| 試験進捗状況 | 試験終了/Completed |
| UMIN試験ID | UMIN000036212 |
| 受付番号 | R000041247 |
| 科学的試験名 | 自家ハムストリング腱を用いた膝前十字靭帯解剖学的2重束再建術後の免荷期間の相違が骨孔拡大に与える影響に関する研究 |
| 一般公開日(本登録希望日) | 2019/03/15 |
| 最終更新日 | 2019/03/15 (1版) |
| 基本情報/Basic information | |||
| 一般向け試験名/Public title | 自家ハムストリング腱を用いた膝前十字靭帯解剖学的2重束再建術後の免荷期間の相違が骨孔拡大に与える影響に関する研究 | Prospective comparisons of femoral tunnel enlargement with two different postoperative non weight bearing periods after double-bundle anterior cruciate ligament reconstruction with hamstring grafts | |
| 一般向け試験名略称/Acronym | 自家ハムストリング腱を用いた膝前十字靭帯解剖学的2重束再建術後の免荷期間の相違が骨孔拡大に与える影響に関する研究 | Prospective comparisons of femoral tunnel enlargement with two different postoperative non weight bearing periods after double-bundle anterior cruciate ligament reconstruction with hamstring grafts | |
| 科学的試験名/Scientific Title | 自家ハムストリング腱を用いた膝前十字靭帯解剖学的2重束再建術後の免荷期間の相違が骨孔拡大に与える影響に関する研究 | Prospective comparisons of femoral tunnel enlargement with two different postoperative non weight bearing periods after double-bundle anterior cruciate ligament reconstruction with hamstring grafts | |
| 科学的試験名略称/Scientific Title:Acronym | 自家ハムストリング腱を用いた膝前十字靭帯解剖学的2重束再建術後の免荷期間の相違が骨孔拡大に与える影響に関する研究 | Prospective comparisons of femoral tunnel enlargement with two different postoperative non weight bearing periods after double-bundle anterior cruciate ligament reconstruction with hamstring grafts | |
| 試験実施地域/Region |
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| 対象疾患/Condition | |||
| 対象疾患名/Condition | 膝前十字靭帯断裂 | Knee anterior cruciate ligament rupture
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| 疾患区分1/Classification by specialty |
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| 疾患区分2/Classification by malignancy | 悪性腫瘍以外/Others | ||
| ゲノム情報の取扱い/Genomic information | いいえ/NO | ||
| 目的/Objectives | ||
| 目的1/Narrative objectives1 | 自家ハムストリング腱を用いた解剖学的2重束膝前十字靭帯再建術は良好な成績が報告されているが、術後の骨孔拡大も懸念されている。また、同術式の術後の免荷期間に関しては日本整形外科学会でも見解の一致をみておらず、明確な指標はないのが現状である。今回は術後の最適な免荷期間と骨孔拡大への影響を明らかにすることを目的とし、診療情報や画像解析についての検討をおこなう。 | Bone tunnel enlargement following primary anterior cruciate ligament (ACL) reconstruction with soft tissue graft might be a severe disadvantage for revision surgery. The postoperative rehabilitation protocol including the non-weight-bearing periods were different depending on the surgeon or institute. To determine the relationship between femoral bone tunnel enlargement and the postoperative non-weight-bearing period after double-bundle ACL reconstruction with hamstring grafts. |
| 目的2/Basic objectives2 | 有効性/Efficacy | |
| 目的2 -その他詳細/Basic objectives -Others | ||
| 試験の性質1/Trial characteristics_1 | ||
| 試験の性質2/Trial characteristics_2 | ||
| 試験のフェーズ/Developmental phase | ||
| 評価/Assessment | ||
| 主要アウトカム評価項目/Primary outcomes | 術後1年経過時の大腿骨骨孔拡大の有無 | Bone tunnel enlargement was evaluated by computed digital radiographs (anteroposterior (A-P) and lateral views) taken on the first postoperative day and at 12 months. |
| 副次アウトカム評価項目/Key secondary outcomes | 1.膝屈曲・伸展筋力
2.膝前後動揺性 3.膝関節可動域 |
1.knee extension and flexion muscle strength
2.side to side difference 3.knee range of motion |
| 基本事項/Base | ||
| 試験の種類/Study type | 介入/Interventional | |
| 試験デザイン/Study design | ||
| 基本デザイン/Basic design | 単群/Single arm | |
| ランダム化/Randomization | 非ランダム化/Non-randomized | |
| ランダム化の単位/Randomization unit | ||
| ブラインド化/Blinding | オープン/Open -no one is blinded | |
| コントロール/Control | 無対照/Uncontrolled | |
| 層別化/Stratification | ||
| 動的割付/Dynamic allocation | ||
| 試験実施施設の考慮/Institution consideration | ||
| ブロック化/Blocking | ||
| 割付コードを知る方法/Concealment | ||
| 介入/Intervention | |||
| 群数/No. of arms | 1 | ||
| 介入の目的/Purpose of intervention | 治療・ケア/Treatment | ||
| 介入の種類/Type of intervention |
