ROM Outcomes in Patients Undergoing a Primary TKA

Study Overview
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Brief Summary
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The goal of this prospective, randomized study is to compare the outcomes of patients undergoing primary TKA after photographing final knee range of motion immediately post-operatively and sharing these photographs with patients at their first follow-up appointment versus a group that does not see a photograph.

Detailed Description
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The goal of this prospective, randomized study is to compare the outcomes of patients undergoing primary total knee arthroplasty (TKA) after photographing final knee range of motion immediately postoperatively and sharing these photographs with patients at their first follow-up appointment versus a group that does not see a photograph. The knee will be photographed in maximum flexion and extension. The primary objectives will be to compare the range of motion of the operative knee at 2 weeks and 6 weeks postoperatively. In the investigator's institution, patients who have failed to achieve 90 degrees of flexion at a postoperative period of 6 weeks undergo manipulation of the knee under anesthesia (MUA). The investigators will also measure how many patients require MUA in the photograph group and non-photograph group. MUA will be performed if patients fail to achieve 90 degrees of flexion at 6 weeks post-op.

Official Title
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Will Visual Affirmation of Knee Range of Motion (ROM) Affect Patient Outcomes in Patients Undergoing a Primary Total Knee Arthroplasty (TKA)? A Prospective, Randomized Study.

Conditions
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Knee Osteoarthritis

Intervention / Treatment
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* Other: Patient will be shown a photograph of their knee at 2 weeks postop
* Other: Patient will not be shown a photograph of their knee at 2 weeks postop


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient is between the age of 22-89 Patient is scheduled to undergo a unilateral, cementless primary TKA, secondary to osteoarthritis Patient agrees to participate as a study subject and signs the Informed Consent and Research Authorization documents Patient is able to read and speak English. Exclusion Criteria: Patient is under the age of 22 or over the age of 89 Patient has preoperative stiffness/contracture of the knee secondary to post-traumatic arthritis Patient is scheduled to undergo a bilateral TKA surgery Patient is unable to read and speak English

Ages Eligible for Study
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Minimum Age: 22 Years
Maximum Age: 89 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: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: A - will be shown their photograph at 2 weeks post-operative.<br>40-50 arms: patients undergoing a unilateral, cementless primary TKA, secondary to osteoarthritis will be shown a photograph of their knee, photographed in maximum flexion and extension, at 2 weeks postoperatively. | Other: Patient will be shown a photograph of their knee at 2 weeks postop<br>* Patients who undergo primary TKA surgery will then be shown a photograph of their knee at 2 weeks postoperative.<br>|
| Active Comparator: B - will not be shown their photograph<br>40-50 arms: patients undergoing a unilateral, cementless primary TKA, secondary to osteoarthritis will not be shown a photograph of their knee, photographed in maximum flexion and extension, at 2 weeks postoperatively. | Other: Patient will not be shown a photograph of their knee at 2 weeks postop<br>* Patients who undergo primary TKA surgery will not be shown a photograph of their knee at 2 weeks postoperative.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| total length of hospital stay | total length of hospital stay as defined by number of days from date of surgery to date of discharge | outcome measure will be taken at 2 weeks postoperatively | 
| Knee Society Score | Knee Society Score. The score is on a scale from 0-100. A higher value represents a better outcome. | outcome measure will be taken preoperatively (4-6 weeks prior to date of surgery) | 
| Knee Society Score | Knee Society Score. The score is on a scale from 0-100. A higher value represents a better outcome. | outcome measure will be taken 6 weeks (± 2 weeks) postoperatively | 
| WOMAC Score | WOMAC score. The score is on a scale from 0-100. In contrast to the Knee Society Score, on the WOMAC a lower value represents a better outcome | outcome measure will be taken preoperatively (4-6 weeks prior to date of surgery) | 
| WOMAC Score | WOMAC score. The score is on a scale from 0-100. In contrast to the Knee Society Score, on the WOMAC a lower value represents a better outcome | outcome measure will be taken 6 weeks (± 2 weeks) postoperatively | 
| Active range-of-motion (ROM) | Active ROM (range-of-motion) as measured by a goniometer (range of 0-135 degrees) | outcome measure will be taken preoperatively (4-6 weeks prior to date of surgery) | 
| Active range-of-motion (ROM) | Active ROM (range-of-motion) as measured by a goniometer (range of 0-135 degrees) | outcome measure will be taken 6 weeks (± 2 weeks) postoperatively | 
| Incidence of loss of knee motion requiring an MUA (manipulation under anesthesia) | Loss of knee motion is defined as failure to achieve greater than 100 degrees of active flexion. Manipulation under anesthesia is an outpatient procedure performed by orthopedic surgeon to help improve patient's range-of-motion. | outcome measure will be taken 6 weeks (± 2 weeks) postoperatively | 
| Operative Time | Total Operative Time as defined in minutes | outcome measure will be taken at 2 weeks postoperatively | 
| Tourniquet time | Total Tourniquet Time is the number of minutes that the tourniquet is inflated, as defined in minutes. | outcome measure will be taken at 2 weeks postoperatively | 
| Estimated Blood Loss (EBL) | Estimated Blood Loss as defined by the amount of intraoperative blood loss measured in cubic centimeters (cc). | outcome measure will be taken at 2 weeks postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants with postoperative complications | Number of Participants with postoperative complications. A postoperative complication is defined as any diagnosis or condition that necessitates a re-operation or procedure on the surgical knee | outcome measure will be taken 6 weeks (± 2 weeks) postoperatively |