Skip to main content
OpenTrials
Completed

NCT Number: NCT03326180

Study of Peri-Articular Anaesthetic for Replacement of the Knee

The clinical and cost effectiveness of peri-articular liposomal bupivacaine plus bupivacaine hydrochloride compared with bupivacaine hydrochloride alone for post-operative recovery after knee replacement surgery: A multi-centre, patient-blinded, randomised controlled trial.

Completed

Looking for future studies?

Notify Me

Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

The Royal Orthopaedic Hospital, Birmingham, United Kingdom

Loading trial locations.

About this study

The trial design is a patient-blinded multi-centre, active comparator, randomised controlled two-arm parallel group superiority trial of liposomal bupivacaine plus bupivacaine hydrochloride versus bupivacaine alone for post-operative pain in patients undergoing knee replacement surgery.

Patients will be randomised in a 1:1 ratio. The randomised controlled trial (RCT) design is robust and reduces any potential bias. Patients will be blinded as to which treatment they receive. Blinding of patients is possible as they will be under general anaesthetic for their knee replacement surgery at the time of the drug administration. Blinding of surgeons, who administer the medication and outcome assessors was not necessary as the primary outcome is a patient reported outcome measure.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Unilateral primary knee replacement, including both total knee replacement (TKR) or unicompartmental knee replacement (UKR), for end stage osteoarthritis
  • American Society of Anaesthesiologists (ASA) Grade I to III
  • Participant is willing and able consent for themselves
  • Male or Female, aged 18 years or above
  • In the Investigator's opinion, is able and willing to comply with all trial requirements

Exclusion criteria

  • Allergy or intolerance to amide type local anaesthetics
  • Objective evidence of nerve damage in the affected lower limb.
  • Rheumatoid arthritis
  • Any other significant disease, disorder or condition which, in the opinion of the Investigator, may either put the participants at risk because of participation in the trial, or may influence the results of the trial, or the participant's ability to participate in the trial.
  • Participants who have participated in another research trial involving an investigational product in the past 6 months.
  • Participants who have significant cognitive impairment or language issues
  • Contra-lateral knee replacement within the trial or within 12 months prior to randomisation

Treatment and study plan

Liposomal bupivacaine

Drug

266mg/20ml vial of EXPAREL

Other names: EXPAREL

Bupivacaine Hydrochloride

Drug

100mg/20ml 0.5% bupivacaine hydrochloride. Branded or generic, must be plain (cannot contain adrenaline/epinephrine)

Other names: Marcain

Primary outcomes

  1. Quality of Recovery 40 (QoR-40)

    Time frame: Change in score between 0, 24, 48 and 72 hours post-operatively

    A 40-item instrument which encompass most aspects of a good quality of recovery after surgery. Consists of five clinically relevant dimensions:

    • Physical comfort (12 items)
    • Emotional state (9 items)
    • Physical independence (5 items)
    • Psychological support (7 items)
    • Pain (7 items).

    The QoR-40 has a possible score of 40 (extremely poor quality of recovery) to 200 (excellent quality of recovery).

  2. Cumulative 0-10 pain Visual Analogue Score (VAS)

    Time frame: Cumulative score at 0, 24, 48 and 72 hours post-operatively

    Cumulative daily pain score at rest.

    A 10 point scale where 0 = no pain, 5 = moderate pain and 10 = worst possible pain.

Secondary outcomes

  1. Mean 0-10 pain Visual Analogue Score (VAS)

    Time frame: 0, 24, 48 and 72 hours post-operatively

    Mean daily pain score at rest.

    A 10 point scale where 0 = no pain, 5 = moderate pain and 10 = worst possible pain.

  2. Opioid consumption

    Time frame: Change in consumption between 0, 24, 48 and 72 hours post-operatively

    Cumulative consumption

  3. Fitness for discharge (as per routine clinical care)

    Time frame: Assessed at 0, 24, 48 and 72 hours post-operatively

    Against pre-defined criteria. Patients would be considered fit for discharge when they meet the following criteria: Ability to mobilize independently; pain score less than or equal to 3mm on a 10 VAS; ability to straight leg raise and ability to bend knee to 90 degrees

  4. Oxford Knee Score (OKS)

    Time frame: Change in score between baseline, 72 hours, 6 weeks, 6 months, 1 year post-operatively

    Functional outcome using validated, patient reported questionnaire

  5. American Knee Society Score (AKSS)

    Time frame: Change in score between baseline, 72 hours, 6 weeks, 6 months, 1 year post-operatively

    Functional outcome using validated, patient reported questionnaire

  6. EuroQol 5 Dimension scale

    Time frame: Change in score between baseline, 72 hours, 6 weeks, 6 months, 1 year post-operatively

    Validated patient reported quality of life questionnaire

  7. Health economics

    Time frame: Change in cost utility between baseline, 6 weeks, 6 months, 1 year post-operatively

    Cost utility analysis

  8. Serious Adverse Events (SAE)

    Time frame: Within 30 days of surgery

    Specifically cardiovascular or wound complications

Sponsors and collaborators

Lead sponsor

University of Leeds

Other

Collaborators

  • University of Oxford

Registry information

Acronym: SPAARK

Important dates

Study start
2018
Primary completion
2021
Study completion
2021
First posted
Oct 31, 2017
Registry last updated
Nov 4, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.