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Trial registered on ANZCTR
Registration number
ACTRN12622000416796p
Ethics application status
Submitted, not yet approved
Date submitted
25/02/2022
Date registered
11/03/2022
Date last updated
11/03/2022
Date data sharing statement initially provided
11/03/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
RaMeiKin - A Prospective Randomised Control Trial Comparing the Effect of Mechanical and Inverse Kinematic Alignment on Clinical and Function Outcomes after Total Knee Replacement
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Scientific title
A Randomised Study comparing the clinical and functional outcomes of mechanical and inverse kinematic alignment for Total Knee Replacement (RaMeiKin).
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Secondary ID [1]
306515
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None
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Universal Trial Number (UTN)
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Trial acronym
RaMeiKin
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Osteoarthritis of the knee
325383
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Total Knee Replacement
325384
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Condition category
Condition code
Musculoskeletal
322766
322766
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0
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Osteoarthritis
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Surgery
322868
322868
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients will receive their total knee replacement according to inverse kinematic alignment principles. The implant will be aligned using computer navigated surgery.
Kinematic principles position the knee replacement in a way that respects the natural joint line and rotational axis of the knee. Each surgery will take approximately 2 hours. The surgeons performing the surgeries have a be fellowship trained in knee arthroplasty. Post-operative alignment will be confirmed using CT and long-leg radiographs
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Intervention code [1]
322942
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Treatment: Devices
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Intervention code [2]
323015
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Treatment: Surgery
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Comparator / control treatment
Patients who have been randomised to this group will have their knee replacement aligned using the mechanical alignment philosophy. This is the more traditional way and places the implant perpendicular to the mechanical axis. This group will also receive the same implant (Genus Knee) as the KA group. The length of surgery will be the similar as those randomised to the intervention (KA) group. This group will also have their alignment confirmed using post-operative CT and radiographs
Eligible patients who are unwilling to be included in the randomised arm of the study will be invited to participate in the observational arm of usual practice. This group will be given either mechanical or kinematic alignment, depending on the surgeon's preference. They will be assessed at their 6 week follow-up for complications and then at 6, 12 and 24 months post surgery. These participants recieving online questionnaires taking approx. 30 minutes in total.
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Control group
Active
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Outcomes
Primary outcome [1]
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Patient Reported Outcome measured using the Oxford Knee Score
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Assessment method [1]
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Timepoint [1]
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Baseline, and 6, 12 ,and 24 months (primary endpoint) post-surgery
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Primary outcome [2]
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Satisfaction Visual Analogue Score (VAS)
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Assessment method [2]
330570
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Timepoint [2]
330570
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Baseline, and 6, 12 ,and 24 months (primary endpoint) post-surgery
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Secondary outcome [1]
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Joint awareness as measure by the Forgotten Joint Score (FJS)
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Assessment method [1]
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Timepoint [1]
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Baseline, and 6, 12, and 24 months post-surgery
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Secondary outcome [2]
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2D-3D image registration derived 6-degree-of-freedom kinematics during kneeling
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Assessment method [2]
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Timepoint [2]
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Baseline, 12 and 24 months post-surgery
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Secondary outcome [3]
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2D-3D image registration derived 6-degree-of-freedom kinematics during stair ascent
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Assessment method [3]
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Timepoint [3]
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baseline, 12 months, 24 months post-surgery
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Secondary outcome [4]
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Knee biomechanics capture by marker-based motion capture
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Assessment method [4]
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Timepoint [4]
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baseline, 12 months, and 24 months post-surgery
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Eligibility
Key inclusion criteria
Independently mobile
Osteoarthritis
On surgical waiting list for a primary total knee replacement
Available for follow up at 6 weeks, 6, 12 and 24 months
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Minimum age
18
Years
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Maximum age
No limit
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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
Patient unable to provide consent (due to reduced cognitive capacity or lack of English proficiency).
Previous neurological or musculoskeletal condition (excluding knee injury) which has affected physical performance.
Patients who have had significant prior surgery or trauma to the affected knee (e.g. prior High Tibial Osteotomy, periarticular fracture, recurrent patella dislocation)
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Study design
Purpose of the study
Treatment
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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)
Central randomisation by computer (RedCap). Participants will be blinded to their randomisation group. The surgeon will be unblinded.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated Permuted block randomisation
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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
Other
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Other design features
Participants will be randomised to either the intervention (KA) or control (MA) group. Participants who decline to be randomised will be allocated to an oberservational group (i.e. standard care)
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/04/2022
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Actual
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Date of last participant enrolment
Anticipated
1/04/2024
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Actual
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Date of last data collection
Anticipated
1/04/2026
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Actual
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Sample size
Target
440
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,NSW
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Funding & Sponsors
Funding source category [1]
310860
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Commercial sector/Industry
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Name [1]
310860
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Adler Orthopaedics
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Address [1]
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Unit 2/61 Southgate Ave
Cannon Hill QLD, 4160
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Country [1]
310860
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Australia
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Primary sponsor type
Hospital
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Name
Trauma and Orthopaedic Research Unit, Canberra Health Services
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Address
Building 6, Level 1
The Canberra Hospital
Garran, ACT, 2605
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Country
Australia
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Secondary sponsor category [1]
312117
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Commercial sector/Industry
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Name [1]
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Adler Orthopaedics
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Address [1]
312117
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Unit 2/61 Southgate Ave
Cannon Hill QLD, 4160
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Country [1]
312117
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Australia
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
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ACT Health Human Research Ethics Committee
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Ethics committee address [1]
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The Canberra Hospital Yamba Dr Garran, ACT, 2605
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Ethics committee country [1]
310422
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Australia
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Date submitted for ethics approval [1]
310422
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04/01/2022
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Approval date [1]
310422
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Ethics approval number [1]
310422
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Summary
Brief summary
This study is a prospective, randomized, longitudinal study of the clinical and biomechanical outcomes of osteoarthritis patients treated by two different alignment philosophies for total knee replacement. All patients will be treated with the same knee system, implanted using nagivated assisted technology. We hypothosize that Inverse Kinematic alignment (iKA) will result in better Oxford Knee score (OKS) and satisfaction visual analogue scale (VAS) score compared to mechanical alignment (MA).
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Paul Smith
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Address
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The Trauma and Orthopaedic Research Unit
Building 6 Level 1
The Canberra Hospital
Yamba Drive
Garran, ACT, 2605
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Country
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Australia
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Phone
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+61 02 6221 9327
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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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Joe Lynch
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Address
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The Trauma and Orthopaedic Research Unit
Building 6 Level 1
The Canberra Hospital
Yamba Drive
Garran, ACT, 2605
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Country
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Australia
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Phone
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+61 02 5124 3873
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Joe Lynch
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Address
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The Trauma and Orthopaedic Research Unit
Building 6 Level 1
The Canberra Hospital
Yamba Drive
Garran, ACT, 2605
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Country
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Australia
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Phone
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+61 02 5124 3873
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Fax
117612
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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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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