| Mean gait velocity | Change from baseline mean values of gait speed, measured in meters per second | Time Frame: 1-3 years after surgery |
| Range of maximal hip extension for both limbs during ending part of mid-stance phase | Change from baseline range of maximal hip extension for both limbs during ending part of mid-stance phase, measured in degrees | Time Frame: 1-3 years after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Bartosz M. MaciÄ…g, MD | Medical University of Warsaw | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Othopedics and Rehabilitation, Medical University of Warsaw | Warsaw | Masovian Voivodeship | 03-984 | Poland |
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| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D010003 | Osteoarthritis |
| ID | Term |
|---|---|
| D009140 | Musculoskeletal Diseases |
| D001168 | Arthritis |
| D012216 | Rheumatic Diseases |
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| ID | Term |
|---|---|
| D019645 | Arthroplasty, Replacement, Knee |
| D001696 | Biomechanical Phenomena |
| ID | Term |
|---|---|
| D019643 | Arthroplasty, Replacement |
| D001178 | Arthroplasty |
| D019637 | Orthopedic Procedures |
| D013514 | Surgical Procedures, Operative |
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Participant will not be informed which type of prosthesis was used in their particular case.
Outcomes Assessor will not be informed which type of prosthesis was used in particular patient.
| Biomechanics | Diagnostic Test | Participants will be asked to perform biomechanical assesment before and following surgery at baseline, 6-8 weeks and 6-months postoperatively |
|
| NexGen Ps or Bioimplanti K-MOD implant | Device | Participant are randomly allocated to receive one of the NexGen PS or Biomplanti K-MOD total knee implant for treatment of end-stage knee osteoarthritis. |
|
| Range of pelvic drop in frontal plane on the opposite site of the bearing limb | Change from baseline range of pelvic drop in frontal plane on the opposite site of the bearing limb, measured in degrees | Time Frame: 1-3 years after surgery |
| D019651 | Plastic Surgery Procedures |
| D019919 | Prosthesis Implantation |
| D055592 | Biophysical Phenomena |
| D055585 | Physical Phenomena |
| D055595 | Mechanical Phenomena |