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Osteoarthritis, KneeNCT04910048

Impact of a POPOP on Preoperative Health, Eligibility, and Clinical & Patient-Reported Outcomes in TJA

A study testing POPOP (preoperative patient optimization program) in people with Osteoarthritis, Knee and Osteoarthritis, Hip, run by University of Arkansas at 1 site in United States.

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

In this pilot study, we will test the hypothesis that a POPOP for currently ineligible UAMS orthopedic surgery patients wanting hip or knee replacement improves markers of preoperative health, ability to reach a BMI threshold <40 kg/m2 required for surgical eligibility, and postoperative outcomes versus SOC. Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
POPOP (preoperative patient optimization program)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
46 participants
Where
1 siteUnited States
Study dates
17 Jan 2022to 3 Sep 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 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • End-stage knee or hip osteoarthritis, avascular necrosis, or rheumatoid arthritis with recommended primary, unilateral total joint arthroplasty by orthopaedic surgeons at the University of Arkansas for Medical Sciences (Jeffrey Stambough, Dr. C. Lowry Barnes, Dr. Simon Mears, and Dr. Benjamin Stronach)
  • BMI between 41.00-48.00 kg/m2 at time of enrollment
  • Over the age of 18 years
  • Would consider undergoing a total joint arthroplasty if eligible
  • Owns a smartphone or tablet with Bluetooth capability, cell signal or WIFI connection
  • Willing to comply with the requirements of the study and provide informed consent prior to enrollment.

Who cannot join

  • Patients with a BMI less than 41.00 or greater than 48.00
  • Pregnancy
  • Breastfeeding
  • History of a major organ transplant or other health issue requiring immunosuppressant drugs
  • Strict vegetarian diet
  • Diagnosis of and/or are taking medication for psychiatric conditions including schizophrenia, bipolar disorder or manic depression
Show all 11Show fewer
  • Patients scheduled for, or those who have previously undergone, bariatric surgery
  • Patients unable to understand and speak English
  • Patients requiring a revision or bilateral TJA
  • Patients unwilling or unable to use a bluetooth-enabled smartphone with cell service or home internet access
  • Incarceration

Trial locations and contacts

1 site in 1 country.

United States1 site
  • UAMS Orthopaedic Clinic - Shackleford

    Little Rock, Arkansas, 72211

Other trials in United States

About this study

Official title: Impact of a Preoperative Patient Optimization Program on Preoperative Health, Eligibility, and Clinical & Patient-Reported Outcomes in Total Joint Arthroplasty

In this pilot study, we will test the hypothesis that a POPOP for currently ineligible UAMS orthopedic surgery patients wanting hip or knee replacement improves markers of preoperative health, ability to reach a BMI threshold <40 kg/m2 required for surgical eligibility, and postoperative outcomes versus SOC.

Read the detailed description

After being informed about the study and potential risks, all patients giving written informed consent will be screened to determine eligibility for study entry. Patients who meet eligibility criteria will be randomized into one of two groups: Standard of Care or the POPOP (20Lighter).

Being tested
POPOP (preoperative patient optimization program), SOC (standard of care)
Keywords
Total joint arthroplasty, Hip arthroplasty, Knee arthroplasty, Surgical ineligibility, Obesity, Patient Reported Outcome Measures, TJA, THA, TKA, PROMs, BMI, HbA1c
Medical subject headings
Osteoarthritis, Knee, Osteoarthritis, Hip, Osteonecrosis, Arthritis, Rheumatoid, Obesity

What participants receive

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

  • POPOP (preoperative patient optimization program)Other

    Also called 20Lighter

    A 2 month structured program focused on reduction of BMI, body weight, visceral fat, body fat and improvement of lean body mass and intracellular fluid.

