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Trial registered on ANZCTR
Registration number
ACTRN12613000240741
Ethics application status
Approved
Date submitted
25/02/2013
Date registered
28/02/2013
Date last updated
28/02/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Prevention of Deep Vein Thrombosis (DVT) in Patients undergoing Total Knee Replacement (TKR)Surgery with Low Molecular Weight Heparin (LMWH) or outpatient Calf Compression Device (CCD) after a short course of LMWH: a randomized prospective study
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Scientific title
Prevention of Deep Vein Thrombosis (DVT) in Patients undergoing Total Knee Replacement (TKR)Surgery
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Secondary ID [1]
281982
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nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Deep Venous Thrombosis
288411
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Condition category
Condition code
Blood
288762
288762
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0
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Clotting disorders
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Blood
288809
288809
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0
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Haematological diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The usual practice of low molecular heparin therapy after orthopedic surgery to reduce risk of DVT and PE remains controversial in terms of length of therapy. This study is aimed at answering this question by reducing the length of therapy from 2 weeks to 1 week, without compromising safety in terms of increasing risk of clotting complications. The usual therapy involves enoxaparim 0.5 mg/kg,daily, commencing 8-12 hours post op, given subcutaneously. The only difference between the study groups was the length of the therapy but given daily.
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Intervention code [1]
286597
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Treatment: Drugs
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Comparator / control treatment
Standard therapy (Control, 2 weeks of low molecular heparin) vs study group (1week of low molecular heparin), given daily, subcutaneously.
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
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No difference between the two groups in terms of clotting episodes post operation, with a 3 month follow up
Method of assessment includes post operative day 5, venous doppler study of the treated limb as well as clinical assessments. In case of an abnormal venous doppler study indicating DVT, then pulmonary CT angiogram was performed to assess any PE.
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Assessment method [1]
288950
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Timepoint [1]
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Patients recruited over a 2 year period and followed up for 3 months and in case of any complications, 12 months, post op
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Secondary outcome [1]
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Leg swelling and pain;
Assessed using pain score charts and calf measurements
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Assessment method [1]
301421
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Timepoint [1]
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total of 3 months of followup post op if no complications. In case of any complications then12 months of follow up.
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Secondary outcome [2]
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hospital length of stay;
Using Date of admission and date of discharge and in case of readmission required, added to the total days of hospitalisation
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Assessment method [2]
301466
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Timepoint [2]
301466
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Total of 3 months of followup
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Secondary outcome [3]
301467
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Wound infection
Using temperature charts, clinical assessment of wound and any concerns full blood count and CRP readings.
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Assessment method [3]
301467
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Timepoint [3]
301467
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Total of 3 months of followup
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Eligibility
Key inclusion criteria
age 18-90
no personal/family hx thrombophilia
BMI <35
english speaking
no anti-coagulation for other reasons
no acute clotting problem
undergoing elective total knee replacement surgery
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Minimum age
18
Years
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Maximum age
90
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
age <18, >90
BMI >35
known history of thrombophilia
already on anti-coagulation
active malignancy or bleeding disorders
unfit to undergo surgical procedure (TKR)
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
participants invited by questionnaire. Those eligible and willing consented. Upon arrival for their operation, allocated (by randomised computer allocation) to a treatment group (standard therapy LMWH or short course LMWH therapy). Clinicians then went ahead and treated patients based on their allocation to a particular treatment group.
The trial coordinator was the person who determined if the patient was eligible for inclusion in the trial and was unaware, when this decision was made, to which group the subject would be allocated. It was allocated by randomisation by computer ( computerised sequence generation)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
computer matching for randomisation (computerised sequence generation)
blinding of patients and clinicians prior to treatment group allocation.
Stratified allocation was not deemed necessaty for this study.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Fisher's exact tests
acceptable group treatment difference of 15% based on previous literature to calculate CI 95%
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
28/12/2011
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
670
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St George Private Hospital - Kogarah
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Recruitment hospital [2]
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Figtree Private Hospital - Figtree
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Recruitment postcode(s) [1]
6407
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2217 - Kogarah
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Recruitment postcode(s) [2]
6408
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2500 - Wollongong
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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A/Prof. Raj Ramakrishna
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Address [1]
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1 Derby Street,
Kogarah, NSW
2217
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Country [1]
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Australia
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Primary sponsor type
Other
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Name
Southern Sydney Hematology
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Address
1 Derby Street,
Kogarah, NSW
2217
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
285586
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Country [1]
285586
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Australia
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Other collaborator category [1]
277304
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Other Collaborative groups
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Name [1]
277304
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Southern Haematology Cancer Research Institute
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Address [1]
277304
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35 Denison Street
Wollongong NSW 2500
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Country [1]
277304
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288862
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Human Rights and Ethics committe
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Ethics committee address [1]
288862
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SEHHREC St.George Public hospital Belgrave street Kogarah NSW 2217
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Ethics committee country [1]
288862
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Australia
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Date submitted for ethics approval [1]
288862
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Approval date [1]
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23/11/2004
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Ethics approval number [1]
288862
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04/64 (SEHHREC)
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Summary
Brief summary
This study hypothesises that shorter duration low molecular weight therpay is as effective as standard therapy in post operative orthopaedic DVT prophylaxis. There will be no significant difference in the incidence of post operative thrombotic events such as DVTs and PE. There mat be added advantages of reduced leg swelling and hence pain with the use of mobile calf compressor device as an outpatient.
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Trial website
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Trial related presentations / publications
There are various published data on the use of a shorter course of LMWH but there are no uniform guidelines developed as the evidence generated lacked clarity. This prompted this study which also aimed at assessing the use of post op outpatient calf compressor to reduce leg swelling and hence pain and improve mobility.
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Raj Ramakrishna
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Address
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1 Derby Street
Kogarah
NSW
2217
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Country
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Australia
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Phone
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+61-2 9553 1272
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Sarika Gupta
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Address
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1 Derby Street
Kogarah
NSW
2217
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Country
37971
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Australia
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Phone
37971
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+61-2 9553 1272
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Fax
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Email
37971
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[email protected]
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Contact person for scientific queries
Name
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Raj Ramakrishna
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Address
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1 Derby Street
Kogarah
NSW
2217
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Country
37972
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Australia
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Phone
37972
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+61-2 9553 1272
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Fax
37972
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Email
37972
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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