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Trial registered on ANZCTR
Registration number
ACTRN12622001046796p
Ethics application status
Submitted, not yet approved
Date submitted
13/07/2022
Date registered
28/07/2022
Date last updated
28/07/2022
Date data sharing statement initially provided
28/07/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Efficacy of pulsed radiofrequency in the management of pain in trapeziometacarpal (TMC) arthritis
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Scientific title
Efficacy of pulsed radiofrequency in the management of pain in trapeziometacarpal (TMC) arthritis
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Secondary ID [1]
307550
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None
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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:
Trapeziometacarpal arthritis
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Hand functional limitation
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Condition category
Condition code
Musculoskeletal
324176
324176
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0
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Osteoarthritis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Twelve patients suffering from pain due to TMC arthritis will be treated with intra-articular pulsed radiofrequency (PRF); after disinfection of the whole skin of the affected hand and forearm, it will be placed on a table equipped with a sterile cover. After a single injection of local anesthetic at the skin entry site (0.20ml of lidocaine 1%), the needle-probe will be placed by the pain therapist (anesthesiologist) in the TMC joint under fluoroscopy guidance with single shot images to control the position of the probe (total x ray exposure time: approximately 20 seconds); then a stimulation of 2Hz, 42°C, 45V for 7 minutes will be applied. The pulse width will be characterized by a duration of 20 msec followed by a wash-out period of 480 msec silent phase. The treatment will be performed once only in an operating room with adequately shielded walls and the total duration of the procedure will be of approximately 20 minutes. During the procedure, patient vital sign will be monitored: noninvasive blood pressure, heart rate, peripheral oxygen saturation, electrocardiography. After the procedure a sterile medication will be applied at the entry point. Patients will be discharged after one hour observation.
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Intervention code [1]
324006
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Treatment: Devices
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Comparator / control treatment
Twelve patients suffering from pain due to TMC arthritis will be treated with intra-articular Sluijter-Teixera Poisson pulsed radiofrequency (STP PRF); STP PRF uses a Poisson distribution of energy delivered by the probe to reduce the heat development. After disinfection of the whole skin of the affected hand and forearm, it will be placed on a table equipped with a sterile cover. After a single injection of local anesthetic at the skin entry site (0.20ml of lidocaine 1%), the needle-probe will be placed by the pain therapist (anesthesiologist) in the TMC joint under fluoroscopy guidance with single shot images to control the position of the probe (total x ray exposure time: approximately 20 seconds); then a stimulation of 2Hz, 42°C, 45V for 7 minutes will be applied. The pulse width will be characterized by a duration of 20 msec followed wash-out period of 480 msec silent phase The treatment will be performed once only in an operating room with adequately shielded walls and the total duration of the procedure will be of approximately 20 minutes. During the procedure, patient vital sign will be monitored: noninvasive blood pressure, heart rate, peripheral oxygen saturation, electrocardiography. After the procedure a sterile medication will be applied at the entry point. Patients will be discharged after one hour observation.
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Control group
Active
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Outcomes
Primary outcome [1]
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Pain measured with numeric rating scale (NRS)
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Assessment method [1]
331987
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Timepoint [1]
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At 15 days, 1 (primary endpoint), 3, 6, and 12 months after the intervention
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Secondary outcome [1]
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Symptoms and functional status of TMC joint measured with Disabilities of the Arm, Shoulder and Hand (DASH)
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Assessment method [1]
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Timepoint [1]
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At 15 days, 1, 3, 6, and 12 months after the intervention
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Secondary outcome [2]
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Opposition of the thumb measured by Kapandji score
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Assessment method [2]
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Timepoint [2]
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At 15 days, 1, 3, 6, and 12 months after the intervention
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Secondary outcome [3]
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Patient's satisfaction measured by Patient’s Global Impression of Change (PGIC)
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Assessment method [3]
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Timepoint [3]
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At 15 days, 1, 3, 6, and 12 months after the intervention
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Secondary outcome [4]
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Grip strength measured by a dynamometer
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Assessment method [4]
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Timepoint [4]
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At 15 days, 1, 3, 6, and 12 months after intervention
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Eligibility
Key inclusion criteria
Age greater than or equal to 18 years; Eaton-Glickel classification from I to IV; pain in the TMC for more than 3 months
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Minimum age
18
Years
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Maximum age
No limit
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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
Previous surgery at TMC joint; other painful disease of the hand (e.g. carpal tunnel syndrome, de Quervain syndrome, trigger finger); neurodegenerative diseases; psychiatric disorders; patients involved in other studies.
