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Effects of infrapatellar fat pad preservation versus resection on clinical outcomes after total knee arthroplasty in patients with knee osteoarthritis (IPAKA): Study protocol for a multicentre, randomised, controlled clinical trial

Citation

Zhu, Z and Han, W and Lu, M and Lin, J and Yin, Z and Shang, X and Weng, X and Zha, Z and Tian, J and Lei, G and Hunter, DJ and Ding, C, Effects of infrapatellar fat pad preservation versus resection on clinical outcomes after total knee arthroplasty in patients with knee osteoarthritis (IPAKA): Study protocol for a multicentre, randomised, controlled clinical trial, BMJ Open, 10, (10) pp. 1-8. ISSN 2044-6055 (2020) [Refereed Article]


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DOI: doi:10.1136/bmjopen-2020-043088

Abstract

Introduction: The infrapatellar fat pad (IPFP) is commonly resected during total knee arthroplasty (TKA) for better exposure. However, our previous studies have suggested that IPFP size was protective against, while IPFP signal intensity alteration was detrimental on knee symptoms and structural abnormalities. We hypothesise that an IPFP with normal qualities, rather than abnormal qualities, should be preserved during TKA. The aim of this study is to compare, over a 1-year period, the postoperative clinical outcomes of IPFP preservation versus resection after TKA in patients with normal or abnormal IPFP signal intensity alteration on MRI.

Methods and analysis: Three hundred and sixty people with end-stage knee osteoarthritis and on the waiting list for TKA will be recruited and identified as normal IPFP quality (signal intensity alteration score ≤1) or abnormal IPFP quality (signal intensity alteration score ≥2). Patients in each hospital will then be randomly allocated to IPFP resection group or preservation group. The primary outcomes are the summed score of self-reported Knee Injury and Osteoarthritis Outcome Score (KOOS), KOOS subscales assessing function in daily activities and function in sport and recreation. Secondary endpoints will be included: KOOS subscales (pain, symptoms and quality of life), Knee Society Score, 100 mm Visual Analogue Scale (VAS) Pain, timed up-and-go test, patellar tendon shortening, 100 mm VAS self-reported efficacy of reduced pain and increased quality of life, and Insall-Salvati index assessed on plain X-ray. Adverse events will be recorded. Intention-to-treat analyses will be used.

Ethics and dissemination:The study is approved by the local Medical Ethics Committee (Zhujiang Hospital Ethics Committee, reference number 2017-GJGBK-001) and will be conducted according to the principle of the Declaration of Helsinki (64th, 2013) and the Good Clinical Practice standard, and in compliance with the Medical Research Involving Human Subjects Act . Data will be published in peer-reviewed journals and presented at conferences, both nationally and internationally.

Trial registration number:This trial was registered at Clinicaltrial.gov website on 19 October 2018 with identify number NCT03763448.

Item Details

Item Type:Refereed Article
Keywords:infrapatellar fat pad, osteoarthritis, randomised controlled trial, total knee arthroplasty
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Clinical health
Objective Field:Human pain management
UTAS Author:Zhu, Z (Mr Zhaohua Zhu)
UTAS Author:Han, W (Dr Weiyu Han)
UTAS Author:Ding, C (Professor Chang-Hai Ding)
ID Code:152450
Year Published:2020
Web of Science® Times Cited:3
Deposited By:Medicine
Deposited On:2022-08-19
Last Modified:2022-08-19
Downloads:0

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