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Knee Arthroplasty, TotalLCPTGNCT07489963

Functional Impact at 12 Months Post-op of Posterior Cruciate Ligament Conservation During Robotic-assisted Surgery (MAKO) for Total Knee Replacement.

A study testing Total knee arthroplasty in people with Knee Arthroplasty, Total, run by Centre Hospitalier Universitaire de Nīmes at 3 sites in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Studies have been made on the best way to do knee surgery and whether to conserve the posterior cruciate ligament or not during total knee prosthesis insertion is still under debate. However, most of these studies were made before the introduction of robotic knee surgery. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Knee Arthroplasty, Total
What is being tested?
Total knee arthroplasty
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
300 participants
Where
3 sitesFrance
Study dates
10 Oct 2025to 1 Sep 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

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

  • Patient scheduled for first-intention robotic-assisted total knee replacement (MAKO).
  • Unilateral replacement, regardless of laterality.
  • Patient able to answer questionnaires.
  • Patient willing to undergo usual 12-month follow-up.
  • Patient has given free and informed consent and has signed the consent form.
  • Patient affiliated with or benefiting from a health insurance scheme.

Who cannot join

  • Patient with intraoperative technical impossibility of retaining PCL (flessum > 20°, flexion stiffening < 100°).
  • Previous posterior cruciate ligament surgery.
  • Post-traumatic gonarthrosis.
  • Valgus > 185°.
  • Patient with septic complication.
  • Patient participating in another interventional trial.
Show all 11Show fewer
  • Patient in an exclusion period determined by another study.
  • Patient under court protection, guardianship or curatorship.
  • Patient unable to give consent.
  • Patients for whom it is impossible to provide informed information.
  • Pregnant women

Trial locations and contacts

3 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Anissa MEGZARI contact

+33466684236

drc@chu-nimes.fr

France3 sites, 3 recruiting
  • Clinique Tivoli-Ducos

    Bordeaux, 33000

    Julien BARDOU-JACQUET, Dr., +335.40.41.70.14, jbardoujacquet@me.com

    Recruiting
  • Hôpital Croix Rousse

    Lyon, 69317

    Sébastien LUSTIG, Pr., +334.26.10.92.47, sebastien.lustig@gmail.com

    Recruiting
  • Nîmes University Hospital

    Nîmes, 30029

    Rémy COULOMB, Dr., +334.66.68.31.56, remy.coulomb@chu-nimes.fr

    Recruiting

Other trials in France

About this study

Official title: Evaluation of the Functional Impact at 12 Months Post-op of Posterior Cruciate Ligament Conservation During Robotic-assisted Surgery (MAKO) for Total Knee Replacement. A Randomized, Single-blind, Multicenter, Controlled Superiority Study.

Studies have been made on the best way to do knee surgery and whether to conserve the posterior cruciate ligament or not during total knee prosthesis insertion is still under debate. However, most of these studies were made before the introduction of robotic knee surgery. It seems timely to do a study comparing these two surgical techniques: preservation versus removal of the posterior cruciate ligament in knee arthroplasty

Read the detailed description

Knee arthroplasty is a growing surgical discipline and 102,655 prostheses were fitted in France in 2019. The principle of total knee arthroplasty (TKA) is to replace a thickness of bone and cartilage whilst maintaining homogeneous tension of the capsulo-ligamentary envelope. Different designs have been developed over the years to achieve a good compromise between stability and mobility, ligament balancing being one of the major challenges of this procedure. The results of this surgery are good, but remain inferior to those of the total hip prosthesis. Around 1/5 patients operated on are dissatisfied.

The posterior cruciate ligament (PCL) plays a role in the stability of the prosthetic knee, preventing anteroposterior translation and allowing femoral roll-back. It also plays a role in flexion space. However, whether or not the PCL is retained during total prosthetic knee insertion has not been shown to make any difference to clinical or functional outcomes.

The proprioceptive role of mechanoreceptors in the anterior cruciate ligament (ACL) has already been demonstrated in several studies. A similar effect can thus be imagined when the PCL is conserved in TKA. Three prospective randomized studies have attempted to demonstrate this. However, those three studies did not find any significant differences in clinical or functional results. It should be noted, however, that all those studies were carried out without the use of robotics or any other means of assessing PCL preservation.

