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Trial registered on ANZCTR
Registration number
ACTRN12622001433796
Ethics application status
Approved
Date submitted
3/11/2022
Date registered
8/11/2022
Date last updated
6/03/2023
Date data sharing statement initially provided
8/11/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Arthroscopic Stiff Elbow release and Botox
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Scientific title
The Effect of Postoperative Administration of Botox vs Placebo (Normal Saline) on Elbow Range of Motion in Patients Undergoing Arthroscopic Osteocapsular Release for Patients with Elbow Contracture: A Pilot Triple-Blind Randomized Controlled Trial
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Secondary ID [1]
308315
0
None
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Universal Trial Number (UTN)
U1111-1284-5107
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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:
Elbow Contracture
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Condition category
Condition code
Musculoskeletal
325154
325154
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The dependent variable (intervention) will be 100 units of Botulinum toxin reconstituted with 2 cc of Normal Saline, introduced using a one-off intramuscular injection into the bifurcation of the biceps in the upper arm and the brachialis at the level of the elbow joint, under ultrasound guidance by the anesthetist postoperatively, at the time when the anesthetist inserts a pain catheter for postoperative pain control for patients undergoing arthroscopic osteocapsular release for elbow contractures. As this trial aims compare the effect of a one-off administration of the intervention (botulinum toxin reconstituted with normal saline) compared to a one-off administration of a placebo (normal saline only) pre-surgery, adherence to the intervention is not applicable.
All other processes of arthroscopic osteocapsular release for elbow contractures will occur as per usual standard care.
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Intervention code [1]
324766
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Treatment: Drugs
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Comparator / control treatment
The control (placebo) will be 2 cc of Normal Saline, in a one-off intramuscular injection into the bifurcation of the biceps in the upper arm and the brachialis at the level of the elbow joint, under ultrasound guidance by the anesthetist postoperatively, at the time when the anesthetist inserts a pain catheter for postoperative pain control. for patients undergoing arthroscopic osteocapsular release for elbow contractures.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Elbow flexion and extension range of motion will be assessed by a blinded member of the study team, who will take photographs of the elbow in maximal active flexion and maximal active extension from the lateral (side) view.
Computer-based software will then be used to assess the range of motion in and flexion-extension.
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Assessment method [1]
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Timepoint [1]
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Preoperatively, and at 3, 6, and 12 months postoperatively
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Primary outcome [2]
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Elbow supination and pronation range of motion will be assessed by a blinded member of the study team, who will take photographs of the patient from the anterior (front) view, with the patient holding straight markers in both hands in maximal active pronation and maximal active supination.
Computer-based software will then be used to assess the range of motion in and pronation-supination.
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Assessment method [2]
332979
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Timepoint [2]
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Preoperatively, and at 3, 6, and 12 months postoperatively
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Secondary outcome [1]
415409
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Mayo Elbow Performance Index
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Assessment method [1]
415409
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Timepoint [1]
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Preoperatively, and at 3, 6, and 12 months postoperatively
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Secondary outcome [2]
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Oxford Elbow Score
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Assessment method [2]
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Timepoint [2]
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Preoperatively, and at 3, 6, and 12 months postoperatively
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Eligibility
Key inclusion criteria
Patient complains of elbow stiffness, end of range of motion pain, and/or mechanical symptoms consistent with a mechanical block to range of motion.
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Minimum age
18
Years
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Maximum age
60
Years
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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
Patients with past history of botulism, peripheral neuropathy, or myasthenia gravis.
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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)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomization
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
To achieve study objectives, ten patients are needed in the intervention group, and ten patients in the control group.
Wilcoxon signed-rank test will be used to compare outcomes at different timepoints within the same group.
Mann Whitney U tests will be used to compare outcomes at the same timepoints between the intervention and control groups.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
21/11/2022
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Actual
15/12/2022
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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
20
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Accrual to date
2
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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Other
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Name [1]
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Orthocentre
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Address [1]
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Orthocentre, 86 Kareena Rd, Caringbah, NSW 2229
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
John Trantalis
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Address
Orthocentre, 86 Kareena Rd, Caringbah, NSW 2229
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Jehan Hamid
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Address [1]
314167
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Orthocentre, 86 Kareena Rd, Caringbah, NSW 2229
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Country [1]
314167
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
311889
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Ramsay Health Care New South Wales | Victoria Human Research Ethics Committee
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Ethics committee address [1]
311889
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Ramsay Health Care NSW | VIC HREC Ramsay Health Care Level 7, Tower B 7 Westbourne Street St Leonards NSW 2065
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Ethics committee country [1]
311889
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Australia
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Date submitted for ethics approval [1]
311889
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31/03/2022
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Approval date [1]
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10/04/2022
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Ethics approval number [1]
311889
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HREC Reference Number: 2021-1010
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Summary
Brief summary
This pilot study aims to compare patient-rated outcomes and range of motion between patients who undergo surgical stiff elbow release, treated with an injection of botulinum toxin (botox) pre-surgery vs placebo. We hypothesized that the injection of botox into the biceps and brachialis immediately before surgery may result in greater range of motion (less stiffness) following surgical release.
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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 John Trantalis
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Address
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Orthocentre, 86 Kareena Rd, Caringbah, NSW 2229
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Country
122730
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Australia
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Phone
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+61 2 9525 2055
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Fax
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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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John Trantalis
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Address
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Orthocentre, 86 Kareena Rd, Caringbah, NSW 2229
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Country
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Australia
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Phone
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+61 2 9525 2055
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Fax
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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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John Trantalis
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Address
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Orthocentre, 86 Kareena Rd, Caringbah, NSW 2229
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Country
122732
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Australia
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Phone
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+61 2 9525 2055
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Fax
122732
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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?
After de-identification, patient age at time of surgery, sex, range of motion in elbow flexion, extension, supination, and pronation, and Mayo Elbow Performance Index and Oxford Elbow Scores.
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When will data be available (start and end dates)?
Start date: Immediately following publication
End date: No end date
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Available to whom?
Case-by-case basis at the discretion of Primary Sponsor and Principal Investigator (upon reasonable request).
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Available for what types of analyses?
Any purpose
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How or where can data be obtained?
access subject to approvals by Principal Investigator (
[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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