Knee Replacement Techniques for Osteoarthritis
(KMART Trial)
Trial Summary
What is the purpose of this trial?
Knee replacement surgery is the second most common surgery in Canada. People who have very painful knee arthritis usually receive a knee replacement where the surgeon aims to make everyone's knee as straight as possible (called mechanical alignment). Mechanical alignment focuses on making the implant last as long as possible. However, everybody's knee shape is different and we think that it is important to take individual differences into account. A newer technique that is more personalized is called restricted kinematic alignment. This technique customizes the placement of the new knee to reproduce each patient's unique knee shape, which may not be perfectly straight. We think this newer technique may feel more natural, be more stable, and lead to better knee function. Restricted kinematic alignment might last as long or longer than mechanical alignment, but the research that has been conducted to date is not clear. We are conducting this study to help surgeons better understand which technique is better. One of the reasons the existing research is not clear is because new developments in robotic technology now allow surgeons to place knee implants very precisely, which was not done in most previous research. In this study everyone will receive a robot-assisted knee surgery so we can be sure the implants are placed as precisely as possible. The purpose of this trial is to determine whether there are differences in patient outcomes using restricted kinematic alignment rather than the traditionally used mechanical alignment for total knee replacements. Participants who are having total knee replacements will be randomized to receive either a robot-assisted total knee replacement using mechanical alignment, or a robot-assisted total knee replacement using restricted kinematic alignment . We will ask participants to walk in a markerless motion capture system which will measure walking characteristics at pre-op, 6 months postop and 12 months postop. Participants will also complete a series of standardized questionnaires at preop and 6 months, 12 months, and 24 month postop.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the treatment Mechanically-Aligned Arthroplasty, Restricted Kinematically-aligned Arthroplasty for knee osteoarthritis?
Research shows that kinematically aligned knee replacements, which aim to mimic the knee's natural movement, often result in better pain relief and a more natural feeling knee compared to mechanically aligned replacements. This suggests that the kinematic alignment technique may be more effective in restoring normal knee function and improving patient outcomes.12345
Is knee replacement surgery using kinematic or mechanical alignment safe?
How does the kinematic alignment technique for knee replacement differ from other treatments for osteoarthritis?
The kinematic alignment technique for knee replacement is unique because it aims to restore the natural alignment of the knee by positioning the implant to match the patient's pre-arthritic knee anatomy, unlike traditional methods that use a standard mechanical alignment. This approach can lead to better functional outcomes and a more natural feeling knee post-surgery.234910
Eligibility Criteria
This trial is for individuals with painful knee arthritis who are candidates for total knee replacement surgery. Participants will be those interested in a robot-assisted procedure and willing to undergo motion capture assessments and complete questionnaires before and after the operation at specified intervals.Inclusion Criteria
Exclusion Criteria
Timeline
Screening
Participants are screened for eligibility to participate in the trial
Preoperative Assessment
Participants undergo preoperative assessment including walking in a markerless motion capture system to measure walking characteristics
Treatment
Participants receive a robot-assisted total knee replacement using either mechanical alignment or restricted kinematic alignment
Postoperative Follow-up
Participants complete standardized questionnaires and undergo assessments at 6, 12, and 24 months post-operation to monitor outcomes such as gait biomechanics, quality of life, and knee function
Treatment Details
Interventions
- Mechanically-Aligned Arthroplasty
- Restricted Kinematically-aligned Arthroplasty
Find a Clinic Near You
Who Is Running the Clinical Trial?
McMaster University
Lead Sponsor
Canadian Orthopaedic Foundation (funding)
Collaborator
Research Institute of St. Joseph's Hamilton
Collaborator