NCT02420951

Brief Summary

The purpose of this study is to determine if an additional injection of local anesthetic immediately prior to removal of the local anesthetic infiltration catheter on postoperative day one is effective in increasing pain reduction, patient satisfaction or outcome measures following total knee replacement (TKR). It is hypothesized that an additional injection of 30ml of .5% bupivacaine solution immediately before infiltration catheter removal will provide pain reduction, patient satisfaction and outcome measures equal or superior to catheter removal with no additional injection. Patients who are undergoing unilateral total knee replacement (TKR) and choose to participate will be randomly assigned to a treatment group.Patients in group one (treatment group) will receive a 30ml dose of .5% bupivacaine solution injected into the local anesthetic infiltration catheter immediately prior to its removal on postoperative day one. Patients in group two (control group) will receive no additional medication during local anesthetic infiltration catheter removal.

Trial Health

100
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
50

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started Oct 2015

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 28, 2015

Completed
3 months until next milestone

First Posted

Study publicly available on registry

April 20, 2015

Completed
6 months until next milestone

Study Start

First participant enrolled

October 5, 2015

Completed
6 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 22, 2016

Completed
9 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 9, 2016

Completed
4 months until next milestone

Results Posted

Study results publicly available

March 31, 2017

Completed
Last Updated

January 12, 2018

Status Verified

December 1, 2017

Enrollment Period

6 months

First QC Date

January 28, 2015

Results QC Date

January 30, 2017

Last Update Submit

December 14, 2017

Conditions

Keywords

KneeArthroplastyBupivacaineAnesthetics, Local

Outcome Measures

Primary Outcomes (1)

  • Pain Assessed Using the VAS 0-10 Pain Scale

    Pain will be assessed using the VAS 0-10 pain scale. 0 is no pain and 10 in worst imaginable pain.

    7 days

Secondary Outcomes (5)

  • Pain Med Consumption Assessed Using Questionnaire/Hospital Records

    2 days

  • Pain Med Consumption Assessed Using Questionnaire/Hospital Records

    7 days

  • Swelling Measured Using a Perometer

    7 days

  • Proprioception Measured Using a SD Balancer

    7 days

  • Quadriceps Strength Measured Using a Biodex Handheld Dynamometer"

    7 days

Study Arms (2)

Injection

EXPERIMENTAL

Will receive injection of 30ml of .5% bupivacaine solution prior to catheter removal

Drug: Bupivacaine

No Injection

ACTIVE COMPARATOR

Will not receive injection of bupivacaine prior to catheter removal

Other: No Intervention

Interventions

Injection of local anesthetic immediately prior to catheter removal, 24 hours postop.

Also known as: marcaine
Injection

No injection of local anesthetic immediately prior to catheter removal, 24 hours postop.

No Injection

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • At least 18 years of age
  • Undergoing unilateral knee replacement
  • If female, not pregnant
  • Agree to participate in the follow-up appointment
  • Understand and sign the informed consent form

You may not qualify if:

  • Bilateral TKA planned
  • Use of narcotic medication before surgery
  • Any other surgery within the three months prior to TKR
  • Inflammatory arthritis
  • Any chronic pain conditions or problems, including but not limited to chronic back pain, fibromyalgia or multiple sclerosis
  • Osteoarthritis of the non-operative knee
  • Osteoarthritis of one or both hips

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (5)

  • Chaumeron A, Audy D, Drolet P, Lavigne M, Vendittoli PA. Periarticular injection in knee arthroplasty improves quadriceps function. Clin Orthop Relat Res. 2013 Jul;471(7):2284-95. doi: 10.1007/s11999-013-2928-4. Epub 2013 Mar 21.

    PMID: 23516031BACKGROUND
  • Barrington JW, Halaszynski TM, Sinatra RS, Expert Working Group On Anesthesia And Orthopaedics Critical Issues In Hip And Knee Replacement Arthroplasty FT. Perioperative pain management in hip and knee replacement surgery. Am J Orthop (Belle Mead NJ). 2014 Apr;43(4 Suppl):S1-S16.

    PMID: 24911869BACKGROUND
  • Teng Y, Jiang J, Chen S, Zhao L, Cui Z, Khan MS, Du W, Gao X, Wang J, Xia Y. Periarticular multimodal drug injection in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1949-57. doi: 10.1007/s00167-013-2566-0. Epub 2013 Jun 20.

    PMID: 23783531BACKGROUND
  • Jiang J, Teng Y, Fan Z, Khan MS, Cui Z, Xia Y. The efficacy of periarticular multimodal drug injection for postoperative pain management in total knee or hip arthroplasty. J Arthroplasty. 2013 Dec;28(10):1882-7. doi: 10.1016/j.arth.2013.06.031. Epub 2013 Aug 1.

    PMID: 23910819BACKGROUND
  • National Center for Health Statistics. National Hospital Discharge Survey, 2010. Hyattsville, Maryland: Public Health Service. 2010.

    BACKGROUND

MeSH Terms

Conditions

Pain

Interventions

Bupivacaine

Condition Hierarchy (Ancestors)

Neurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

AnilidesAmidesOrganic ChemicalsAniline CompoundsAmines

Results Point of Contact

Title
Dr. Wolfgang Fitz
Organization
Brigham and Women's Hospital

Study Officials

  • Wolfgang Fitz, MD

    Brigham and Women's Hospital

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
No
Restrictive Agreement
No

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: We randomized 50 patients undergoing TKA at one institution into two groups. Group 1, 25 patients, received a postoperative intra-articular catheter in combination with injection of 30 ml of 0.5% Marcaine the day after surgery before removal. Group 2, 25 patients, received no pain catheter. Both groups received intraoperative pericapsular injection and postoperative pain medication. We measured pain scores using the Visual Analog Scale (VAS) and recorded narcotic medication consumption in morphine milligram equivalents (mgs).
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Orthopedic Surgeon

Study Record Dates

First Submitted

January 28, 2015

First Posted

April 20, 2015

Study Start

October 5, 2015

Primary Completion

March 22, 2016

Study Completion

December 9, 2016

Last Updated

January 12, 2018

Results First Posted

March 31, 2017

Record last verified: 2017-12

Data Sharing

IPD Sharing
Will not share