Targeted rehabilitation to improve outcome after total knee replacement (TRIO): study protocol for a randomised controlled trial View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2014-12

AUTHORS

A Hamish RW Simpson, David F Hamilton, David J Beard, Karen L Barker, Timothy Wilton, James D Hutchison, Chris Tuck, Andrew Stoddard, Gary J Macfarlane, Gordon D Murray

ABSTRACT

BACKGROUND: Approximately 20% of patients are not satisfied with the outcome of total knee replacement, great volumes of which are carried out yearly. Physiotherapy is often provided by the NHS to address dysfunction following knee replacement; however the efficacy of this is unknown. Although clinically it is accepted that therapy is useful, provision of physiotherapy to all patients post-operatively does not enhance outcomes at one year. No study has previously assessed the effect of targeting therapy to individuals struggling to recover in the early post-operative phase.The aim of the TRIO study is to determine whether stratifying care by targeting physiotherapy to those individuals performing poorly following knee replacement is effective in improving the one year outcomes. We are also investigating whether the structure of the physiotherapy provision itself influences outcomes. METHODS/DESIGN: The study is a multi-centre prospective randomised controlled trial (RCT) of patients undergoing primary total knee replacement, with treatment targeted at those deemed most susceptible to gain from it. Use of the national PROMS programme for pre-operative data collection allows us to screen all patients at initial post-operative clinical review, and recruit only those deemed to be recovering slowly.We aim to recruit 440 patients through various NHS orthopaedic centres who will undergo six weeks of physiotherapy. The intervention will be either 'intensive' involving both hospital and home-based functional exercise rehabilitation, or 'standard of care' consisting of home exercises. Patients will be randomised to either group using a web-based system. Both groups will receive pre and post-intervention physiotherapy review. Patients will be followed-up to one year post-operation. The primary outcome measure is the Oxford Knee Score. Secondary outcomes are patient satisfaction, functional ability, pain scores and cost-effectiveness. TRIAL REGISTRATION: Current Controlled Trials ISRCTN23357609. ClinicalTrials.gov NCT01849445. More... »

PAGES

44

References to SciGraph publications

  • 2008-09. The NICE Cost-Effectiveness Threshold in PHARMACOECONOMICS
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1186/1745-6215-15-44

    DOI

    http://dx.doi.org/10.1186/1745-6215-15-44

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1011971226

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/24484541


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    JSON-LD is a popular format for linked data which is fully compatible with JSON.

    curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1186/1745-6215-15-44'

    N-Triples is a line-based linked data format ideal for batch operations.

    curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1186/1745-6215-15-44'

    Turtle is a human-readable linked data format.

    curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1186/1745-6215-15-44'

    RDF/XML is a standard XML format for linked data.

    curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1186/1745-6215-15-44'


     

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    285 https://www.grid.ac/institutes/grid.4305.2 schema:alternateName University of Edinburgh
    286 schema:name Centre for Population Health Sciences, University of Edinburgh, EH8 9AG, Edinburgh, UK
    287 Department of Trauma and Orthopaedics, University of Edinburgh, EH16 4SB, Edinburgh, UK
    288 Edinburgh Clinical Trials Unit, University of Edinburgh, EH4 2XU, Edinburgh, UK
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    290 https://www.grid.ac/institutes/grid.461589.7 schema:alternateName Nuffield Orthopaedic Centre
    291 schema:name Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, OX3 7LD, Oxford, UK
    292 Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, OX3 7HE, Oxford, UK
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    294 https://www.grid.ac/institutes/grid.4991.5 schema:alternateName University of Oxford
    295 schema:name Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, OX3 7LD, Oxford, UK
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    297 https://www.grid.ac/institutes/grid.7107.1 schema:alternateName University of Aberdeen
    298 schema:name Department of Orthopaedic Surgery, University of Aberdeen, AB25 2ZD, Aberdeen, UK
    299 Epidemiology Group, School of Medicine and Dentistry, University of Aberdeen, AB25 2ZD, Aberdeen, UK
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