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Orthopedic ProcedureNCT03028779

Implementation of Fast-track Surgery Program for Total Hip and Knee Replacement and the Evaluation of the Risks and Benefits for the Patient

A study testing Fast-track Total Hip and knee arthroplasty in people with Orthopedic Procedure, run by Maisonneuve-Rosemont Hospital at 1 site in Canada.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Implementation of Fast-track surgery for total hip replacement and total knee replacement and evaluation of the risks and benefits for the patients. Read more about this study

Who is it for?
Ages 18 to 75 yearsHealthy volunteers can take part
Conditions the study is for
Orthopedic Procedure
What is being tested?
Fast-track Total Hip and knee arthroplasty
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
150 participants
Where
1 siteCanada
Study dates
Nov 2016to Sep 2025
Phase
Interventional
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 18 to 75 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Patient understanding the conditions of the study and ready to participate for the duration of the study
  • Patient able to give their informed consent
  • Aged between 18 and 75 years
  • Patient needing a primary total hip or knee replacement (not associated with unusual treatment such as bone graft, osteotomy, revision implant, etc.
  • The patient as a family member or a companion available the day of the pre-op evaluation, the day of surgery and at home after the surgery for a week fallowing the surgery
  • Women in age to procreate have to accept to add another contraception method one month fallowing the intake of Emend/ Aprepitant received pre-surgery.

Who cannot join

  • Living further than 50 Km from Maisonneuve-Rosemont Hospital
  • Lack of services offered by the CLSC (home health care services) in their area
  • BMI over 40
  • Psychiatric desease limiting the participation in the study
  • Pregnancy
  • The need of long therm urinary foley post-op
Show all 19Show fewer
  • Allergies to sulfinamide or to the other medications intended in the protocol
  • Presenting a cognitive impairment or a communication problem preventing the realisation of the protocol
  • The patient has had a pulmonary embolism or veinous thromboembolism in the past year
  • Necessitating a long therm anticoagulation therapy
  • Under corticotherapy or has received a systemic corticotherapy in the past year (unless a positive confirmation of a cortrosyn test done before the surgery)
  • Subject with a systemic involvement(diabetic, cardiac, renal, hematologic, etc.) necessitating special perisurgical care (intensive care unit, multiples transfusions, dialysis, etc.)
  • Inflammatory or tumoral joint disease ( rheumatoid arthritis, lupus, etc.)
  • Subject presenting a coagulation problem increasing their bleeding risk per and post surgery (ie : thrombocytopenia, hemophilia, etc.)
  • Subject presenting a locomotion problem ,other then to the joint to be replaced, enforcing functional limitations keeping them from mobilizing without technical or physical aid
  • Presenting neurological or balance disorder
  • Having a living space incompatible with post-surgery home care
  • Under treatment with a medication substrate or strong inhibitor of CYP3A4
  • Subject with Clcr < 30 ml/min ( Cockcroft-Gault formula)

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • Hôpital Maisonneuve-Rosemont

    Montreal, Quebec, H1T 2M4

Other trials in Canada

About this study

Implementation of Fast-track surgery for total hip replacement and total knee replacement and evaluation of the risks and benefits for the patients.

Read the detailed description

The primary goal of the study is to evaluate the risk and the possible implementation of the project of the total knee (TKR) or hip (THR) replacement in a fast track setting. The specifics features of such a study are to introduce intervention modalities and care rapidly to minimize and prevent all known complications associated with THR or TKR.

Following a total hip replacement (THR), the length of stay is usually 1 to 3 days and 3 to 5 days for a total knee replacement (TKR). The investigators have developed a new protocol with intensive care giving the possibility to return home in less than 24 hours and want to evaluate the feasibility and security of such a protocol.