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| 介入1/Interventions/Control_1 | ハムストリング腱を用いた膝前十字靭帯解剖学的2重束再建術を施行し、直後より術後装具を用いて手術室にて膝固定を行った症例を対象とし、膝固定は1週間とする。術後の免荷期間を1週間群、2週間群に分類する。術式は同一である。術後免荷期間以外のリハビリプロトコールは同一であり術後1週の膝固定を行い、完全免荷以後に部分荷重歩行を開始し、1週免荷群は4週で2週免荷群は5週で全荷重となる。術後3カ月よりランニング動作を開始し、術後6カ月でジャンプ、ステップ動作を始める。術後8カ月でスポーツ復帰を許可する。通常診療として術後3,6,8,12カ月目で膝レントゲン撮影、筋力測定膝不安定性測定および可動域測定をおこなっている。 | These cases who were undergoing primary double-bundle ACL reconstruction with hamstring grafts were allocated into two different postoperative non-weight-bearing protocol groups; the allocation was conducted in a serial consecutive, not randomized,fashion:the first consecutive group of patients(Group A)received 1 week of non-weight-bearing postoperatively;the second consecutive group of patients received 2 weeks of non-weight-bearing Group B).In the operation room,the knee was immobilized with a brace with the knee positioned in the angle 20 of flexion for both groups to maintain the same angle as during graft fixation at surgery to avoid stress on the grafts. After the protocol immobilization period, range of motion exercises were performed gradually, with knee flexion of 10 degrees started with a locked hard brace for 1 week, following which full extension was allowed for both groups. In group A, partial weight-bearing was started at 1 week following surgery, with full weight-bearing at 4 weeks. For group B, partial weight-bearing was started at 2 weeks after surgery, with full weight-bearing at 5 weeks. Therefore, the non-weight-bearing period of group A was 1 week, and that of group B was 2 weeks. All patients used the knee brace for the first 3 months after surgery. Jogging and running were allowed at 3 months postoperatively. Return to the athletic movement such as jumping or cutting actions were allowed at 6 months. and return to full sports activity was no sooner than 8 months after surgery | |
| 介入2/Interventions/Control_2 | |||
| 介入3/Interventions/Control_3 | |||
| 介入4/Interventions/Control_4 | |||
| 介入5/Interventions/Control_5 | |||
| 介入6/Interventions/Control_6 | |||
| 介入7/Interventions/Control_7 | |||
| 介入8/Interventions/Control_8 | |||
| 介入9/Interventions/Control_9 | |||
| 介入10/Interventions/Control_10 | |||
| 適格性/Eligibility | |||||
| 年齢(下限)/Age-lower limit |
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| 年齢(上限)/Age-upper limit |
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| 性別/Gender | 男女両方/Male and Female | ||||
| 選択基準/Key inclusion criteria | 対象者
医の倫理委員会承認後~2018年3月31日までに宮崎大学医学部附属病院整形外科において自家ハムストリング腱を用いた膝前十字靭帯解剖学的2重束再建術を受け、術後12ヵ月目の診療が可能であった患者を対象とする。なお、コントロール群として、本研究以前(平成22年4月から平成24年3月)に当院にて膝前十字靭帯再建術を施行し、通常診療の経過で入手したデータを用いる。 選択基準 1.術後リハビリプランおよび経過診察を完遂できた患者 2.術後12ヵ月経過時のレントゲン撮影、経過診察、膝屈曲・伸展筋力測定、膝可動域測定および膝関節動揺性測定が可能であった患者 |
Subject
The present prospective, comparative clinical research was conducted in 2014, involving patients who underwent double-bundle ACL reconstruction with hamstring tendon autografts, under the same surgical technique and the same surgical devices at our institute. The experimental design was reviewed and approved by the Committee for Ethics at our institution. The procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. We obtained written, informed consent form from all patients and guardians for publication of this report and any accompanying images. As control, data of the patients who underwent ACL reconstruction with same procedure at 2012-13 in our institute were employed. Selection Criteria 1.Patients who completed the rehabilitation protocol during the follow-up period 2. Patients who could collected the full clinical and radiological data available, such as general clinical scores, knee extension/flexion muscle strength measurements, and femoral bone tunnel enlargement measured by digital radiography of the knee 12 months postoperatively. |
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| 除外基準/Key exclusion criteria | 1.膝複合靭帯損傷症例
2.半月縫合術を併用した症例 3.反張膝症例 4.経過中に再受傷した症例 5.15歳以下の小児例 6.その他、実施責任者が被験者として不適当と判断した患者 |
1.knee multiple ligament injury cases
2.ACL reconstruction with meniscal repair cases 3.The genu recurvatum cases 4.Re-injury cases 5.Under 15 years old cases 6.other unsuitable cases |
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| 目標参加者数/Target sample size | 30 | ||||
| 責任研究者/Research contact person | ||||||||||||||
| 責任研究者/Last name of lead principal investigator |
