ARTHROPLASTY, REPLACEMENTPhase 1/2PACENCT02728661
Patient-Centered Weight Loss Program for Knee Replacement Patients
A Phase 1/2 study testing PACE and Delayed PACE in people with ARTHROPLASTY, REPLACEMENT, run by Northwestern University at 1 site in United States.
Trial summary
PACE is a patient-centered weight loss program that was developed specifically for knee replacements based on input from stakeholders, including knee replacement patients, physical therapists, and orthopedic surgeons. Read more about this study
- Who is it for?
- Ages 40 to 79 years
- Conditions the study is for
- ARTHROPLASTY, REPLACEMENT
- What is being tested?
- PACE and Delayed PACE
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 16 participants
- Where
- 1 siteUnited States
- Study dates
- May 2016to Jun 2017
- Phase
- Phase 1/2
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 40 to 79 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- BMI between 25-45 kg/m2
- Have a scheduled knee replacement at least 1 week away from baseline assessment
- Obtain physician approval to participate
- English speaking
- willing to attend 3 in-person assessments.
Who cannot join
- Have any contraindications to diet or weight loss
- Undergoing simultaneous bilateral knee replacement or have a scheduled or anticipated knee replacement for the contralateral knee in the next 26 weeks
- Have a mobility limiting comorbidity besides relating to TKR
- Taking anti-obesity medications
- Enrolled in a formal weight loss program
- Have had or is planning to have bariatric/gastric/lapband surgery
- Is planning to relocate out of the Chicago land area in the next 12 months.
Trial locations and contacts
1 site in 1 country.
About this study
PACE is a patient-centered weight loss program that was developed specifically for knee replacements based on input from stakeholders, including knee replacement patients, physical therapists, and orthopedic surgeons. In this pilot study, participants undergoing knee replacement will be randomized to either start a weight loss program before surgery (PACE) or after surgery (Delayed PACE). Both programs will receive a 14-week intervention and complete assessments at baseline (up to 6 weeks prior to surgery), 12 weeks after surgery, and 26 weeks after surgery.
Read the detailed description
It is estimated that half of patients diagnosed with knee osteoarthritis (OA) will need a total knee replacement (TKR) during their lifetime. Of patients who need a TKR, 80-95% are overweight or obese. While patients are encouraged to lose weight, limited, if any, guidance is provided to achieve recommended weight loss. Many patients perceive that TKR is a necessary precursor for the initiation of weight loss. Yet, 66% of patients actually gain weight by 2 years after surgery. Patients undergoing TKR not only face unique barriers (i.e., pain, mobility limitations, motivation) to weight loss, but also have to balance pre- and post-operative concerns from physicians, surgeons, and rehabilitation specialists. To best accommodate the needs of both patients (pre- and post-TKR) and healthcare professionals (i.e., surgeon, physical therapist), patient and stakeholder engagement and activation is imperative in the development of a patient-centered weight loss intervention. Investigators completed 20 interviews with patients pre- and post-TKR and identified weight loss barriers, preferred intervention components (e.g., delivery method, contact frequency, self-monitoring modality) and patient-reported outcomes (e.g., physical function, pain) viewed as critical by patients. Investigators developed a patient-centered weight loss program (PACE) guided by these results and additional input from stakeholders to meet the needs of patients and healthcare professionals. PACE is a randomized pilot study comparing weight loss and patient-reported outcomes between PACE (program starting up to 6 weeks pre-TKR to 12 weeks post-TKR) and Delayed PACE (program starting 12 weeks post-TKR to 26 weeks post-TKR).
- Conditions
- ARTHROPLASTY, REPLACEMENT
- Being tested
- PACE, Delayed PACE
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PACEBehavioural
PACE is an 14 week behavioral weight loss intervention developed specifically for knee replacement patients that starts up to 6 weeks prior to surgery.
