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Trial registered on ANZCTR
Registration number
ACTRN12606000389505
Ethics application status
Approved
Date submitted
28/08/2006
Date registered
5/09/2006
Date last updated
4/04/2008
Type of registration
Retrospectively registered
Titles & IDs
Public title
An evaluation of knee stability and functions following ACL reconstruction (semitendinosus/gracillis grafts) comparing manually versus mechanically tensioned grafts (using a tensioning device).
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Scientific title
An evaluation of knee stability and functions following Anterior Cruciate Ligament (ACL) reconstruction (semitendinosus/gracillis grafts) comparing manually versus mechanically tensioned grafts (using a tensioning device).
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Knees requiring ACL-Anterior Cruciate Ligament reconstruction
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Condition category
Condition code
Musculoskeletal
1446
1446
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0
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Other surgery
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Two tensioning methods for ACL reconstruction will be used: 1.Manual Tensioning (control group-semitendinosus/gracillis grafts) 2.Tensioning with a Graft Tensioner (intervention group-a tensioning device). Both groups will follow the same postoperative protocols.
Estimated time for procedure 70 mins
Surgical protocol
Tensioning Device Intervention Group:
The graft is fixed to the tensioning device via suture tying
The grafts are tensioned to 60 N for Semitendinosis and 40 Nfor gracillis
The knee is cycled 15 times through full range of motion
The tension is checked and adjusted so that 50 N remain on the semitendinosis graft and 30 N on the gracillis graft
The tibial screw is then fixed in situ with the tension maintained
The femoral fixation will be standardised
Post Operative Management
Both groups will be reconstructed using the semitendinosus/gracilis graft. The same postoperative protocols will be adhered to which involves an accelerated rehabilitation approach. The aim of this protocol is normal gait no aids by 2 weeks, normal range of movement, and minimal swelling within 6 weeks, and the aim of returning to sport in 6-9 months. Patients will be assessed preoperatively, and at 2 weeks, 3, 6 and 12 months post operatively using the measures outlined above.
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Intervention code [1]
1333
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Treatment: Surgery
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Comparator / control treatment
Manually Tensioned Control Group:
Tension and fixation will follow the accepted standard practice of graft fixation
The sutures on the end of the hamstring grafts will be held by the surgeon with force applied whilst the knee is cycled 15 times through a full range of motion
The tibial screw will be fixed in situ with the manually applied tension
The femoral fixation is standardised
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Control group
Active
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Outcomes
Primary outcome [1]
1996
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1.ACL integrity using the KT1000 (a measure of antero-posterior laxity).
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Assessment method [1]
1996
0
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Timepoint [1]
1996
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Collected in the preoperative period, 2 weeks, 6 months, and 12 months post operatively
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Primary outcome [2]
1997
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2.Functional Hop Test (a measure of confidence and function).
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Assessment method [2]
1997
0
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Timepoint [2]
1997
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Measured only at Pre-op 6 and 12 months.
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Secondary outcome [1]
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Lysholm Knee Score, Tegner Activity Level, and the International Knee Documentation Committee (IKDC) Score.
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Assessment method [1]
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Timepoint [1]
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Measured preoperatively (within 4 weeks), and postoperatively at 2 weeks 3, 6, and 12 months.
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Eligibility
Key inclusion criteria
Adult participants.The expected age range of subjects undergoing ACL surgery is between 18-40 years.Patients undergoing primary ACL reconstructionDiagnosis of ACL ruptureHealthy and no comorbidities that would prevent participating in the required rehabilitation programmeNormal mentation with the ability to accurately follow commandsAbility to participate voluntarily and provide signed informed consent.
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Minimum age
18
Years
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Maximum age
Not stated
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Persons with concomitant medical conditions such as malignant tumours or severe Chronic Obstructive Pulmonary Disease that would prevent participation in their rehabilitation programmeInability to follow commandsPersons not able to mobilise in a bipedal manner with or without a walking aid.Conditions preventing full weight bearing post-operativelyThe inability to provide signed informed consentRevision ACL or any previous major arthrotomy on the knee to be operated onPersons not suitable for a gracilis/semitendinosus graftConcomitant meniscal or collateral ligament injuries or any lower limb injury affecting the knee.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
1. Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation. Ratio 1:1
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Physiotherapist blind to intervention collects all measures at each assessment point. Participants blinded to intervention. Surgeon not involved in data collection.
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Phase
Phase 1
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
14/07/2006
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
50
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Queensland Health
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Address [1]
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QLD Health
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
Queensland Health
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Address
QLD Health - QEII Jubilee Hospital
Kessels Rd
Nathan, Brisbane QLD
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Nil
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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088/060
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Ethics committee address [1]
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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25/05/2006
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Ethics approval number [1]
3009
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2006/072
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Summary
Brief summary
We hypothesise that participants receiving a mechanically tensioned ACL graft have superior knee stability and hence function.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Michael Bourke
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Address
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QEII Jubile Hospital
PMB 2
Acacia Ridge
Brisbane QLD 4110
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Country
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Australia
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Phone
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+61 7 32756173
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Fax
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+61 7 32756579
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Email
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[email protected]
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Contact person for scientific queries
Name
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Garry Kirwan
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Address
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QEII Jubile Hospital
PMB 2
Acacia Ridge
Brisbane QLD 4110
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Country
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Australia
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Phone
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+61 7 32756331
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Fax
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+61 7 32756579
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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