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CoxarthrosisDEXANCT04317872

Effect of Peri-operative Glucocorticoids on Short-term Functional Outcome After THA

A study testing High dose of peri-operative intravenous dexamethasone and Low dose of peri-operative intravenous dexamethasone in people with Coxarthrosis and Avascular Necrosis of Hip, run by Universitaire Ziekenhuizen KU Leuven at 1 site in Belgium.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This randomized, single surgeon, placebo controlled, double blind study will be conducted in order to investigate whether or not peri-operative high doses of intravenous glucocorticoids improve short-term functional outcome after direct anterior total hip arthroplasty. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Coxarthrosis, Avascular Necrosis of Hip
What is being tested?
High dose of peri-operative intravenous dexamethasone and Low dose of peri-operative intravenous dexamethasone
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
71 participants
Where
1 siteBelgium
Study dates
1 Jul 2020to 3 May 2024
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • All patients undergoing unilateral uncemented THA for primary OA or AVN of the hip under general anesthesia (GA)
  • Aged 18 years and above (including women of child bearing age)
  • Able to provide informed consent

Who cannot join

  • Younger than 18 years
  • Known alcohol or drug abuse
  • Known allergy for glucocorticoids
  • Administration of any glucocorticoids in the last three months
  • Usage of strong analgesia (such as lyrica or oxycodone) as regular medication
  • Usage of medication with anticipated interactions with glucocorticoids
Show all 16Show fewer
  • Known gastric ulcer
  • Insulin dependent diabetes mellitus
  • Severe heart disease (NYHA > 2)
  • Liver or renal failure
  • Systemic rheumatoid diseases
  • Insufficient understanding of the Dutch language
  • Unable to provide informed consent
  • Pre-operative use of walking aids
  • Gross anatomical deformities
  • Significant intra-operative complications such as periprosthetic fracture

Trial locations and contacts

1 site in 1 country.

Belgium1 site
  • University Hospitals of Leuven

    Leuven, 3000

Other trials in Belgium

About this study

Official title: Do Peri-operative High Doses of Intravenous Glucocorticoids Improve Short-term Functional Outcome After Direct Anterior Total Hip Arthroplasty? A Randomized, Single Surgeon, Placebo Controlled, Double Blind Study

This randomized, single surgeon, placebo controlled, double blind study will be conducted in order to investigate whether or not peri-operative high doses of intravenous glucocorticoids improve short-term functional outcome after direct anterior total hip arthroplasty. So far, it has been proven that high dose glucocorticoids reduce immediate post-operative pain and nausea, but no data exists on functional outcome during the first 6 weeks. Our hypothesis is that patients in the intervention group will follow a so-called "get ahead, stay ahead" principle and that glucocorticoids can be considered an important tool (adjuvant treatment) in the enhanced recovery pathway after THA with significant socio-economic implications.

Read the detailed description

Patients listed for a direct anterior total hip arthroplasty by a single surgeon will be recruited for this study and allocated to one of two groups:

  1. intervention group: 25 grams of iv dexamethasone at induction followed by 10 mg of iv dexamethasone 12 hours later
  2. control group: 5 grams of iv dexamethasone at induction followed by placebo 12 hours later Both patients and surgeons will be blinded. Primary outcome measure will be number of steps during the first 6 weeks as measured by a pedometer. Secondary outcome measures will be side effects, complications, Patient Reported Outcome Measures, pain, nausea, stiffness, achievement of clinical milestones and use of analgesia/anti-emetics. This data will be collected using a tailor made application for a smartphone or tablet and data collecting will start one week before surgery until 6 weeks after surgery.

Based on a power analysis both groups will consist of 35 patients each.

Being tested
High dose of peri-operative intravenous dexamethasone, Low dose of peri-operative intravenous dexamethasone
Keywords
Total Hip Arthroplasty, Direct Anterior Approach, Glucocorticoids, Short term functional outcome
Medical subject headings
Osteoarthritis, Hip

What participants receive

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

  • High dose of peri-operative intravenous dexamethasoneDrug

    Also called Aacidexam

    25mg aacidexam is administered during induction followed by 10mg on the ward after 12 hours

  • Low dose of peri-operative intravenous dexamethasoneDrug

    Also called Aacidexam

    10mg aacidexam is administered during induction followed by placebo on the ward after 12 hours

