NCT04199780

Brief Summary

The purpose of this study is to determine whether a new medical technology can help reduce post-operative total knee or hip pain when combined with a Cognitive-Behavioral intervention (CBI). This new medical technology, is called transcranial direct current stimulation (tDCS), it uses a very small amount of electricity to temporarily stimulate specific areas of the brain thought to be involved in pain reduction. The electrical current passes through the skin, scalp, hair, and skull and requires no additional medication, sedation, or needles. This study will investigate the effects of tDCS, the Cognitive-Behavioral (CB) intervention and their combination on pain among veterans following total knee arthroplasty (TKA) or total hip arthroplasty (THA). The Veteran may benefit in the form of decreased pain and opioid requirements following knee or hip replacement surgery. However, benefit is only likely if Veterans are randomized to one of the 3 (out of 4) groups. This study hopes to determine the effects of these interventions and combined effect on post-operative pain, opioid use and functioning during the 48-hour post-operative period following a total knee or hip replacement.

Trial Health

57
Monitor

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
132

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Jan 2021

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

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

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

December 6, 2019

Completed
10 days until next milestone

First Posted

Study publicly available on registry

December 16, 2019

Completed
1.1 years until next milestone

Study Start

First participant enrolled

January 11, 2021

Completed
5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2026

Completed
7 months until next milestone

Study Completion

Last participant's last visit for all outcomes

July 31, 2026

Completed
Last Updated

July 30, 2025

Status Verified

July 1, 2025

Enrollment Period

5 years

First QC Date

December 6, 2019

Last Update Submit

July 25, 2025

Conditions

Keywords

total knee arthroplastypainpostsurgical painopioidtranscranial direct current stimulationtDCSbrain stimulationtotal hip arthroplastyTKATHA

Outcome Measures

Primary Outcomes (1)

  • postoperative opioid pain medication use

    Patient controlled analgesic medication usage (the morphine equivalent dose (MED); mg of morphine) during the acute 48-hour post-operative period following total knee arthroplasty (TKA) or total hip arthroplasty (THA).

    48 hours

Secondary Outcomes (3)

  • Long term outcomes of patient reported pain ratings

    1 month

  • Long term outcomes of patient reported pain ratings

    3 months

  • Long term outcomes of patient reported pain ratings

    6 months

Study Arms (4)

Group 1- real tDCS and real CBI

EXPERIMENTAL

4 active treatments of tDCS and active cognitive behavioral intervention (CBI)

Device: Transcranial Direct Current StimulationBehavioral: Cognitive-Behavioral (CB) intervention

Group 2- real tDCS and sham CBI

EXPERIMENTAL

4 active treatments of tDCS and education-only-control cognitive intervention

Device: Transcranial Direct Current StimulationBehavioral: Cognitive-Behavioral (CB) intervention

Group 3- sham tDCS and real CBI

EXPERIMENTAL

4 sham treatments of tDCS and active cognitive behavioral intervention (CBI)

Device: Transcranial Direct Current StimulationBehavioral: Cognitive-Behavioral (CB) intervention

Group 4- sham tDCS and sham CBI

SHAM COMPARATOR

4 sham treatments of tDCS and education-only-control cognitive intervention

Device: Transcranial Direct Current StimulationBehavioral: Cognitive-Behavioral (CB) intervention

Interventions

Transcranial direct current stimulation (tDCS), stimulates specific areas of the brain via electric current passed through electrodes placed on the scalp. During tDCS, low amplitude direct currents penetrates the skull to enter the brain and modulates neuronal activity.

Also known as: tDCS
Group 1- real tDCS and real CBIGroup 2- real tDCS and sham CBIGroup 3- sham tDCS and real CBIGroup 4- sham tDCS and sham CBI

CBI generally consist of cognitive coping strategies (e.g., distraction, relabeling, reducing pain-catastrophizing) and self-management (e.g., relaxation strategies, guided imagery) designed to enhance perceived control and reduce sympathetic nervous system tone.

Also known as: CBI
Group 1- real tDCS and real CBIGroup 2- real tDCS and sham CBIGroup 3- sham tDCS and real CBIGroup 4- sham tDCS and sham CBI

Eligibility Criteria

Age18 Years - 90 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Participants will be 120 patients (132 recruited to account for 10% drop-out rate) undergoing TKA or THA surgery at the Ralph H. Johnson VAMC in Charleston SC.
  • Mentally capable of reading, writing, giving consent, and following instructions
  • Cleared for, and scheduled for unilateral TKA or THA surgery
  • Able to hear CB intervention and understand educational materials through headphones in English

You may not qualify if:

  • implanted medical devices above the waist
  • pregnant
  • history of seizures
  • allergic to latex rubber
  • psychiatric conditions except for depression and/or anxiety disorders (commonly seen in this population).

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Ralph H. Johnson VA Medical Center, Charleston, SC

Charleston, South Carolina, 29401-5703, United States

RECRUITING

MeSH Terms

Conditions

Pain, PostoperativePain

Interventions

Transcranial Direct Current StimulationMethods

Condition Hierarchy (Ancestors)

Postoperative ComplicationsPathologic ProcessesPathological Conditions, Signs and SymptomsNeurologic ManifestationsSigns and Symptoms

Intervention Hierarchy (Ancestors)

Electric Stimulation TherapyTherapeuticsConvulsive TherapyPsychiatric Somatic TherapiesBehavioral Disciplines and ActivitiesElectroshockPsychological TechniquesInvestigative Techniques

Study Officials

  • Jeffrey J Borckardt, PhD

    Ralph H. Johnson VA Medical Center, Charleston, SC

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Jeffrey J Borckardt, PhD

CONTACT

Donald (Hugh) L Myrick, MD BS

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
FACTORIAL
Sponsor Type
FED
Responsible Party
SPONSOR

Study Record Dates

First Submitted

December 6, 2019

First Posted

December 16, 2019

Study Start

January 11, 2021

Primary Completion

January 1, 2026

Study Completion

July 31, 2026

Last Updated

July 30, 2025

Record last verified: 2025-07

Data Sharing

IPD Sharing
Will not share

Locations