To evaluate the security and feasibility of this protocol the investigators want to recruit 150 participants who will agree to enroll in this study.The investigators will evaluate these variables; number of complications occuring within the 12 months fallowing the surgery, number of readmission post-surgery, pain control efficiency, number of blood transfusion needed, length of wound spread, patient satisfaction and the cost of the program implementation. The investigators want to identify the success and failure factors to optimise the program afterwards.

In order to achieve the evaluation, the investigators will compare the data obtain from the 150 patients to the data retrieved in the medical files of the patients that already had the same usual intervention in the past, with the standard length of stay.

Being tested
Fast-track Total Hip and knee arthroplasty
Keywords
Outpatient,fast-track, arthroplasty, Total knee arthroplasty (TKA), Total hip Arthroplasty (THA)

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Fast-track Total Hip and knee arthroplastyProcedure or surgery

    To be able to do a total knee or hip arthroplasty and return the patient home in less then 24 hours

Study groups in NCT03028779
Study groupRoleWhat they receive
Fast-track total hip or knee arthroplastyExperimentalBe able to return patient home on the same day of a total hip or knee surgery.
Receives: Procedure: Fast-track Total Hip and knee arthroplasty

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of participants with adverse events

    All complications related with the surgery from pre-surgery to 1 year after the surgery:

    -Adverse events classification using (Clavien-Dindo Scale) Complication meaning the number of : blood loss/transfusion, wound infection, pain control, dressing problems, leg discrepancy, falls, unexpected fallow up phone calls to the assistant, hospital readmission after discharge, neurological impairment (example; drop foot), range of motion impairment following surgery.

    Measured: 1 year

Secondary outcomes (72)
  1. The cost of the outpatient procedure evaluation for the TKR or THR

    Estimation of the surgery costs and post surgery costs will be evaluated (procedure, surgery time, medication, lab test etc...) Costs for the hospital such as the cost for the surgery and their complications Costs outside the hospital such as the medication and the cost associated with the lost of productivity Lost of productivity; Work Productivity and Activity Impairment test (WPAI)

    Measured: 1 year

  2. Health outcome before surgery at medical evaluation

    EQ 5D health questionnaire

    Measured: before surgery at medical evaluation up to 3 months before surgery

  3. Health outcome 6 months after surgery

    EQ 5D health questionnaire

    Measured: 6 months after surgery

  4. Patient sex

    Patient sex; men or women Surgery date: (yyyy/mm/dd) Name of the surgeon Height in meters weight in kg BMI in kg/m2 Health and medical history Physical status score (ASA)

    Measured: up to 3 month before surgery

  5. Patient date of birth

    Patient date of birth Surgery date: (yyyy/mm/dd) Name of the surgeon Height in meters weight in kg BMI in kg/m2 Health and medical history Physical status score (ASA)

    Measured: up to 3 months before surgery

  6. Surgery Date

    Surgery date (yyyy/mm/dd) Name of the surgeon Height in meters weight in kg BMI in kg/m2 Health and medical history Physical status score (ASA)

    Measured: Day of surgery

  7. Name of surgeon

    Name of the surgeon

    Measured: Day of surgery

  8. BMI

    BMI in kg/m2

    Measured: up to 3 months before surgery

  9. Health and medical history

    Health and medical history

    Measured: up to 3 months before surgery

  10. Physical status score (ASA)

    Physical status score (ASA)

    Measured: up to 3 months before surgery

  11. Surgery Time

    Evaluation of the surgery length in minutes

    Measured: The day of surgery

  12. Type of prosthesis

    The type of prosthesis Total Knee Replacement (TKR) or Total Hip Replacement (THR)

    Measured: The day of surgery

  13. Operated side; left or right leg

    The side on which the patient is having the TKR(total knee replacement) or THR (total hip replacement)

    Measured: The day of surgery, when patient arrives in OR

  14. Quantity of blood in mL loss during surgery

    Quantity in mL of blood loss during surgery, measured after closing the surgical site.

