Intra-articular Volumetric Assessment After Total Knee Arthroplasty
Condition: Hematoma
MeSH terms: Hematoma
Study type: Observational

Summary: 
      The purpose of the study: is to quantify the amount of post-operative effusion or hematoma
      present after total knee arthroplasty pre-operatively, post-operative day #0,1.

      Patients undergoing a total knee arthroplasty will undergo an MRI on the operative knee at
      the following times:

        -  Pre-operatively

        -  Post-operative day #1 (approximately 16-20 hours post op)

        -  Post-operative day #2 (approximately 36-40 hours post op) This will be conducted by the
           Loma Linda radiology department as per normal protocols. No special imaging procedures
           will be undertaken.

      Subjects will be both male and females, they will be patients from the Principle Investigator
      and Co-Investigators practice. Subjects will be between the ages of 18-89 years of age.

      The total participation will last approximately 30 days.

      Subject selection will be approximately 10 English speaking, both male and female between the
      ages of 18 to 89 years of age. Subjects will be recruited from the Principal Investigators
      and Co-Investigators clinic. There will be no advertising or electronic recruiting. The study
      is expected to last 12 months.
    

Detailed description: 
      STUDY DESIGN:

      Background or rationale for this study:

      Total knee arthroplasty is one of the most successful orthopedic surgeries performed in the
      United States, and consistently has shown to have excellent outcomes for patients, with low
      complication rates. However, when complications do happen, they can range from superficial
      infection to repeated deep infection requiring prosthesis exchange or amputation. Another
      significant complication of total knee arthroplasty is joint stiffness. Range of motion loss
      can also be an extremely debilitating complication necessitating prolonged physical therapy,
      return to the operating theater for manipulation or even total synovectomy and polyethylene
      exchange.

      Although it is currently known that post-operative hematoma leads to adverse outcomes
      following total knee arthroplasty, there is currently no literature to quantify the average
      size or progression of the intra-articular bleeding post operatively. It would be reasonable
      to assume that all patients develop a slight hematoma post operatively. The investigator aims
      to assess the size, and possible progression of the intra-articular hematoma following total
      knee arthroplasty.

      OBJECTIVES:

      The investigator aims to:

      Quantify the amount of post-operative effusion or hematoma present after total knee
      arthroplasty pre-operatively, post-operative day #0, 1.

      Procedures involved (Research Interventions)

      Patients undergoing a total knee arthroplasty will undergo an MRI of the operative knee at
      the following times:

        -  Pre-operatively

        -  Post-operative day #1 (approximately 16-20 hours post op)

        -  Post-operative day #2 (approximately 36-40 hours post op)

      This will be conducted by the Loma Linda radiology department as per normal protocols. No
      special imaging procedures will be undertaken.

      No changes in operative technique or post-operative protocol will be undertaken due to study
      apart from the above imaging.

      All imaging will be kept on the LLUMC PACS system. Concise review of literature that supports
      the rationale, objectives, and methodology of the proposed study.
    

Intervention name(s): MRI
Intervention type(s): Other
Intervention description(s): Patients undergoing a total knee arthroplasty, will undergo additional MRI's. One MRI pre-operatively.
2nd MRI post-operatively on day 1. 3rd MRI post-operatively on day 2.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients that will undergoing a Total Knee Arthroplasty