Posterior cruciate ligament and total knee arthroplasty: retain, sacrifice or substitute? A prospective, randomised clinical trial

ISRCTN ISRCTN82612978
DOI https://doi.org/10.1186/ISRCTN82612978
Secondary identifying numbers TYH7306
Submission date
11/05/2007
Registration date
12/09/2007
Last edited
18/03/2016
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Knee osteoarthritis is a condition where the cartilage inside the knee joint is worn away, leading to the bones rubbing against each other and becoming damaged. In knee replacement surgery, the damaged joint surface is removed and replaced with an implant. The posterior cruciate ligament is one of the four major ligaments of the knee. During knee replacement surgery the posterior cruciate ligament can either be kept in place, removed, or replaced with an implant. The aim of this study is to compare patient outcomes after total knee replacement surgery where the posterior cruciate ligament is retained, sacrificed or replaced.

Who can participate?
Patients aged 18 to 80 with primary osteoarthritis of the knee

What does the study involve?
Participants are randomly allocated to undergo knee replacement surgery where the posterior cruciate ligament is either be kept in place, removed, or replaced with an implant. Participants undergo walking tests and their knee function, osteoarthritis symptoms and quality of life are measured at 2, 5 and 10 years.

What are the possible benefits and risks of participating?
Not provided at time of registration

Where is the study run from?
Helsinki University Central Hospital (Finland)

When is the study starting and how long is it expected to run for?
April 2006 to December 2018

Who is funding the study?
1. Helsinki University Central Hospital (Finland)
2. Orion-Farmos Research Foundation (Finland)

Who is the main contact?
Dr Ville Remes
ville.remes@hus.fi

Contact information

Dr Ville Remes
Scientific

Helsinki University Central Hospital
Surgical Hospital
P.O. Box 263
00029 HUS
Helsinki
FIN-0009
Finland

Email ville.remes@hus.fi

Study information

Study designProspective randomised clinical trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titlePosterior cruciate ligament and total knee arthroplasty: retain, sacrifice or substitute? A prospective, randomised clinical trial
Study objectivesTo compare clinical, functional and radiological outcome after Total Knee Arthroplasty (TKA) between three different groups:
1. After Cruciate Retaining (CR) TKA and Posterior Cruciate Ligament (PCL) retained
2. After CR TKA and PCL sacrificed
3. After posterior stabilised TKA
Ethics approval(s)Ethical committee of Surgical Department, Turku University Central Hospital, 02/05/2006, ref: TEKOHeKuTu2006/11032006
Health condition(s) or problem(s) studiedSevere knee osteoarthritis
Intervention1. Total Knee Arthroplasty (TKA) with Posterior Cruciate Ligament (PCL) retained
2. TKA with PCL excised, but not replaced
3. TKA with PCL excised and replaced with posterior stabilised implant

Follow-up will take place at 10 years.
Intervention typeProcedure/Surgery
Primary outcome measureA 0.8 point (0.5 SD) difference in Total Knee Function Questionnaire and 15 mm difference in Visual Analogue Score (VAS) scale measuring subjective satisfaction, measured at 2, 5 and 10 years.
Secondary outcome measures1. A difference of 15 points in the Western Ontario and McMasters Universities Osteoarthritic Index (WOMAC) questionnaire, converted to a scale of 0 to 100, measured at 2, 5 and 10 years
2. Difference in indicators of functional capacity (20-metre walking test and 3-metre "up and go" test), measured at 2, 5 and 10 years
3. Difference in the observed change in the quality of life, measured at 2, 5 and 10 years
4. Difference in the Oxford Knee questionnaire, measured at 2, 5 and 10 years
Overall study start date20/04/2006
Completion date31/12/2018

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexNot Specified
Target number of participants285
Key inclusion criteria1. Primary osteoarthritis of the knee, planned to be treated by knee replacement surgery
2. Operation can be performed using condylar knee design
3. Collaterals are intact
4. Mechanical axis is at least one degree in varus
5. Aged 18 to 80 years
6. The patient's mother tongue is Finnish
Key exclusion criteria1. Patient has a secondary osteoarthritis of knee
2. The patient has undergone endoprosthetic surgery of the other knee or ankle in the preceding 12 months, or such a procedure is planned for the patient in the next 12 months
3. Simultaneous, one-stage knee arthroplasty
4. The patient has undergone surgery of the other knee, hip or ankle with an unsatisfactory outcome
5. The patient has been diagnosed with or is suspected to have an untreated or recurring malignancy or systemic infection
6. A disease treated with cortisone or immunosuppressive medication
7. The patient's cooperation is impaired for any reason
8. Any systemic disease that impairs the patient's mobility
9. Obesity, Body Mass Index (BMI) greater than 40
10. Female patients in fertile age who are planning to have children during the study
11. The patient has previously undergone an operation of the knee region other than arthroscopy or open menisectomy that extended below the subcutaneous tissue
12. The patient has a secondary knee osteoarthritis
13. Permanent patellar dislocation
14. Extra-articular deformity
15. Mechanical axis more than fifteen degrees on varus, neutral or in valgus
Date of first enrolment20/04/2006
Date of final enrolment31/12/2018

Locations

Countries of recruitment

  • Finland

Study participating centre

Helsinki University Central Hospital
Helsinki
FIN-0009
Finland

Sponsor information

Helsinki University Central Hospital (Finland)
Hospital/treatment centre

Surgical Hospital
P.O. Box 263
Helsinki
FIN-00029 HUS
Finland

Website http://www.hus.fi/
ROR logo "ROR" https://ror.org/02e8hzf44

Funders

Funder type

Hospital/treatment centre

Helsingin ja Uudenmaan Sairaanhoitopiiri
Government organisation / Local government
Alternative name(s)
Helsinki University Central Hospital, HUS
Location
Finland
Orion-Farmos Research Foundation (Finland)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Editorial Notes

18/03/2016: Plain English summary added.