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| 所属組織/Organization | 宮崎大学医学部附属病院 | University of Miyazaki Hospital | ||||||||||||
| 所属部署/Division name | 整形外科 | Orthopaedic Surgery | ||||||||||||
| 郵便番号/Zip code | 8891692 | |||||||||||||
| 住所/Address | 宮崎県宮崎市清武町木原5200 | 5200 Kihara Kiyotake Miyazaki 889-1692 JAPAN | ||||||||||||
| 電話/TEL | 0985850986 | |||||||||||||
| Email/Email | seikei@med.miyazaki-u.ac.jp | |||||||||||||
| 試験問い合わせ窓口/Public contact | ||||||||||||||
| 試験問い合わせ窓口担当者/1st name of contact person |
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| 組織名/Organization | 宮崎大学医学部附属病院 | University of Miyazaki Hospital | ||||||||||||
| 部署名/Division name | 整形外科 | Orthopaedic Surgery | ||||||||||||
| 郵便番号/Zip code | 8891692 | |||||||||||||
| 住所/Address | 宮崎県宮崎市清武町木原5200 | 5200 Kihara Kiyotake Miyazaki 889-1692 JAPAN | ||||||||||||
| 電話/TEL | 0985850986 | |||||||||||||
| 試験のホームページURL/Homepage URL | ||||||||||||||
| Email/Email | seikei@med.miyazaki-u.ac.jp | |||||||||||||
| 実施責任組織/Sponsor | ||
| 機関名/Institute | 宮崎大学 | University of Miyazaki Hospital |
| 機関名/Institute (機関選択不可の場合) |
宮崎大学医学部附属病院 | |
| 部署名/Department | 整形外科 | |
| 研究費提供組織/Funding Source | ||
| 機関名/Organization | 無し | None |
| 機関名/Organization (機関選択不可の場合) |
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| 組織名/Division | ||
| 組織の区分/Category of Funding Organization | 自己調達/Self funding | |
| 研究費拠出国/Nationality of Funding Organization | ||
| その他の関連組織/Other related organizations | ||
| 共同実施組織/Co-sponsor | ||
| その他の研究費提供組織/Name of secondary funder(s) | ||
| IRB等連絡先(公開)/IRB Contact (For public release) | ||
| 組織名/Organization | 宮崎大学臨床研究支援センター | University of Miyazaki Research Support Center |
| 住所/Address | 宮崎県宮崎市清武町木原5200 | University of Miyazaki Hospital |
| 電話/Tel | 0985850986 | |
| Email/Email | seikei@med.miyazaki-u.ac.jp | |
| 他機関から発行された試験ID/Secondary IDs | ||
| 他機関から発行された試験ID/Secondary IDs | いいえ/NO | |
| 試験ID1/Study ID_1 | ||
| ID発行機関1/Org. issuing International ID_1 | ||
| 試験ID2/Study ID_2 | ||
| ID発行機関2/Org. issuing International ID_2 | ||
| 治験届/IND to MHLW | ||
| 試験実施施設/Institutions | ||
| 試験実施施設名称/Institutions | ||
| その他の管理情報/Other administrative information | ||||||||
| 一般公開日(本登録希望日)/Date of disclosure of the study information |
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| 関連情報/Related information | ||
| プロトコル掲載URL/URL releasing protocol | ||
| 試験結果の公開状況/Publication of results | 最終結果が公表されている/Published | |
| 結果/Result | ||
| 結果掲載URL/URL related to results and publications | ||
| 組み入れ参加者数/Number of participants that the trial has enrolled | 28 | |
| 主な結果/Results | ||
| 主な結果入力日/Results date posted | ||
| 結果掲載遅延/Results Delayed | ||
| 結果遅延理由/Results Delay Reason | ||
| 最初の試験結果の出版日/Date of the first journal publication of results | ||
| 参加者背景/Baseline Characteristics | ||
| 参加者の流れ/Participant flow | ||
| 有害事象/Adverse events | ||
| 評価項目/Outcome measures | ||
| 個別症例データ共有計画/Plan to share IPD | ||
| 個別症例データ共有計画の詳細/IPD sharing Plan description | ||
| 試験進捗状況/Progress | ||||||||
| 試験進捗状況/Recruitment status | 試験終了/Completed | |||||||
| プロトコル確定日/Date of protocol fixation |
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| 倫理委員会による承認日/Date of IRB |
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| 登録・組入れ開始(予定)日/Anticipated trial start date |
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| フォロー終了(予定)日/Last follow-up date |
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| 入力終了(予定)日/Date of closure to data entry | ||||||||
| データ固定(予定)日/Date trial data considered complete |
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| 解析終了(予定)日/Date analysis concluded |
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| その他/Other | ||
| その他関連情報/Other related information | ||
| 管理情報/Management information | ||||||||
| 登録日時/Registered date |
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| 最終更新日/Last modified on |
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| 閲覧ページへのリンク/Link to view the page | |
| URL(日本語) | https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000041247 |
| URL(英語) | https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000041247 |