    Measured: Day of the surgery after closing of the surgical site

  15. The time the patient arrives on the treatment floor

    The time in hours and minutes at which the patient arrives on the treatment floor

    Measured: The day of surgery when the patient arrives on treatment floor

  16. Blood loss in dressing before discharge in %

    Percentage evaluation of the quantity of blood in the dressing, where on the dressing, the type of dressing and the aspect of the dressing.

    Measured: Day of the surgery before discharge from hospital up to 24h after surgery

  17. Time at discharged from the hospital

    The time in hours and minutes at which the patient leaves the hospital after discharged from hospital care.

    Measured: Day of surgery,at discharge time up to 24h after surgery

  18. Number of failure to discharge

    The number of failure to discharge patient according to the discharged criterias

    Measured: through study completion up to 2 years

  19. Pain score before surgery (VAS)

    Pain evaluation using the visual analog scale (VAS) zero to ten

    Measured: Before surgery at the medical evaluation pre surgery

  20. Pain score after surgery in recovery room (VAS)

    Pain evaluation using the visual analog scale (VAS) zero to ten in recovery room, day 0

    Measured: Day of surgery, after surgery in recovery room, day 0

  21. Pain score after surgery on treatment floor before discharge (VAS)

    Pain evaluation using the visual analog scale (VAS) zero to ten

    Measured: Day of surgery before discharge

  22. Pain score 1-3 days after surgery (VAS)

    Pain evaluation using the visual analog scale (VAS) zero to ten

    Measured: 1-3 day after surgery

  23. Pain score 4 to 6 weeks after surgery (VAS)

    Pain evaluation using the visual analog scale (VAS) zero to ten

    Measured: 4 to 6 weeks after surgery

  24. Pain score 10 to 12 weeks after surgery (VAS)

    Pain evaluation using the visual analog scale (VAS) zero to ten

    Measured: 10-12 weeks after surgery

  25. Pain score 6 months after surgery (VAS)

    Pain evaluation using the visual analog scale (VAS) zero to ten

    Measured: 6 months after surgery

  26. Pain score one year after surgery (VAS)

    Pain evaluation using the visual analog scale (VAS) zero to ten

    Measured: one year after surgery

  27. Level of hemoglobin outcome before surgery

    Blood test done by nurse evaluating the level in g/L

    Measured: Before surgery at the medical evaluation pre surgery up to 3 months before surgery

  28. Level of hemoglobin outcome after surgery

    Blood test done by nurse evaluating the level on g/L ,when the patient arrives in recovery room.

    Measured: Day of surgery, when the patient arrives in the recovery room

  29. Level of hemoglobin outcome 3 to 4 days after surgery

    Blood test done by nurse evaluating the level of hemoglobine on g/L

    Measured: 3 to 4 days after surgery

  30. Presence of post surgery symptoms in recovery room

    Evaluation of the symptoms after surgery such as syncope, dizziness, nausea, vomit, headaches.

    Measured: Day of surgery, when the patient arrives in the recovery room

  31. Presence of post surgery symptoms on treatment floor

    subjective evaluation of the symptoms after surgery such as syncope, dizziness, nausea, vomit, headaches

    Measured: Day of surgery, when patient arrives on treatment floor

  32. Presence of post surgery symptoms before discharge

    subjective evaluation of the symptoms after surgery such as syncope, dizziness, nausea, vomit, headaches

    Measured: Day of surgery, before discharge up to 24h after srugery

  33. Blood pressure outcome before surgery at the medical evaluation pre surgery

    Measure of blood pressure in mmHg Measure of the pulse in bpm Measure of saturation in % Measure of the oral temperature in Celcius