Delayed PACEBehavioural
Delayed PACE is an 14 week behavioral weight loss intervention developed specifically for knee replacement patients that starts 12 weeks after surgery.
| Study group | Role | What they receive |
|---|---|---|
| PACE | Experimental | PACE participants will begin up to 6 weeks prior to their scheduled TKR and continue until 12 weeks after their TKR. Participants will be given personalized weight, dietary, and physical activity goals. Participants will be encouraged to monitor their dietary intake and physical activity using their preferred method of self-monitoring. Participants will have regular contact with their coaches either in-person or over the telephone on a weekly or bi-weekly basis, based on preference during the first 14 weeks (from up to 6 weeks pre-op to 12 weeks post-op). Further, participants may opt to receive regular text messages or emails from coaches if they prefer. At 12 weeks, PACE participants will enter a maintenance period and not have any contact with coaches. Receives: Behavioral: PACE |
| Delayed PACE | Experimental | After being notified of their randomized condition at baseline (up to 6 weeks prior to surgery), Delayed PACE participants will not have contact with coaches until 12 weeks after surgery. At 12 weeks after surgery, Delayed PACE participants will be given personalized weight, dietary, and physical activity goals. Participants will be encouraged to monitor their dietary intake and physical activity using their preferred method of self-monitoring. Participants will have regular contact with their coaches either in-person or over the telephone on a weekly or bi-weekly basis, based on preference during the first 14 weeks. Further, participants may opt to receive regular text messages or emails from coaches if they prefer. Receives: Behavioral: Delayed PACE |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in weight measured with a balance-beam scale
Measured: Change from baseline to 12 and 26 weeks
Secondary outcomes (2)
Change in physical function assessed by the timed up and go
Measured: Change from baseline to 12 and 26 weeks
Change in pain measured by WOMAC
Measured: Change from baseline to 12 and 26 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Apr 2016 (estimated)
- Study startMay 2016
- Primary completionJun 2017
- Study completionJun 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for ARTHROPLASTY, REPLACEMENTStudies of the same condition, open and under way.
- More trials run by Northwestern UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1/2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 16 participants (actual)
Sponsor and investigators
- Lead sponsor
- Northwestern University
- Sponsor type
- University, hospital or other
- Collaborators
- Agency for Healthcare Research and Quality (AHRQ)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02728661
- Sponsor's protocol ID
- K12HS023011
- Acronym
- PACE
- Status last verified
- Oct 2023
- First submitted
- 29 Mar 2016
- Last updated
- 26 Oct 2023
- Results posted
- No
- Data monitoring committee
- Yes
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 26 Oct 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Patient-Centered Weight Loss Program for Knee Replacement Patients
- ClinicalTrials.gov ID
- NCT02728661
- Acronym / sponsor ID
- PACE / K12HS023011
- Conditions
- ARTHROPLASTY, REPLACEMENT
- Phase
- Phase 1/2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 16 participants (actual)
- Lead sponsor
- Northwestern UniversityUniversity, hospital or other
- Collaborators
- Agency for Healthcare Research and Quality (AHRQ)
- Study start
- May 2016
- Primary completion
- Jun 2017 (actual)
- Study completion
- Jun 2017 (actual)
- First posted
- 5 Apr 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
PACE is a patient-centered weight loss program that was developed specifically for knee replacements based on input from stakeholders, including knee replacement patients, physical therapists, and orthopedic surgeons. In this pilot study, participants undergoing knee replacement will be randomized to either start a weight loss program before surgery (PACE) or after surgery (Delayed PACE). Both programs will receive a 14-week intervention and complete assessments at baseline (up to 6 weeks prior to surgery), 12 weeks after surgery, and 26 weeks after surgery.
