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Crepitus causing unsatisfied result to patients after posterior stabilized total knee arthroplasty. Recent retrospective study demonstrated removal of hyperplastic synovium in distal quadriceps caused reduce of crepitus. However, this study has limitation of time gap exist between arms, different in observation time and bias caused by retrospective review. Thus aim of this study is that by randomized trial, verified hyperplastic synovium in distal quadriceps causing crepitus.
Target enrolled patients in this study are scheduled to perform both total knee arthroplasty. Experimental group is randomized side (right or left) of knee, and control group is other side of knee. Both arms decided by randomized number table. Crepitus measured after 3mo, 6mo, 1year after surgical treatment
Surgical treatment of TKA with synovium removal in distal quadriceps tendon performed classifed as experimental arm and TKA wiout synovium removal classified as control arm. Before surgical treatment, radiologic and physiological evaluation performed to check too much variance shown in either arm. Radiologic parameter include Hip knee ankle angle, Femoral tibial angle, Level of joint line, Insall-Salvati ratio, Posterior tibial slope, Posterior femoral condylar offset, Patellar thickness, Patellar tilt, Patellar displacement. During surgical treatment patella resurfacing in either group excluded this study. Indication of patella resufacing is ICRS grade IV in lateral surface of patella. After surgical procedure done check grade of crepitus (0-no crepitation, 1-fine crepitation, 2-coarse crepitation) with WOMAC, Knee Society Score, Eq-5D (European quality of life -5 Dimensions), Forgotten joint score after 3month, 6month and 1year after surgical procedure.
Other collecting variance Age, Gender, BMI, Range of motion of knee, Fmoeral/Tibial component size, PE thickness
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Synovium removal group | Experimental |
| |
| Synovium sustain group | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Prepectoral | Procedure | Remove all visible synovium in suprapatellar area under distal quadriceps tendon. All other procedures (Total Knee arthroplasty) are same with no intervention arm. |
| Measure | Description | Time Frame |
|---|---|---|
| Crepitus grade | Crepitus grade divided 3 categories ; 0-no crepitus, 1-asymptomatic crepitus, 2-Painful crepitus | 3month, 6month, 1year after surgical treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Hip knee ankle angle | Identify postop alignment of lower extrimities, which is mechanical axis between femur and tibia in scanogram of low extremity. | 3month, 6month, 1year after surgical treatment |
| Insall-Salvati ratio |
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Inclusion Criteria:
1.Patients who scheduled to perform both total knee arthroplasty(TKA) using posteiror crucitate sustain type (PS)
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Woo Suk Lee | Contact | 82-2-2019-4601 | gsirb@yuhs.ac |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Gangnam Severance Hospital | Recruiting | Seoul | GangnamGu | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35962233 | Result | Chumchuen S, Kanitnate S, Wattanasirisombat K, Tammachote N. Synovium removal from the articular side of the quadriceps tendon around the superior pole of patella reduces the crepitus after total knee arthroplasty. Int Orthop. 2022 Nov;46(11):2561-2567. doi: 10.1007/s00264-022-05539-2. Epub 2022 Aug 13. |
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| Subpectoral | Procedure | No remove any synovium in suparapatellar area under distal quadriceps tendon. All other preocedures are same with experimental arm. |
|
Measured in true lateral position in 30' knee flextion, measureing patellar position in lateral plain radiograph of knee.
| 3month, 6month, 1year after surgical treatment |
| Patellar displacement | Measuring patellar position in merchant view of plain radiograph. | 3month, 6month, 1year after surgical treatment |
| Patellar tilt angle | Measuring patellar position in merchant view of plain radiograph. | 3month, 6month, 1year after surgical treatment |
| Tibia offset | Estimate tibial component position in lateral plain radiograph. | 3month, 6month, 1year after surgical treatment |
| Knee society score | Clinical score evaluate functional ability of patients after surgery (0-100; high value represent better outcome) | 3month, 6month, 1year after surgical treatment |
| WOMAC score | Clinical score evaluate pain, stiffness, function of knee after surgery (0-96; low value represent better outcome) | 3month, 6month, 1year after surgical treatment |
| Forgotten joint score | Clinical score evaluate functional outcome after surgery (0-100; low value represent better outcome) | 3month, 6month, 1year after surgical treatment |
| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| D001172 | Arthritis, Rheumatoid |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
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