Study groups in NCT04317872
Study groupRoleWhat they receive
Current protocolExperimental"Current protocol": patients will receive a single shot of 25mg of aacidexam iv (5cc) at induction. After 12 hours these patients will another shot of 10mg of aacidexam iv (2cc) on the ward.
Receives: Drug: High dose of peri-operative intravenous dexamethasone
Old protocolActive comparator"Old protocol": patients will receive a single shot of 5mg of aacidexam iv at induction (5cc). After arrival 12 hours these patients will receive a placebo, i.e. a shot of 2 cc of NaCl 0.9% iv (Mini-Plasco van B. Braun).
Receives: Drug: Low dose of peri-operative intravenous dexamethasone

What is being measured

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

  1. Steps

    Number of steps as measured by a pedometer

    Measured: 6 weeks

Secondary outcomes (16)
  1. Post-operative nausea and vomiting

    Post-operative nausea and vomiting Visual Analogue Scale scores

    Measured: up to 1 week, 0-10, lower scores indicate better clinical outcome

  2. Same day mobilization

    Whether or not if was possible for the physiotherapists to mobilize the patient on the day of surgery

    Measured: 1 day (yes or no)

  3. Clinical milestones

    Time to achieve certain clinical milestones, e.g. climbing stairs, driving a car, etc

    Measured: 6 weeks

  4. Oxford Hip Score

    Patients Reported Outcome Measures

    Measured: 6 weeks

  5. Western Ontario and McMaster Universities Osteoarthritis Index

    Patients Reported Outcome Measures

    Measured: 6 weeks

  6. Hip dysfunction and Osteoarthritis Outcome Score

    Patients Reported Outcome Measures

    Measured: 6 weeks

  7. Forgotten Joint Score

    Patients Reported Outcome Measures

    Measured: 6 weeks

  8. Short Form 36

    Patients Reported Outcome Measures

    Measured: 6 weeks

  9. Fatigue Severity Scale

    Patients Reported Outcome Measures

    Measured: 6 weeks

  10. Groningen Activity Restriction Scale

    Patients Reported Outcome Measures

    Measured: 6 weeks

  11. Pain scores

    Visual Analogue Scale scores during the day, the night and during exercises

    Measured: 6 weeks, 0-10, lower scores indicate better clinical outcome

  12. Stiffness

    Visual Analogue Scale scores

    Measured: 6 weeks, 0-10, lower scores indicate better clinical outcome

  13. Use of Analgesia

    The use of analgesia such as paracetamol (acetominophen), NSAIDs, and morphine(like) substances

    Measured: 6 weeks

  14. Use of Anti-emetics

    The use anti-emetics to reduce direct post-operative nausea

    Measured: Up to 1 week

  15. Complications

    The occurrence of complications such as wound healing problems, infections, allergic reactions, venous thrombo-embolisms, etc

    Measured: 6 weeks

  16. Side effects

    The occurrence of side-effects

    Measured: 6 weeks

Timeline

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

  1. First posted23 Mar 2020
  2. Study start1 Jul 2020
  3. Primary completion3 May 2024
  4. Study completion3 May 2024

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
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
A randomized, single surgeon, placebo controlled, double blind study using two parallel study groups
Masking
Double blind
Who is masked
Participant, Care provider
Enrolment
71 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04317872
Sponsor's protocol ID
S63584
Acronym
DEXA
Status last verified
Apr 2025
First submitted
17 Mar 2020
Last updated
15 Apr 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Learmonth ID, Young C, Rorabeck C. The operation of the century: total hip replacement. Lancet. 2007 Oct 27;370(9597):1508-19. doi: 10.1016/S0140-6736(07)60457-7.

    PubMed 17964352
  • Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg. 1999 Sep;89(3):652-8. doi: 10.1097/00000539-199909000-00022.

    PubMed 10475299
  • Marques EM, Jones HE, Elvers KT, Pyke M, Blom AW, Beswick AD. Local anaesthetic infiltration for peri-operative pain control in total hip and knee replacement: systematic review and meta-analyses of short- and long-term effectiveness. BMC Musculoskelet Disord. 2014 Jul 5;15:220. doi: 10.1186/1471-2474-15-220.

    PubMed 24996539
  • Myles PS, Williams DL, Hendrata M, Anderson H, Weeks AM. Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10,811 patients. Br J Anaesth. 2000 Jan;84(1):6-10. doi: 10.1093/oxfordjournals.bja.a013383.