Robotics have made it possible to obtain better results, as well as greater accuracy and reproducibility of the surgical procedure and better intraoperative laxity control based on the concept of functional alignment.

Mechanical alignment was the first to be used during insertion of the prosthetic knee. It facilitates alignment according to the tibial and femoral mechanical axis, and better implant survival thanks to improved stress distribution. However, the patient's anatomy is not respected, leading to a certain amount of patient dissatisfaction. The concept of kinematic (or anatomic) alignment was designed to achieve greater respect for patient anatomy and ligament balancing. More recently, with the advent of navigation and robotics, the authors have described functional alignment, which optimizes TKA alignment according to residual ligament tension.

Since robotic assistance provides better control of the procedure and, in particular, better preservation of PCL integrity in this surgical variant, we believe it is time to conduct a high-level evidence study comparing these two surgical techniques: preservation versus removal of the posterior cruciate ligament in knee arthroplasty. The investigators hypothesize that preserving the PCL will lead to better functional results, a better quality of life and an earlier return to activity.

Being tested
Total knee arthroplasty
Keywords
Robot-Assisted Surgery, Knee Arthroplasty, Total

What participants receive

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

  • Total knee arthroplastyProcedure or surgery

    Robot-assisted total knee arthroplasty

Study groups in NCT07489963
Study groupRoleWhat they receive
LCP+ groupExperimentalRobot-assisted total knee arthroplasty with conservation of the posterior cruciate ligament
Receives: Procedure: Total knee arthroplasty
LCP- groupActive comparatorRobot-assisted total knee arthroplasty with ablation of the posterior cruciate ligament
Receives: Procedure: Total knee arthroplasty

What is being measured

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

  1. Functional impact at of posterior cruciate ligament preservation in the LCP+group

    Evaluated according to the FJS-12 (Forgotten Joint Score) self-questionnaire. The FJS-12 is a self-administered questionnaire consisting of 12 items.

    The patient is asked to rate their awareness of their artificial joint for the 12 activities. Each item is then given a score of between 0-4 on a five-point Likert scale in which : 0 - Never,1 - Almost Never, 2 - Seldom, 3 - Sometimes,4 - Mostly.

    The answers are then summed and divided by the number of completed items. The mean value is then multiplied by 25 to obtain the total score of 0-100. The higher scores indicating better outcomes (less awareness of the joint).

    Measured: 12 months post-surgery

  2. Functional impact at of posterior cruciate ligament resection in the LCP-group

    Evaluated according to the FJS-12 (Forgotten Joint Score) self-questionnaire. The FJS-12 is a self-administered questionnaire consisting of 12 items.

    The patient is asked to rate their awareness of their artificial joint for the 12 activities. Each item is then given a score of between 0-4 on a five-point Likert scale in which : 0 - Never,1 - Almost Never, 2 - Seldom, 3 - Sometimes,4 - Mostly.

    The answers are then summed and divided by the number of completed items. The mean value is then multiplied by 25 to obtain the total score of 0-100. The higher scores indicating better outcomes (less awareness of the joint).

    Measured: 12 months post-surgery

Secondary outcomes (17)
  1. Functional impact at of posterior cruciate ligament preservation in the LCP+group

    Evaluated according to the FJS-12 (Forgotten Joint Score) self-questionnaire. The FJS-12 is a self-administered questionnaire consisting of 12 items.

    The patient is asked to rate their awareness of their artificial joint for the 12 activities. Each item is then given a score of between 0-4 on a five-point Likert scale in which : 0 - Never,1 - Almost Never, 2 - Seldom, 3 - Sometimes,4 - Mostly.

    The answers are then summed and divided by the number of completed items. The mean value is then multiplied by 25 to obtain the total score of 0-100. The higher scores indicating better outcomes (less awareness of the joint).

    Measured: 4.5 months post-surgery

  2. Functional impact at of posterior cruciate ligament ablation in the LCP-group

    Evaluated according to the FJS-12 (Forgotten Joint Score) self-questionnaire. The FJS-12 is a self-administered questionnaire consisting of 12 items.

