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Ultrasound guided needle therapy in LE


- candidate number16887
- NTR NumberNTR4569
- ISRCTNISRCTN no longer applicable
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR17-mrt-2014
- Secondary IDsnot applicable 
- Public TitleUltrasound guided needle therapy in LE
- Scientific Title(Cost)-Effectiveness of Ultrasound Guided Percutaneous treatment of Lateral Epicondylitis using perforation, or infiltration with autologous blood, PRP’s or dextrose in relation to pain; A randomized controlled trial.
- ACRONYM
- hypothesisOur hypothesis is that there is no difference in efficacy between perforation and perforation with application of one of the injection fluids. The potential health care efficiency gain consists of more homogeneity in the treatment of LE. Hereby, unnecessary treatments can be avoided, a more universal method of treatment can be established and the quality of the treatment can be improved.
- Healt Condition(s) or Problem(s) studiedLateral Epicondylitis , Treatment
- Inclusion criteria•Patients referred by their GP to the orthopaedic surgeon for injection therapy
•Age between 18 and 65 years
•Diagnosed with unilateral Lateral Epicondylitis
•Unsuccessful conservative treatment
•Able to read and write in Dutch
•More than 6 weeks of pain and disability at work
•Provision of informed consent by patient.

In addition, pain reduction seems dependent on physical factors like high physical job demands and psychosocial factors like pain catastrophizing. To secure similar group sizes and comparable work-related characteristics at each point in time, pre-stratification and block randomization will be used.
- Exclusion criteriaA potential subject who meets any of the following criteria will be excluded from participation in this study:
· Prior injection therapy, surgery or trauma at the affected elbow.
· Inflammatory diseases (i.e. rheumatoid arthritis, psoriatic arthritis, or reactive arthritis).
· Patients with any other elbow pathology.
· Neck pain or shoulder pain or other chronic widespread pain syndromes.
· Traumatic onset of LE.
· Bilateral LE.
· Abnormalities on the X-ray.
· Patients with additional pain at the medial epicondyl.
· Allergy for lidocaine
- mec approval receivedno
- multicenter trialyes
- randomisedyes
- masking/blindingSingle
- controlPlacebo
- groupCrossover
- Type2 or more arms, randomized
- Studytypeintervention
- planned startdate 1-nov-2015
- planned closingdate1-jan-2017
- Target number of participants165
- InterventionsThe following treatments are investigated:
- Perforation with infiltration of autologous blood; blood is taken by venipuncture and directly injected in the affected tendon
- Perforation with infiltration of dextrose: solution with 4ml of 50% dextrose+ 4ml of 90% saline + 2ml of 1% lidocaine
- Perforation without infiltration all treatments will be performed ultrasound guided and in a standardized and automated way
- Primary outcomeTThe main study parameters are the changes in pain using a Visual Analog Scale (VAS, 0-100) (Bodian e.a. 2001) 5 months after treatment:
- After provocation test; pain during resisted dorsiflexion of the wrist during full elbow extension
- Secondary outcomeSecondary study parameters are the changes in pain using a Visual Analog Scale (VAS, 0-100) compared to baseline 5 months after treatment and after 8 weeks and 1 year after treatment, functional recovery, Quality adjusted life years and complications
- TimepointsAssessments will be made before the treatment (baseline), after 8 weeks, 5 months and 1 years after treatment. At each follow-up visit the orthopedic surgeon or trained investigator will perform a physical examination of the elbow and patients will be asked to complete questionnaires. At the last follow-up visit, the surgeon or investigator will rate any interventions and/or complications
- Trial web site
- statusplanned
- CONTACT FOR PUBLIC QUERIESMD R. Keijsers
- CONTACT for SCIENTIFIC QUERIESMD R. Keijsers
- Sponsor/Initiator Amphia Hospital Breda, Onze Lieve Vrouwe Gasthuis (OLVG), Academic Medical Center (AMC), Amsterdam
- Funding
(Source(s) of Monetary or Material Support)
- Publications
- Brief summary
- Main changes (audit trail)
- RECORD17-mrt-2014 - 18-okt-2015


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