    Measured: before surgery at the medical evaluation pre surgery

  34. Pulse outcome before surgery at the medical evaluation pre surgery

    Measure of the pulse in bpm

    Measure of the oral temperature in Celcius

    Measured: before surgery at the medical evaluation pre surgery

  35. Saturation outcome before surgery at the medical evaluation pre surgery

    measure of saturation in % with index finger

    Measured: before surgery at the medical evaluation pre surgery

  36. Temperature outcome before surgery at the medical evaluation pre surgery

    Measure of oral temperature in Celsius with thermometer

    Measured: Before surgery at the medical evaluation pre surgery

  37. Blood pressure outcome in recovery room

    Measure of blood pressure in mmHg Measure of the pulse in bpm Measure of saturation in % Measure of the oral temperature in Celcius

    Measured: Day of surgery,when patient arrives in recovery room

  38. Pulse outcome in recovery room

    Measure of the pulse in bpm Measure of saturation in % Measure of the oral temperature in Celcius

    Measured: Day of surgery, when patient arrives in recovery room

  39. Saturation outcome in recovery room

    Measure of saturation in % with index finger

    Measured: Day of surgery, when patient arrives in recovery room

  40. Temperature outcome in recovery room

    Measure of oral temperature in Celsius with thermometer

    Measured: Day of surgery, when patient arrives in recovery room

  41. Blood pressure outcome before discharge

    Measure of blood pressure in mmHg Measure of the pulse in bpm Measure of saturation in % Measure of the oral temperature in Celcius

    Measured: Day of surgery, before discharge up to 24hours after surgery

  42. Pulse outcome before discharge

    Measure of pulse in bpm Measure of the pulse in bpm Measure of saturation in % Measure of the oral temperature in Celcius

    Measured: Day of surgery, before discharge up to 24hours after surgery

  43. Saturation outcome before discharge

    Measure of saturation in % with index finger

    Measured: Day of surgery, before discharge up to 24hours after surgery

  44. Temperature outcome before discharge

    Measure of the oral temperature in Celsius with thermometer

    Measured: Day of surgery before discharge up to 24hours after surgery

  45. Blood pressure outcome at home 1 to 2 days after surgery

    Measure of blood pressure in mmHg

    Measured: at home 1 to 2 days after surgery

  46. Pulse outcome at home 1 to 2 days after surgery

    Measure of the pulse in bpm

    Measured: at home 1 to 2 days after surgery

  47. Saturation outcome at home 1 to 2 days after surgery

    Measure of saturation in %

    Measured: at home 1 to 2 days after surgery

  48. Temperature outcome at home 1 to 2 days after surgery

    Measure of the oral temperature in Celsius

    Measured: at home 1 to 2 days after surgery

  49. Presence of big toe extension of the operated limb in recovery room

    Neurological assesment myotomes evaluation; extension of the big toe of the operated limb.

    Measured: Day of surgery, when patient arrives in recovery room

  50. Presence of plantarflexion of the operated limb in recovery room

    Neurological assesment Myotomes evaluation; plantarflexion of the operated limb.

    Measured: Day of surgery, when patient arrives in recovery room

  51. Presence of dorsiflexion of the operated limb in recovery room

    Neurological assesment, myotomes evaluation; platarflexion of the operated limb

    Measured: Day of surgery, when patient arrives in recovery room

  52. Dermatomes evaluation of the operated lower limb on treatment floor

    Dermatomes; all lower limbs L2 to S1-S2 if normal and comparable to other limb.

    Measured: Day of the surgery, on treatment floor 4-6 hours after surgery

  53. Functional evaluation outcome SF-36 at the medical evaluation before surgery

    SF-36 health score questionnaire

    Measured: Before surgery at medical evaluation up to 3 months before surgery

  54. Functional evaluation outcome, health score (SF-36) 6 months after surgery

    SF-36 health score questionnaire

    Measured: 6months after surgery

  55. Functional evaluation outcome hip disability and osteoarthritis outcome score (HOOS) at medical evaluation before surgery