  • SOC (standard of care)Other

    Referral to a dietician for two months of self-directed weight loss

Study groups in NCT04910048
Study groupRoleWhat they receive
Standard of CareActive comparatorThe first arm consists of UAMS standard of care (SOC), including providing a brochure with information (contact information, brief educational information) for the patient to consult with a nutritionist to help with self-directed weight loss.
Receives: Other: SOC (standard of care)
Intervention (POPOP)ExperimentalThe second arm is a specified 2-month POPOP focused on weight loss administered by the external partner, 20Lighter. The program includes customized meal plans; vitamin, mineral and nutritional supplementation; and daily engagement via a smartphone app with a 20Lighter health care provider. Video conferencing appointments will occur approximately every 3 weeks. The program does not require any exercise or physical engagement but does necessitate that patients have a smartphone or tablet with Bluetooth capability, cell signal or WIFI connection. During the first 40 days the customized meal plans are adhered to, then from days 41-60 patients will transition back to a normal dietary lifestyle via a customized plan based on considerations including, food preferences, physical engagement and height. Patients who achieve a BMI below 40.0 before the end of the 60 day program may be seen sooner than 90d for follow-up appointment in the UAMS clinic.
Receives: Other: POPOP (preoperative patient optimization program)

What is being measured

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

  1. Change of pre-operative BMI

    Assessment of mean change in BMI (Body Mass Index, kg/m2) between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

Secondary outcomes (14)
  1. Pre-operative health & nutritional status as assessed by change of red blood cell count

    Change of values in red blood cells as assessed by (Complete Blood Count) between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

  2. Pre-operative health & nutritional status as assessed by change of white blood cell count

    Change of values in white blood cells as assessed by CBC (Complete Blood Count) between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

  3. Pre-operative health & nutritional status as assessed by change of platelet count

    Change of values in platelets as assessed by CBC (Complete Blood Count) between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

  4. Pre-operative health & nutritional status as assessed by change of albumin

    Change of values in Albumin as assessed by CMP (Comprehensive Metabolic Panel) between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

  5. Pre-operative health & nutritional status as assessed by change of ALT (alanine aminotransferase)

    Change of values in ALT (alanine aminotransferase) as assessed by CMP (Comprehensive Metabolic Panel) between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

  6. Pre-operative health & nutritional status as assessed by change of AST (aspartate aminotransferase)

    Change of values in AST (aspartate aminotransferase) as assessed by CMP (Comprehensive Metabolic Panel) between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

  7. Pre-operative health & nutritional status as assessed by change of BUN (blood urea nitrogen)

    Change of values in BUN (blood urea nitrogen) as assessed by CMP (Comprehensive Metabolic Panel) between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

  8. Change of pre-operative health & nutritional status as assessed by Creatinine

    Change of values in Creatinine as assessed by CMP (Comprehensive Metabolic Panel) between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

  9. Change of pre-operative type 2 diabetes as assessed by HbA1c (Hemaglobin A1c) laboratory test values

    Assessment of change in HbA1c (Hemaglobin A1c) between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

  10. Change of pre-operative inflammation as assessed by CRP (C-Reactive Protein) laboratory test values

    Assessment of change in CRP (C-Reactive Protein) between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

  11. Change of pre-operative PROMs (Knee Replacement)

    Assessment of change in the patient reported outcomes survey KOOS Jr, knee replacement patients between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

  12. Change of pre-operative PROMs (Hip Replacement)

    Assessment of change in the patient reported outcomes survey HOOS Jr, hip replacement patients between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

  13. Change of pre-operative PROMIS Pain Interference

    Assessment of change in PROMIS Pain Interference patient reported outcome instrument between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

  14. Change of pre-operative PROMIS Physical Function

    Assessment of change in PROMIS Physical Function patient reported outcome instrument between the date of enrollment to follow-up visit to occur between days 70-110

    Measured: Approximately 70-110 days from study enrollment

Timeline

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

  1. First posted2 Jun 2021
  2. Study start17 Jan 2022
  3. Primary completion1 Apr 2023
  4. Study completion3 Sep 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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Two group randomized control trial comparing the intervention (POPOP) and standard of care (SOC).
Masking
None (open label)
Enrolment
46 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04910048
Sponsor's protocol ID
262790
Status last verified
Sep 2024
First submitted
20 May 2021
Last updated
19 Sep 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be shared. Statistics based on aggregated de-identified data will be assessed, and disseminated at industry conferences and peer-reviewed publication.

Publications

  • Bolognesi MP, Marchant MH Jr, Viens NA, Cook C, Pietrobon R, Vail TP. The impact of diabetes on perioperative patient outcomes after total hip and total knee arthroplasty in the United States. J Arthroplasty. 2008 Sep;23(6 Suppl 1):92-8. doi: 10.1016/j.arth.2008.05.012.