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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)
Central randomization by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The allocation will be performed by a random sequence of numbers generated by a computer
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Data will be first analyzed with Shapiro test to assess the normal distribution. Parametric data will be presented as mean and standard deviation (SD), whereas non parametric data as median and interquartile range (IQR). Statistical analysis will be performed through analysis of variance (ANOVA) for parametric data and Friedman test for non parametric data; ANOVA post hoc analysis will be performed with Tukey test, whereas Friedman post hoc analysis will be performed with Dunn test with Bonferroni correction. Differences will be considered statistically significant when p<0.05.
We determined the sample size assuming alpha=0.05, beta=0.10, and, a standard deviation of 1.1 in order to detect a difference in NRS at 1 month after intervention of 2 point; we estimated a sample size of 8 patients for each of the two groups. We will enroll 12 patients per group, considering a potential 30% drop out rate.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/09/2022
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Actual
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Date of last participant enrolment
Anticipated
1/11/2022
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Actual
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Date of last data collection
Anticipated
1/11/2023
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Actual
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Sample size
Target
24
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
24891
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Italy
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State/province [1]
24891
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Azienda Ospedaliera Universitaria -Federico II
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Address [1]
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Via Sergio Pansini, 5 80131 Naples
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Country [1]
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Italy
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Primary sponsor type
Individual
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Name
Pasquale Buonanno
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Address
Azienda Ospedaliera Universitaria Federico II
Via Sergio Pansini, 5 80131 Naples
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Country
Italy
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Secondary sponsor category [1]
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Individual
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Name [1]
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Francesco Smeraglia
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Address [1]
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Azienda Ospedaliera Universitaria Federico II
Via Sergio Pansini, 5 80131 Naples
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Country [1]
313299
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Italy
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
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Comitato Etico Federico II-AORN Cardarelli Comitato Etico “Università Federico II-AORN Car
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Ethics committee address [1]
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Via Sergio Pansini, 5 80131 Naples
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Ethics committee country [1]
311267
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Italy
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Date submitted for ethics approval [1]
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11/07/2022
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Approval date [1]
311267
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Ethics approval number [1]
311267
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Summary
Brief summary
TMC osteoarthritis has a prevalence of 10% and the subsequent pain can cause discomfort and functional limitations which deeply impact everyday life. Radiological images are fundamental to define the stage of the disease which is usually assesed by Eaton-Glickel classification. Conservative treatment is not generally effective and the effectiveness of surgical approach is not yet clearly defined. Intra-articular pulsed radiofrequency may be considered to manage pain in TMC osteoarthritis: it uses electrical energy to modulate the transmission of pain signal through the nerves. Classic PRF is characterized by fixed parameters of the stimulation; STP-PRF is a novel approach to PRF characterized by a variation of energy delivered according to a Poissson distribution thus limiting the development of heat. The aim of our study is to assess the effectiveness of PRF in the management of pain due to TMC osteoarthritis and to compare PRF and STP-PRF. Our hypothesis is that PRF, which has proved to efficiently relieve other joint pains, can be similarly effective in the management of TMC osteoarthritis; furthermore, we hypothesize that STP-PRF could be superior to classical PRF.
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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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Dr Pasquale Buonanno
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Address
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Azienda Ospedaliera Universitaria Federico II
Via Sergio Pansini, 5 80131 Naples
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Country
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Italy
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Phone
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+390817462545
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Fax
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+380817464719
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Email
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[email protected]
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Contact person for public queries
Name
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Pasquale Buonanno
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Address
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Azienda Ospedaliera Universitaria Federico II
Via Sergio Pansini, 5 80131 Naples
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Country
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Italy
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Phone
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+390817462545
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Fax
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+380817464719
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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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Pasquale Buonanno
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Address
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Azienda Ospedaliera Universitaria Federico II
Via Sergio Pansini, 5 80131 Naples
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Country
120512
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Italy
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Phone
120512
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+390817462545
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Fax
120512
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+380817464719
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
All the demographic data and the outcomes measured without limitations
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When will data be available (start and end dates)?
Data will be available after publication with no end date
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Available to whom?
To qualified researchers for scientific purposes
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Available for what types of analyses?
For articles to be published in international scientific journal
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How or where can data be obtained?
Data can be requested by email to the Principal investigator (Pasquale Buonanno,
[email protected]
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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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