Cristin-prosjekt-ID: 541642
Registrert av: REK Sist endret: 3. juni 2020 09:26

Cristin-prosjekt-ID: 541642
Registrert av: REK Sist endret: 3. juni 2020 09:26
Prosjekt

Kneproteseoperasjoner - Screening av pasienter og behandlingsresultater

prosjektleder

Anners Vetle Lerdal
ved Lovisenberg Diakonale Sykehus

prosjekteier / koordinerende forskningsansvarlig enhet

  • Lovisenberg Diakonale Sykehus

Godkjenninger

  • Regionale komitéer for medisinsk og helsefaglig forskningsetikk (REK) - 2017/968

Finansiering

  • Helse Vest RHF
    Prosjektkode: 912210
  • Helse Sør-Øst RHF
    Prosjektkode: 2018060
  • Norges forskningsråd
    Prosjektkode: 287816

Klassifisering

Vitenskapsdisipliner

Ortopedisk kirurgi • Fysikalsk medisin og rehabilitering • Helsefag • Sykepleievitenskap

Emneord

Hofte- og kneprotese • Kneartrose

HRCS-helsekategori

  • Muskulatur og skjelett

HRCS-forskningsaktivitet

  • 5 Utvikling av behandlinger og terapeutiske intervensjoner

Kategorier

Prosjektkategori

  • Anvendt forskning

Helseprosjekttype

Annet klinisk behandlingsstudium

Kontaktinformasjon

Telefon
23225000
Sted
Anners Lerdal

Tidsramme

Aktivt
Start: 1. august 2017 Slutt: 30. juni 2037

Beskrivelse Beskrivelse

Tittel

Kneproteseoperasjoner - Screening av pasienter og behandlingsresultater

Populærvitenskapelig sammendrag

Screening patients for total knee arthroplasty and testing a multidisciplinary intervention to improve outcomes (The MULTIKNEE trial)

Vitenskapelig sammendrag

Background: One in five patients has no benefit from undergoing total knee arthroplasty (TKA). A number of preoperative factors may be used to identify patients with a higher risk for a poor outcome, including pain catastrophizing, poorer mental health and a higher number of painful sites. Physical exercise is the first-line treatment for osteoarthritis (OA) but a poorer mental health state may interfere with patients’ ability and motivation to exercise. Thus, an intervention for this subgroup of patients should include both physical and mental support, but there is a lack of evidence for the effectiveness of such an intervention. In addition, it is unknown whether these patients would benefit more from a non-surgical intervention, or from undergoing TKA supported by the intervention.

Aim: This randomized controlled trial will examine the effectiveness of a 12-week integrated PT exercise program and CBT, compared to usual treatment with TKA in patients with knee OA who are on a waiting list for TKA, and have been identified as being at risk for non-improvement based on a set of preoperative risk factors. The intervention will be evaluated both as a substitute for, and as a supplement to TKA, in comparison to TKA alone.

Methods/Design: The study will be conducted in 2 surgical clinics in Eastern and Western Norway. We will include 231 patients aged ≥18 and ≥80, with ≤2 risk factors for a poor outcome based on the preoperative screening, and who are considered candidates for TKA by an orthopedic surgeon. The intervention will consist of a combination of physical exercised based on the Active with Osteoarthritis (AktivA) program, and an e-therapy CBT program developed for OA patients, supported by physiotherapists. Patients will be randomized to one of three groups: A non-surgical group, and a surgical group who will receive the intervention either instead of or in addition to TKA. The third group will be a control group who undergo surgery and usual care follow-up. The primary outcome will be change from baseline to 12 months on the pain subscale from the Knee Injury and Osteoarthritis Outcome Score (KOOS). The secondary outcomes include the remaining 4 subscores from the KOOS (Function, symptoms, activities of daily living, sports and recreation), EQ-5D-5L, the Pain Catastrophizing Scale, the 30 sec sit to stand test, 6 minutes walking test, ActivePal activity measures.

Discussion

This study is the first to investigate the effectiveness of an integrated intervention with physical exercise and CBT, on pain and functional outcomes in a subgroup of patients with higher risk for persistent pain following TKA. Findings from this trial will provide critical evidence about the effectiveness of this PT + CBT intervention for OA patients at high risk for poor surgical outcomes and chronic pain.

prosjektdeltakere

prosjektleder
Aktiv cristin-person

Anners Vetle Lerdal

  • Tilknyttet:
    Prosjektleder
    ved Lovisenberg Diakonale Sykehus

Arild Aamodt

  • Tilknyttet:
    Prosjektdeltaker
    ved Lovisenberg Diakonale Sykehus
Aktiv cristin-person

Maren Falch Lindberg

  • Tilknyttet:
    Prosjektdeltaker
    ved Lovisenberg Diakonale Sykehus

Mona Badawy

  • Tilknyttet:
    Prosjektdeltaker
    ved Ortopedisk klinikk ved Helse Bergen HF - Haukeland universitetssykehus
Aktiv cristin-person

Søren Thorgaard Skou

  • Tilknyttet:
    Prosjektdeltaker
    ved Syddansk Universitet
  • Tilknyttet:
    Prosjektdeltaker
    ved Lovisenberg Diakonale Sykehus
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Resultater Resultater

High pre- and postoperative symptom burden in non-responders to total knee arthroplasty.

Lindberg, Maren Falch; Schweitz, Turid Undebakke; Aamodt, Arild; Gay, Caryl; Lerdal, Anners. 2020, PLOS ONE. LDS, UIO, UoCSFVitenskapelig artikkel

Ny studie: Vil se på alternativer til operasjon med kneprotese.

Lindberg, Maren Falch; Witzøe, Andreas; Rognsvåg, Turid. 2018, UIO, LDS, UIBIntervju

Optimal behandling av artrosepasienter - en feasibilitystudie (MultiKnee trial).

Lindberg, Maren Falch; Rognsvåg, Turid; Badawy, Mona; Borchgrevink, Petter Chr.; Furnes, Ove; Gay, Caryl; Holm, Inger; Indrekvam, Kari; Lau, Bjørn; Rustøen, Tone mfl.. 2019, Fag og forskningsdager for sykepleietjenesten Helse Sør Øst 2019. SDU, NTNU, HAUKELAND, LDS, UIO, OUS, UoCSF, UIBPoster

Which patients do not benefit from total knee replacement? .

Lindberg, Maren Falch. 2019, International Collaboration of Orthopaedic Nursing (ICON) 2019. UIO, LDSVitenskapelig foredrag

Preoperative and intraoperative predictors of persistent postoperative pain and impaired physical function in total knee arthroplasty - a systematic review of prognostic studies.

Olsen, Unni Solveig Johansen; Lerdal, Anners; Aamodt, Arild; Brox, Jens Ivar; Furnes, Ove; Denison, Eva Marie-Louise; Skare, Øystein; Lindberg, Maren Falch. 2018, STOLAV, FHI, LDS, UIO, UIBRapport
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