    PubMed 18722309
  • Boyce L, Prasad A, Barrett M, Dawson-Bowling S, Millington S, Hanna SA, Achan P. The outcomes of total knee arthroplasty in morbidly obese patients: a systematic review of the literature. Arch Orthop Trauma Surg. 2019 Apr;139(4):553-560. doi: 10.1007/s00402-019-03127-5. Epub 2019 Feb 16.

    PubMed 30778723
  • Gerlach E, Selley R, Johnson D, Nicolay R, Versteeg G, Plantz M, Tjong V, Terry M. Patient-Reported Outcomes Measurement Information System Validation in Hip Arthroscopy: A Shift Towards Reducing Survey Burden. Cureus. 2021 Feb 10;13(2):e13265. doi: 10.7759/cureus.13265.

    PubMed 33728201
  • Goodman SM, Mehta BY, Mandl LA, Szymonifka JD, Finik J, Figgie MP, Navarro-Millan IY, Bostrom MP, Parks ML, Padgett DE, McLawhorn AS, Antao VC, Yates AJ, Springer BD, Lyman SL, Singh JA. Validation of the Hip Disability and Osteoarthritis Outcome Score and Knee Injury and Osteoarthritis Outcome Score Pain and Function Subscales for Use in Total Hip Replacement and Total Knee Replacement Clinical Trials. J Arthroplasty. 2020 May;35(5):1200-1207.e4. doi: 10.1016/j.arth.2019.12.038. Epub 2019 Dec 27.

    PubMed 31952945
  • Harold RE, Butler BA, Delagrammaticas D, Sullivan R, Stover M, Manning DW. Patient-Reported Outcomes Measurement Information System Correlates With Modified Harris Hip Score in Total Hip Arthroplasty. Orthopedics. 2021 Jan 1;44(1):e19-e25. doi: 10.3928/01477447-20201202-02. Epub 2020 Dec 7.

    PubMed 33284982
  • Horn ME, Reinke EK, Couce LJ, Reeve BB, Ledbetter L, George SZ. Reporting and utilization of Patient-Reported Outcomes Measurement Information System(R) (PROMIS(R)) measures in orthopedic research and practice: a systematic review. J Orthop Surg Res. 2020 Nov 23;15(1):553. doi: 10.1186/s13018-020-02068-9.

    PubMed 33228699
  • Keeney BJ, Austin DC, Jevsevar DS. Preoperative Weight Loss for Morbidly Obese Patients Undergoing Total Knee Arthroplasty: Determining the Necessary Amount. J Bone Joint Surg Am. 2019 Aug 21;101(16):1440-1450. doi: 10.2106/JBJS.18.01136.

    PubMed 31436651
  • Lingamfelter M, Orozco FR, Beck CN, Harrer MF, Post ZD, Ong AC, Ponzio DY. Nutritional Counseling Program for Morbidly Obese Patients Enables Weight Optimization for Safe Total Joint Arthroplasty. Orthopedics. 2020 Jul 1;43(4):e316-e322. doi: 10.3928/01477447-20200521-08. Epub 2020 Jun 5.

    PubMed 32501522
  • Shaka H, Ojemolon PE. Impact of Obesity on Outcomes of Patients With Hip Osteoarthritis Who Underwent Hip Arthroplasty. Cureus. 2020 Oct 10;12(10):e10876. doi: 10.7759/cureus.10876.

    PubMed 33178529
  • Shapiro JA, Narayanan AS, Taylor PR, Olcott CW, Del Gaizo DJ. Fate of the Morbidly Obese Patient Who Is Denied Total Joint Arthroplasty. J Arthroplasty. 2020 Jun;35(6S):S124-S128. doi: 10.1016/j.arth.2020.01.071. Epub 2020 Feb 4.

    PubMed 32088050

Questions about this trial

What is this clinical trial studying?

A study testing POPOP (preoperative patient optimization program) in people with Osteoarthritis, Knee and Osteoarthritis, Hip, run by University of Arkansas 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 6 inclusion and 11 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 19 Sep 2024. 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.

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 of pre-operative BMI (time frame: Approximately 70-110 days from study enrollment). 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 NCT04910048, which also lists 10 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 19 Sep 2024.

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