Clinical trial NCT06555055: Trochlear Thickness and Its Effect on the Outcomes of Total Knee Arthroplasty
Official title: Trochlear Thickness and Its Effect on the Outcomes of Total Knee Arthroplasty
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Knee Osteoarthritis
Keywords: Knee Osteoarthritis
patellofemoral
TKA
Trochlear thickness
Lead sponsor: Ain Shams University
Sponsor class: OTHER
Collaborators: name: Ain Shams University
First posted: 2024-08-15
Enrollment: 87
Sex: ALL
Minimum age (years): 40
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: patients with primary knee osteoarthritis

Brief summary: Total knee arthroplasty (TKA ) is the gold standard treatment for advanced knee osteoarthritis. only 85% (75% to 92%) of patients with total knee arthroplasty are satisfied with their operations and 30% develops patellofemoral complications.

Numerous biomechanical studies suggest that patellofemoral tracking is not always restored to physiological values, because the prosthetic trochlea may differ from the native trochlea. no study has been con-ducted to investigate the thickness of the trochlear groove and its effect on the outcome of Total knee replacement (TKR), So many people has different measurements of trochlear thickness which may affect Patellofemoral joint (PFJ) so knowing of native trochlear thickness in patients with KNEE Osteoarthritis (OA) can affect the outcomes of total knee arthroplasty.

Detailed description: Total knee arthroplasty is the gold standard treatment for advanced knee osteoarthritis. In spite of the great advance in the prosthesis design, surgical techniques and rehabilitation programs, only 85% (75% to 92%) of patients with total knee arthroplasty are satisfied with their operations and 30% develops patellofemoral complications. Patellofemoral complications after TKR are usually caused by multiple factors related to surgical technique (e.g., implant positioning and sizing, soft-tissue balancing, patellar resurfacing, etc.) and implant design (e.g., trochlear thickness, sagittal curvature, patellar component shape).

Numerous biomechanical studies suggest that patellofemoral tracking is not always restored to physiological values, because the prosthetic trochlea may differ from the native trochlea.

Theoretically decreasing of contact area distance of trochlea might increase the contact pressure in the patellofemoral joint. The increased contact pressure will elevate the stress in the subchondral bone of the patellofemoral joint, which is hypothesized to be a cause of patellofemoral pain.

A mechanical experiment was performed in an attempt to analyze the influence of thickening of the patella on the knee extension movement. The measurement show that anterior advancement of the extensor apparatus at the level of the patella gives a mechanical advantage, enabling the quadriceps to extend the knee with the use of less force. so increase thickness of patella affects the quadriceps function but no study has been shown the effect of trochlear thickness on quadriceps or patellofemoral joint.

Nonetheless, no study has been con-ducted to investigate the thickness of the trochlear groove and its effect on the outcome of TKR, So many people has different measurements of trochlear thickness which may affect PFJ so knowing of native trochlear thickness in patients with KNEE OA can affect the outcomes of total knee arthroplasty.

Preoperative and postoperative radiography (CT scan) can provide an adequate measurement of trochlear thickness which will help in understanding more about PFJ and its effect in the total knee replacement.

Eligibility criteria: Inclusion Criteria:

* Advanced knee osteoarthritis in which total knee arthroplasty is indicated

Exclusion Criteria:

* Revision total knee arthroplasty
* Previous osteotomy around the knee
* Post traumatic knee arthritis
* Inflammatory knee arthritis

Primary outcomes:
measure: Functional outcome
timeFrame: preoperative and six months postoperatively
measure: Functional Outcome
timeFrame: preoperative and six months postoperatively
measure: Functional Outcome
timeFrame: preoperative and six months postoperatively
Secondary outcomes:
Other outcomes:
Locations:
city: Cairo
country: Egypt
facility: Ain Sahms University
state: Abbasia
Study officials:
affiliation: Ain Shams University
name: Ibrahim B Anis, MS
role: PRINCIPAL_INVESTIGATOR
affiliation: Ain Shams University
name: Wael S Abd El Mageed, MD
role: STUDY_DIRECTOR
affiliation: Ain Shams University
name: Sherif M El Sayed, MD
role: STUDY_DIRECTOR
affiliation: Ain Shams University
name: Zeiad M Zakaria, MD
role: STUDY_DIRECTOR
affiliation: Ain Shams University
name: Mohmed E Awad, MD
role: STUDY_DIRECTOR
References:
citation: Ranawat CS, Flynn WF Jr, Saddler S, Hansraj KK, Maynard MJ. Long-term results of the total condylar knee arthroplasty. A 15-year survivorship study. Clin Orthop Relat Res. 1993 Jan;(286):94-102.
citation: Healy WL, Wasilewski SA, Takei R, Oberlander M. Patellofemoral complications following total knee arthroplasty. Correlation with implant design and patient risk factors. J Arthroplasty. 1995 Apr;10(2):197-201. doi: 10.1016/s0883-5403(05)80127-5.
citation: Dejour H, Walch G, Neyret P, Adeleine P. [Dysplasia of the femoral trochlea]. Rev Chir Orthop Reparatrice Appar Mot. 1990;76(1):45-54. French.