    PubMed 10740539
  • Salerno A, Hermann R. Efficacy and safety of steroid use for postoperative pain relief. Update and review of the medical literature. J Bone Joint Surg Am. 2006 Jun;88(6):1361-72. doi: 10.2106/JBJS.D.03018.

    PubMed 16757774
  • Choi PT, Bhandari M, Scott J, Douketis J. Epidural analgesia for pain relief following hip or knee replacement. Cochrane Database Syst Rev. 2003;2003(3):CD003071. doi: 10.1002/14651858.CD003071.

    PubMed 12917945
  • Moskal JT, Capps SG. Meta-analysis of Intravenous Tranexamic Acid in Primary Total Hip Arthroplasty. Orthopedics. 2016 Sep 1;39(5):e883-92. doi: 10.3928/01477447-20160526-02. Epub 2016 Jun 1.

    PubMed 27248332
  • Hojer Karlsen AP, Geisler A, Petersen PL, Mathiesen O, Dahl JB. Postoperative pain treatment after total hip arthroplasty: a systematic review. Pain. 2015 Jan;156(1):8-30. doi: 10.1016/j.pain.0000000000000003.

    PubMed 25599296
  • Nanni M, Perna F, Calamelli C, Donati D, Ferrara O, Parlato A, D'Arienzo M, Faldini C. Wound drainages in total hip arthroplasty: to use or not to use? Review of the literature on current practice. Musculoskelet Surg. 2013 Aug;97(2):101-7. doi: 10.1007/s12306-013-0270-3. Epub 2013 May 25.

    PubMed 23709186
  • Villatte G, Mathonnet M, Villeminot J, Savary M, Theissen A, Ostermann S, Erivan R, Raynaud-Simon A, Slim K. [Interest of enhanced recovery programs in the elderly during total hip arthroplasty A systematic review]. Geriatr Psychol Neuropsychiatr Vieil. 2019 Sep 1;17(3):234-242. doi: 10.1684/pnv.2019.0796. French.

    PubMed 31251213
  • Kardash KJ, Sarrazin F, Tessler MJ, Velly AM. Single-dose dexamethasone reduces dynamic pain after total hip arthroplasty. Anesth Analg. 2008 Apr;106(4):1253-7, table of contents. doi: 10.1213/ANE.0b013e318164f319.

    PubMed 18349202
  • Mathiesen O, Jacobsen LS, Holm HE, Randall S, Adamiec-Malmstroem L, Graungaard BK, Holst PE, Hilsted KL, Dahl JB. Pregabalin and dexamethasone for postoperative pain control: a randomized controlled study in hip arthroplasty. Br J Anaesth. 2008 Oct;101(4):535-41. doi: 10.1093/bja/aen215. Epub 2008 Jul 23.

    PubMed 18653493
  • Bergeron SG, Kardash KJ, Huk OL, Zukor DJ, Antoniou J. Perioperative dexamethasone does not affect functional outcome in total hip arthroplasty. Clin Orthop Relat Res. 2009 Jun;467(6):1463-7. doi: 10.1007/s11999-009-0733-x. Epub 2009 Feb 18.

    PubMed 19224304
  • Rasmussen ML, Mathiesen O, Dierking G, Christensen BV, Hilsted KL, Larsen TK, Dahl JB. Multimodal analgesia with gabapentin, ketamine and dexamethasone in combination with paracetamol and ketorolac after hip arthroplasty: a preliminary study. Eur J Anaesthesiol. 2010 Apr;27(4):324-30. doi: 10.1097/EJA.0b013e328331c71d.

    PubMed 19734790
  • Miyagawa Y, Ejiri M, Kuzuya T, Osada T, Ishiguro N, Yamada K. Methylprednisolone reduces postoperative nausea in total knee and hip arthroplasty. J Clin Pharm Ther. 2010 Dec;35(6):679-84. doi: 10.1111/j.1365-2710.2009.01141.x.

    PubMed 21054459

Questions about this trial

What is this clinical trial studying?

A study testing High dose of peri-operative intravenous dexamethasone and Low dose of peri-operative intravenous dexamethasone in people with Coxarthrosis and Avascular Necrosis of Hip, run by Universitaire Ziekenhuizen KU Leuven at 1 site in Belgium.

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 3 inclusion and 16 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 15 Apr 2025. 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 Belgium. 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?

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?

Steps (time frame: 6 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04317872, which also lists 27 linked publications.

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 15 Apr 2025.

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