    The patient is asked to rate their awareness of their artificial joint for the 12 activities. Each item is then given a score of between 0-4 on a five-point Likert scale in which : 0 - Never,1 - Almost Never, 2 - Seldom, 3 - Sometimes,4 - Mostly.

    The answers are then summed and divided by the number of completed items. The mean value is then multiplied by 25 to obtain the total score of 0-100. The higher scores indicating better outcomes (less awareness of the joint).

    Measured: 4.5 months post-surgery

  3. Algo-functional OKS (Oxford Knee Score) in the LCP+group

    The OKS is a patient-reported outcome measure that consists of 12 questions about an individual's level of function, activities of daily living and how they have been affected by pain over the preceding four weeks. It uses a scoring system from 0-4 where four is the best outcome and total scores range from 0 (poorest function) to 48 (maximal function).

    Measured: 4.5 months post-surgery

  4. Algo-functional OKS (Oxford Knee Score) in the LCP+group

    The OKS is a patient-reported outcome measure that consists of 12 questions about an individual's level of function, activities of daily living and how they have been affected by pain over the preceding four weeks. It uses a scoring system from 0-4 where four is the best outcome and total scores range from 0 (poorest function) to 48 (maximal function).

    Measured: 12 months post-surgery

  5. Algo-functional OKS (Oxford Knee Score) in the LCP-group

    The OKS is a patient-reported outcome measure that consists of 12 questions about an individual's level of function, activities of daily living and how they have been affected by pain over the preceding four weeks. It uses a scoring system from 0-4 where four is the best outcome and total scores range from 0 (poorest function) to 48 (maximal function).

    Measured: 4.5 months post-surgery

  6. Algo-functional OKS (Oxford Knee Score) in the LCP-group

    The OKS is a patient-reported outcome measure that consists of 12 questions about an individual's level of function, activities of daily living and how they have been affected by pain over the preceding four weeks. It uses a scoring system from 0-4 where four is the best outcome and total scores range from 0 (poorest function) to 48 (maximal function).

    Measured: 12 months post-surgery

  7. KSS (Knee Society Score) in the LCP+ group

    The KSS questionnaire includes a Knee Score, rating the knee joint itself (pain, range of motion, stability and radiographic alignment), and a Function Score (patient's walking distance, climbing stairs and use of walking aids).The Knee Score allocates a maximum of 100 points to evaluate range of motion (1 point per 5°, maximum 125°), stability (medial/lateral (15 points) and anterior/posterior (10 points)) and pain (50 points) with deductions for extension lag, flexion contracture and malalignment (if leg axis < 5 or > 10° on radiological examination). A maximum score of 100 points is a well-aligned knee with 125° of motion, almost none anteroposterior or mediolateral instability and no pain. The Function Score considers walking distance (50 points) and stair-climbing (50 points) with deduction if a walking aid is used. A patient who walks unlimited and has no trouble climbing stairs gets the maximum Function Score of 100 points.

    Measured: 4.5 months post-surgery

  8. KSS (Knee Society Score) in the LCP+ group

    The KSS questionnaire includes a Knee Score, rating the knee joint itself (pain, range of motion, stability and radiographic alignment), and a Function Score (patient's walking distance, climbing stairs and use of walking aids).The Knee Score allocates a maximum of 100 points to evaluate range of motion (1 point per 5°, maximum 125°), stability (medial/lateral (15 points) and anterior/posterior (10 points)) and pain (50 points) with deductions for extension lag, flexion contracture and malalignment (if leg axis < 5 or > 10° on radiological examination). A maximum score of 100 points is a well-aligned knee with 125° of motion, almost none anteroposterior or mediolateral instability and no pain. The Function Score considers walking distance (50 points) and stair-climbing (50 points) with deduction if a walking aid is used. A patient who walks unlimited and has no trouble climbing stairs gets the maximum Function Score of 100 points.