    HOOS; hip disability and osteoarthritis outcome score questionnaire

    Measured: Before surgery at medical evaluation up to 3 months before surgery

  56. Functional evaluation outcome HOOS 6 months after surgery

    HOOS; hip disability and osteoarthritis outcome score questionnaire

    Measured: 6 months after surgery

  57. Functional evaluation outcome, knee disability and osteoarthritis outcome score (KOOS) at medical evaluation before surgery

    KOOS; knee disability and osteoarthritis outcome score questionnaire

    Measured: Before surgery at medical evaluation up to 3 months before surgery

  58. Functional evaluation outcome KOOS 6 months after surgery

    KOOS; knee disability and osteoarthritis outcome score questionnaire

    Measured: 6 months after surgery

  59. Range of motion outcome of the knee or hip at medical evaluation

    Range of motion (ROM) of the knee or hip in degrees in flexion using a goniometer

    Measured: Before surgery at medical evaluation up to 3 months before surgery

  60. Range of motion outcome of the knee or hip on treatment floor

    Range of motion (ROM) of the knee or hip in degrees in flexion using a goniometer

    Measured: Day of surgery, 4-6 hours after surgery

  61. Range of motion outcome of the knee or hip 3 days after surgery

    Range of motion (ROM) of the knee or hip in degrees in flexion using a goniometer

    Measured: 3 days after surgery

  62. Range of motion outcome of the knee or hip 4-6 weeks after surgery

    Range of motion (ROM) of the knee or hip in degrees in flexion using a goniometer

    Measured: 4-6 weeks after surgery

  63. Range of motion outcome of the knee or hip 10-12 weeks after surgery

    Range of motion (ROM) of the knee or hip in degrees in flexion using a goniometer

    Measured: 10-12 weeks after surgery

  64. Range of motion outcome of the knee or hip 6 months after surgery

    Range of motion (ROM) of the knee or hip in degrees in flexion using a goniometer

    Measured: 6 months after surgery

  65. Range of motion outcome of the knee or hip 1 year after surgery

    Range of motion (ROM) of the knee or hip in degrees in flexion using a goniometer

    Measured: 1 year after surgery

  66. Straight leg raise (SLR) outcome after surgery

    Measure of the height of the leg from the bed to the heel in centimeters

    Measured: 3-4 hours after surgery

  67. Walk outcome before surgery at at medical evaluation

    Timed up and go (TUG) test

    Measured: Before surgery at at medical evaluation up to 3 months before surgery

  68. Walk outcome 40 meters walk test at medical evaluation

    Measure of time on m /s to walk 40 meters

    Measured: Before surgery at medical evaluation up to 3 months before surgery

  69. Walk outcome 6 months after surgery

    Timed up and go (TUG) test

    Measured: 6 months after surgery

  70. Walk outcome 40 meters walk test 6 months after surgery

    Measure of time on m /s to walk 40 meters

    Measured: 6 months after surgery

  71. Stairs climb outcome day of surgery

    Stair climb test; how much time it takes in seconds to go up and down a flight of stairs.

    Measured: Day of surgery before discharge up to 24hours after surgery

  72. Stairs climb outcome 6 months after surgery

    Stair climb test; how much time it takes in seconds to go up and down a flight of stairs

    Measured: 6 months after surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Jan 2017 (estimated)
  2. Study startNov 2016
  3. Primary completionSep 2019
  4. Study completionSep 2025 (estimated)

Resources

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 N/A
Primary purpose
Other
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
150 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03028779
Sponsor's protocol ID
MaisonneuveRH2
Status last verified
Mar 2023
First submitted
22 Dec 2016
Last updated
17 Mar 2023
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Fast-track Total Hip and knee arthroplasty in people with Orthopedic Procedure, run by Maisonneuve-Rosemont Hospital at 1 site in Canada.

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 6 inclusion and 19 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: status not confirmed, as of the sponsor's last update on 17 Mar 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 Canada. 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.

Are results available for this study?

Results are not available in the source record.

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?

Number of participants with adverse events (time frame: 1 year). 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 17 Mar 2023.

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