Injection of Hyaluronic Acid Versus Corticosteroid for Treatment of Trigger Finger
Ultrasound-Guided Injection of Hyaluronic Acid Versus Corticosteroid for Treatment of Trigger Finger: Randomized Controlled Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Early Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Sahar S Khalil, SSR
- Phone Number: 00971557557453
- Email: sskhalil@dha.gov.ae
Study Contact Backup
- Name: Mohamed M Abdulla, Consultant
- Phone Number: 00971506584352
- Email: mmabdulla@dha.gov.ae
Study Locations
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-
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Dubai, United Arab Emirates
- Recruiting
- Dubai Hospital- Dubai Health Authority
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Contact:
- Phone Number: 00971 442195718
- Email: mmabdulla@dha.gov.ae
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Principal Investigator:
- Sahar Khalil, SSR
-
Sub-Investigator:
- Mohamed Abdulla
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adult (>18 years)
- Patients with a clinical diagnosis of trigger finger grade 1-3 on the Quinnell grading scale and confirmed diagnosis by ultrasound.
Exclusion Criteria:
- Quinnell's classification grade IV (contracture)
- Prior injection within 6 months
- Prior operation of the affected finger
- Presence of any contracture in the proximal interphalangeal or metacarpophalangeal joint, and
- History of diabetes, hypothyroidism, and
- Rheumatic or connective tissue disease
- Allergy to triamcinolone or hyaluronic acid
- Pregnancy
- Secondary triggering e.g. Trauma, infection
- Trigger finger symptoms duration >6 months
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Hyaluronic acid
1mL of hyaluronic acid (20 mg/2 mL; Hyalgan, Fidia, Abano Terme, Italy) infiltration at A1-Pulley under ultrasound guidance after subcutaneous 2% lidocaine without epinephrine infiltration of the skin overlying the A1-pulley.
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A1-Pulley infiltration for trigger finger
Other Names:
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Active Comparator: Triamcinolone acetonide
1 mL of Triamcinolone acetonide 10mg/ml infiltration at A1-Pulley under ultrasound guidance after subcutaneous 2% lidocaine without epinephrine infiltration of the skin overlying the A1 pulley.
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A1-Pulley infiltration for trigger finger
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Quinnell trigger finger grading system:
Time Frame: 1 and 3 months post-injection
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Change in Quinnell grading overtime within 3 months after injection.
Trigger fingers are rated as follows: Grade 0: normal finger movements, Grade 1: uneven finger movements, Grade 2: actively correctable triggering, Grade 3: passively correctable triggering, and Grade 4: locked digit.
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1 and 3 months post-injection
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Visual analogue scale (VAS) of pain
Time Frame: 1 and 3 months post-injection
|
Change in pain Visual analogue scale will be recorded.
The patient marks on the 100 mm in length line the point that he/she feels to represent his/her perception of pain at the current state.
The VAS score is determined by measuring in millimetres from the left hand end of the line to the point that the patient marks ( a higher score indicates greater pain intensity).
Categorization of none, mild, moderate and severe pain will be also used (none = 0, mild = 1-4, moderate = 5-6, and severe = 7-10).
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1 and 3 months post-injection
|
|
Frequency of tender trigger nodules
Time Frame: 1 and 3 months post-injection
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Identifying the presence of tender nodules at A1-pulley of the affected finger by palpation
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1 and 3 months post-injection
|
|
The Quick Disability of the Arm, Shoulder and Hand score
Time Frame: 1 and 3 months post-injection
|
Patients will be asked to fill a questionnaire form.
It is an 11-item form that assesses the upper limb function on a scale of 1-5, with scores ranging from 11 to 55, with the higher scores representing more disability and worse upper limb function.
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1 and 3 months post-injection
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Changes in Grip strength
Time Frame: 1 and 3 months post-injection
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Measured by the dynamometer strength test (Jamar grip dynamometer)
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1 and 3 months post-injection
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Patient satisfaction with therapy
Time Frame: 1 and 3 months post-injection
|
Participating patients will be asked to classify their result into 1 of 4 categories: (1) complete resolution of symptoms, (2) improved result, but incomplete resolution of symptoms, not warranting further treatment, (3) partial response, but unsatisfactory, warranting further treatment, and (4) no response.
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1 and 3 months post-injection
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Ultrasound evaluation of A1-Pulley
Time Frame: 1 and 3 months post-injection
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Detailed ultrasonography evaluation of A1-Pulley.
Comparing the A1-Pulley ultrasonographic parameters over 3 months after injection (at the follow-up appointment)
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1 and 3 months post-injection
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Sahar S Khalil, SSR, Specialist Senior Registrar- Physical Medicine and rehabilitation Department- Dubai hospital
- Study Chair: Mohamed M Abdulla, Consultant, Consultant and Head of Physical Medicine and rehabilitation Department- Dubai hospital
Publications and helpful links
General Publications
- Liu DH, Tsai MW, Lin SH, Chou CL, Chiu JW, Chiang CC, Kao CL. Ultrasound-Guided Hyaluronic Acid Injections for Trigger Finger: A Double-Blinded, Randomized Controlled Trial. Arch Phys Med Rehabil. 2015 Dec;96(12):2120-7. doi: 10.1016/j.apmr.2015.08.421. Epub 2015 Sep 1.
- Callegari L, Spano E, Bini A, Valli F, Genovese E, Fugazzola C. Ultrasound-guided injection of a corticosteroid and hyaluronic acid: a potential new approach to the treatment of trigger finger. Drugs R D. 2011;11(2):137-45. doi: 10.2165/11591220-000000000-00000.
- Abate M, Schiavone C, Salini V. The use of hyaluronic acid after tendon surgery and in tendinopathies. Biomed Res Int. 2014;2014:783632. doi: 10.1155/2014/783632. Epub 2014 May 8.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Musculoskeletal Diseases
- Muscular Diseases
- Tendinopathy
- Tendon Entrapment
- Trigger Finger Disorder
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Anti-Inflammatory Agents
- Immunosuppressive Agents
- Immunologic Factors
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Protective Agents
- Adjuvants, Immunologic
- Viscosupplements
- Triamcinolone
- Triamcinolone Acetonide
- Triamcinolone hexacetonide
- Triamcinolone diacetate
- Hyaluronic Acid
Other Study ID Numbers
Other Study ID Numbers
- DSREC-12/2019_03
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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