    Measured: 12 months post-surgery

  9. KSS (Knee Society Score) in the LCP- group

    The KSS questionnaire includes a Knee Score, rating the knee joint itself (pain, range of motion, stability and radiographic alignment), and a Function Score (patient's walking distance, climbing stairs and use of walking aids).The Knee Score allocates a maximum of 100 points to evaluate range of motion (1 point per 5°, maximum 125°), stability (medial/lateral (15 points) and anterior/posterior (10 points)) and pain (50 points) with deductions for extension lag, flexion contracture and malalignment (if leg axis < 5 or > 10° on radiological examination). A maximum score of 100 points is a well-aligned knee with 125° of motion, almost none anteroposterior or mediolateral instability and no pain. The Function Score considers walking distance (50 points) and stair-climbing (50 points) with deduction if a walking aid is used. A patient who walks unlimited and has no trouble climbing stairs gets the maximum Function Score of 100 points.

    Measured: 4.5 months post-surgery

  10. KSS (Knee Society Score) in the LCP- group

    The KSS questionnaire includes a Knee Score, rating the knee joint itself (pain, range of motion, stability and radiographic alignment), and a Function Score (patient's walking distance, climbing stairs and use of walking aids).The Knee Score allocates a maximum of 100 points to evaluate range of motion (1 point per 5°, maximum 125°), stability (medial/lateral (15 points) and anterior/posterior (10 points)) and pain (50 points) with deductions for extension lag, flexion contracture and malalignment (if leg axis < 5 or > 10° on radiological examination). A maximum score of 100 points is a well-aligned knee with 125° of motion, almost none anteroposterior or mediolateral instability and no pain. The Function Score considers walking distance (50 points) and stair-climbing (50 points) with deduction if a walking aid is used. A patient who walks unlimited and has no trouble climbing stairs gets the maximum Function Score of 100 points.

    Measured: 12 months post-surgery

  11. Radiological posterior laxity in the LCP+ group

    Qualitative. Radiological examination as part of standard treatment.

    Measured: 4.5 months post-surgery

  12. Radiological posterior laxity in the LCP+ group

    Qualitative. Radiological examination as part of standard treatment.

    Measured: 12 months post-surgery

  13. Radiological posterior laxity in the LCP- group

    Qualitative. Radiological examination as part of standard treatment.

    Measured: 4.5 months post-surgery

  14. Radiological posterior laxity in the LCP- group

    Qualitative. Radiological examination as part of standard treatment.

    Measured: 12 months post-surgery

  15. Cost to the community of the care pathway associated with rehabilitation in the LCP+ group

    Quantitative, in Euros per patient.

    Measured: Up to 12 months after surgery

  16. Cost to the community of the care pathway associated with rehabilitation in the LCP- group

    Quantitative, in Euros per patient.

    Measured: Up to 12 months after surgery

  17. Sustainability of the annual planned budget if using the strategy under evaluation, nationwide, from the health insurance's point of view

    Cost to the French health insurance system of adopting the technique of robotic knee arthroplasty with conservation of the posterior cruciate ligament

    Measured: Up to 12 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 posted24 Mar 2026
  2. Study start10 Oct 2025
  3. Primary completion1 Apr 2027 (estimated)
  4. Study completion1 Sep 2028 (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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a prospective, multicenter, randomized (ratio 1:1), single-blind superiority study comparing two techniques for first-line robotic-assisted total knee replacement (MAKO): preservation of the posterior cruciate ligament (experimental group: "LCP+") versus ablation (control group: "LCP-") . Self-evaluation by the patient, blinded to the group he or she is in, at 12 months.
Masking
Single blind
Who is masked
Participant
Enrolment
300 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07489963
Sponsor's protocol ID
PHRCI/2023/RC01
Acronym
LCPTG
Status last verified
Mar 2026
First submitted
18 Mar 2026
Last updated
27 Mar 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Total knee arthroplasty in people with Knee Arthroplasty, Total, run by Centre Hospitalier Universitaire de Nīmes at 3 sites in France.

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: looking for participants now, as of the sponsor's last update on 27 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in France. 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?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Rémy COULOMB, Dr (+334.66.68.31.56, remy.coulomb@chu-nimes.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Functional impact at of posterior cruciate ligament preservation in the LCP+group (time frame: 12 months post-surgery). The study lists 2 primary outcomes in all. 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 27 Mar 2026.

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