Evaluation of the Triamcinolone -Acetonide Therapy for the Treatment of the Medial Plica Syndrome
Eco-guided Treatment With Triamcinolone-Acetonide in the Treatment of Medial Plica Syndrome - A Pilot Study
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Luca Andriolo, MD
- Email: luca.andriolo@ior.it
Study Contact Backup
- Name: Roberta Licciardi, MSc
- Phone Number: 0516366567
- Email: roberta.licciardi@ior.it
Study Locations
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Bologna, Italy, 40136
- Istituto Ortopedico Rizzoli
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Ultrasonographic and/or MRI signs of medial plica pathology;
- VAS pain 4-8 at time of inclusion;
- Failure, defined as the persistence of symptomatology, after at least one course of conservative treatment of at least 6 weeks (rest and drug treatment, physiotherapy);
- Ability and consent of patients to actively participate in clinical follow-up;
Exclusion Criteria:
- BMI > 35;
- Patients with: rheumatic diseases, diabetes, infectious processes, epilepsy, severe stage osteoporosis
- Patients undergoing intra-tendon infiltration of other substance within the previous 6 months;
- Patients undergoing surgery on the affected knee within the previous 12 months;
- Patients undergoing femoro- patellar joint stabilization surgery to the affected knee;
- Trauma to the affected knee within the past 6 months;
- Episodes of patellar dislocation and subluxation to the affected knee;
- State of immunodepression;
- Ongoing systemic inflammatory diseases (stabilized outcomes of these diseases are not considered absolute contraindications).
- Contraindications to use or hypersensitivity to the active ingredient (Triamcinolone Acetonide) or to the excipients (sodium chloride, benzyl alcohol, sodium carboxymethylcellulose, polysorbate 80 and water for injectable preparations)found within Kenacort as per the product package insert;
12. Contraindications or hypersensitivity to the active ingredient of the local anesthetic (Lidocaine) or their excipients; 13. Pregnancy or lactation status or intention to become pregnant during the period of study participation. In particular, in the case of a suspected pregnancy , this will be excluded by serological testing (hCG).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Eco-guided Triamcinolone-Acetonide injection
Patients affected by medial plica syndrome will be treated with an eco-guided injection of Triamcinolone-Acetonide.
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The treatment consists in injecting 1 ml of Kenacort (corresponding to 40 mg of Triamcinolone Acetonide) diluted in about 1 ml of local anesthetic (Lidocaine) directly into the medial fold of the knee.
Through an ultrasound guidance with "in plane" technique, the flute beak of the needle will be positioned between the two sheets of the synovial fold and the injection will be performed.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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KUJALA Scale (Kujala Anterior Knee Pain Scale (AKPS
Time Frame: 6 months FU
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This is a patient-reported assessment of patellofemoral disorders that evaluates subjective symptoms and functional limitations.
The evaluation consist of 13 questions with a total score of 100 points.
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6 months FU
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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KOOS (Knee Injury and Osteoarthritis Outcome Score)
Time Frame: baseline, 1 month, 3 months, 6 and 12 months FU
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KOOS SCORE consists of 5 subscales and covers: pain (9 items), symptoms (7 items, two of which are related to stiffness), functions and activities of daily living (17 items), physical function, sports and leisure activities (5 items) and quality of life in relation to the knee (4 items).
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baseline, 1 month, 3 months, 6 and 12 months FU
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VAS (Visual Analogue Scale)
Time Frame: baseline, 1 month, 3 months, 6 and 12 months FU
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VAS is a visual analogue scale consisting of a range scale (10 cm length), the ends of which correspond to "no pain" and "the strongest pain imaginable
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baseline, 1 month, 3 months, 6 and 12 months FU
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Patient Acceptable Symptom State (PASS)
Time Frame: baseline, 1 month, 3 months, 6 and 12 months, 24 months FU
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A tool to assess patient satisfaction in consideration of their current degree of pain, function, and daily activity.
Patients can express if their state of health will be satisfying, answering "yes" or "no".
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baseline, 1 month, 3 months, 6 and 12 months, 24 months FU
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Ultrasound assessment
Time Frame: baseline, 1 month, 3 months FU
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This examination is useful to evaluate the evolution of plica thickness;
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baseline, 1 month, 3 months FU
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MRI assessment
Time Frame: baseline, 6 months FU
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This assessment is useful for evaluating plica retraction
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baseline, 6 months FU
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Final treatment opinion
Time Frame: 24 months follow-up
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The patient should indicate satisfaction and relative degree with treatment at the end of the clinical trial (24 months follow-up).
All patients will be able to indicate their health condition by choosing from this answers; "Full recovery", "much better", "somewhat better", "no change", "a little worse", "much worse".
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24 months follow-up
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Patient Rehabilitation Monitoring
Time Frame: 12 months follow-up
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The patient will be asked if he/she performs the planned rehabilitation activity for the 12 weeks following treatment.
All patients will be able to answer "yes"or "no" regarding the rehabilitation.
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12 months follow-up
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Luca Andriolo, MD, Istituto Ortopedico Rizzoli
Publications and helpful links
General Publications
- Delgado DA, Lambert BS, Boutris N, McCulloch PC, Robbins AB, Moreno MR, Harris JD. Validation of Digital Visual Analog Scale Pain Scoring With a Traditional Paper-based Visual Analog Scale in Adults. J Am Acad Orthop Surg Glob Res Rev. 2018 Mar 23;2(3):e088. doi: 10.5435/JAAOSGlobal-D-17-00088. eCollection 2018 Mar.
- Collins NJ, Prinsen CA, Christensen R, Bartels EM, Terwee CB, Roos EM. Knee Injury and Osteoarthritis Outcome Score (KOOS): systematic review and meta-analysis of measurement properties. Osteoarthritis Cartilage. 2016 Aug;24(8):1317-29. doi: 10.1016/j.joca.2016.03.010. Epub 2016 Mar 21.
- Bellary SS, Lynch G, Housman B, Esmaeili E, Gielecki J, Tubbs RS, Loukas M. Medial plica syndrome: a review of the literature. Clin Anat. 2012 May;25(4):423-8. doi: 10.1002/ca.21278.
- Dupont JY. Synovial plicae of the knee. Controversies and review. Clin Sports Med. 1997 Jan;16(1):87-122. doi: 10.1016/s0278-5919(05)70009-0.
- Jee WH, Choe BY, Kim JM, Song HH, Choi KH. The plica syndrome: diagnostic value of MRI with arthroscopic correlation. J Comput Assist Tomogr. 1998 Sep-Oct;22(5):814-8. doi: 10.1097/00004728-199809000-00028.
- Amatuzzi MM, Fazzi A, Varella MH. Pathologic synovial plica of the knee. Results of conservative treatment. Am J Sports Med. 1990 Sep-Oct;18(5):466-9. doi: 10.1177/036354659001800503.
- Rovere GD, Adair DM. Medial synovial shelf plica syndrome. Treatment by intraplical steroid injection. Am J Sports Med. 1985 Nov-Dec;13(6):382-6. doi: 10.1177/036354658501300603.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
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 (Estimated)
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
Keywords
Additional Relevant MeSH Terms
- Musculoskeletal Diseases
- Pathologic Processes
- Joint Diseases
- Disease
- Syndrome
- Synovitis
- Immunosuppressive Agents
- Immunologic Factors
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Inflammatory Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Enzyme Inhibitors
- Triamcinolone
- Triamcinolone Acetonide
- Triamcinolone hexacetonide
- Triamcinolone diacetate
Other Study ID Numbers
Other Study ID Numbers
- PLICA
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
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