The Impact of Total Knee Arthroplasty Surgical Technique on Coronal Plane Motion and PatelloFemoral Articulation

Study Overview
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Brief Summary
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The purpose of this study is to examine the impact of two surgical techniques on the outcome of the knee replacement surgery.

Detailed Description
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How stable a total knee replacement is depends on the correct and precise rotation of the femoral component. Abnormal femoral component rotation has been associated with numerous adverse conditions including knee instability, knee pain, scar tissue, and abnormal knee motion. Controversy exists, however, regarding the most favorable surgical technique to determine accurate femoral component rotation. Some doctors prefer a measured resection technique in which landmarks on the femur bone are used to determine where to place the femoral component. Others recommend a gap-balancing technique in which the femoral component is positioned by balancing the ligaments of the knee and placing it in the position where each ligament is equally strained. The purpose of this study is to examine the impact of the measured resection and gap-balancing surgical technique on how the total knee replacement moves and patient knee outcome scores. Knee outcome scores are assessed from the responses given by patients to questions about outcomes associated with total knee replacement related to pain, symptoms, activities of daily living, sport and recreational function, and knee-related quality of life.

Official Title
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The Impact of Total Knee Arthroplasty Surgical Technique on Coronal Plane Motion and PatelloFemoral Articulation

Conditions
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Osteoarthritis

Intervention / Treatment
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* Procedure: Gap balanced surgical technique
* Procedure: Measured resection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Surgeon and patient have determined that patient requires a primary total knee arthroplasty and agrees to participate and signs the informed consent for study. Exclusion Criteria: History of alcoholism Unable to speak English Inflammatory Arthritis Pregnant women or any woman with plans to begin a family.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Gap balanced surgical technique<br>Study patients in this arm of the study will have their knee replacement done using the gap balanced technique. Gap balancing adjusts the bony cuts for femoral rotation to balance the soft tissues of the knee in flexion. | Procedure: Gap balanced surgical technique<br>* Gap balanced surgical technique<br>|
| Active Comparator: Measured resection surgical technique<br>Study patients in this arm of the study will have their knee replacement done using the measured resection surgical technique. Pre-determined bony cuts are made and appropriate balance is obtained by judicious soft tissue releases as required. | Procedure: Measured resection<br>* Measured resection surgical technique<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The primary objective will be to assess coronal balance through a range of motion. | Assessed through dynamic fluoroscopic analysis. | One year post-operatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patellofemoral tracking | Assessed using dynamic fluoroscopy. | One year post-operatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Total knee replacement, Gap balanced, Measured resection