Detailed description
It is estimated that half of patients diagnosed with knee osteoarthritis (OA) will need a total knee replacement (TKR) during their lifetime. Of patients who need a TKR, 80-95% are overweight or obese. While patients are encouraged to lose weight, limited, if any, guidance is provided to achieve recommended weight loss. Many patients perceive that TKR is a necessary precursor for the initiation of weight loss. Yet, 66% of patients actually gain weight by 2 years after surgery. Patients undergoing TKR not only face unique barriers (i.e., pain, mobility limitations, motivation) to weight loss, but also have to balance pre- and post-operative concerns from physicians, surgeons, and rehabilitation specialists. To best accommodate the needs of both patients (pre- and post-TKR) and healthcare professionals (i.e., surgeon, physical therapist), patient and stakeholder engagement and activation is imperative in the development of a patient-centered weight loss intervention. Investigators completed 20 interviews with patients pre- and post-TKR and identified weight loss barriers, preferred intervention components (e.g., delivery method, contact frequency, self-monitoring modality) and patient-reported outcomes (e.g., physical function, pain) viewed as critical by patients. Investigators developed a patient-centered weight loss program (PACE) guided by these results and additional input from stakeholders to meet the needs of patients and healthcare professionals. PACE is a randomized pilot study comparing weight loss and patient-reported outcomes between PACE (program starting up to 6 weeks pre-TKR to 12 weeks post-TKR) and Delayed PACE (program starting 12 weeks post-TKR to 26 weeks post-TKR).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| PACE | Experimental | Behavioral: PACEPACE participants will begin up to 6 weeks prior to their scheduled TKR and continue until 12 weeks after their TKR. Participants will be given personalized weight, dietary, and physical activity goals. Participants will be encouraged to monitor their dietary intake and physical activity using their preferred method of self-monitoring. Participants will have regular contact with their coaches either in-person or over the telephone on a weekly or bi-weekly basis, based on preference during the first 14 weeks (from up to 6 weeks pre-op to 12 weeks post-op). Further, participants may opt to receive regular text messages or emails from coaches if they prefer. At 12 weeks, PACE participants will enter a maintenance period and not have any contact with coaches. |
| Delayed PACE | Experimental | Behavioral: Delayed PACEAfter being notified of their randomized condition at baseline (up to 6 weeks prior to surgery), Delayed PACE participants will not have contact with coaches until 12 weeks after surgery. At 12 weeks after surgery, Delayed PACE participants will be given personalized weight, dietary, and physical activity goals. Participants will be encouraged to monitor their dietary intake and physical activity using their preferred method of self-monitoring. Participants will have regular contact with their coaches either in-person or over the telephone on a weekly or bi-weekly basis, based on preference during the first 14 weeks. Further, participants may opt to receive regular text messages or emails from coaches if they prefer. |
Who may qualify
- Ages
- 40 to 79 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- BMI between 25-45 kg/m2
- Have a scheduled knee replacement at least 1 week away from baseline assessment
- Obtain physician approval to participate
- English speaking
- willing to attend 3 in-person assessments.
Key exclusion criteria (7 listed)
- Have any contraindications to diet or weight loss
- Undergoing simultaneous bilateral knee replacement or have a scheduled or anticipated knee replacement for the contralateral knee in the next 26 weeks
- Have a mobility limiting comorbidity besides relating to TKR
- Taking anti-obesity medications
- Enrolled in a formal weight loss program
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PACEPACE is an 14 week behavioral weight loss intervention developed specifically for knee replacement patients that starts up to 6 weeks prior to surgery. | Behavioural | PACE |
| Delayed PACEDelayed PACE is an 14 week behavioral weight loss intervention developed specifically for knee replacement patients that starts 12 weeks after surgery. | Behavioural | Delayed PACE |
Primary outcome
Change in weight measured with a balance-beam scale
Time frame: Change from baseline to 12 and 26 weeks
2 secondary outcomes
Change in physical function assessed by the timed up and go
Time frame: Change from baseline to 12 and 26 weeks
Change in pain measured by WOMAC
Time frame: Change from baseline to 12 and 26 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 Oct 2023.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1/2 study testing PACE and Delayed PACE in people with ARTHROPLASTY, REPLACEMENT, run by Northwestern University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 26 Oct 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in weight measured with a balance-beam scale (time frame: Change from baseline to 12 and 26 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Oct 2023.