- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02417987
High Volume Injection or Autologous Conditioned Plasma (ACP) in Chronic Achilles Tendinopathy
High Volume Injection (HVI) or Autologous Conditioned Plasma (ACP) in Chronic Achilles Tendinopathy: A Randomized Controlled Double Blinded Trial
The aim of the study is to examine patients with chronic Achilles Tendinopathy (AT) and to compare the effect of high volume injection (HVI) or autologous conditioned plasma (ACP) in combination with eccentric training to placebo treatment (sham treatment combined with eccentric exercises).
Healthy males with AT will be randomly assigned to either 1) HVI (50 mls;10 mls 0.5% bupivacaine hydrochloride and 20 mg of Depomedrol followed by 40 mls saline), 2) ACP (~ 4 mls) or 3) Placebo (Plc) treatment. All subjects will perform a 12-wk eccentric training program and examinations will be done at baseline (before treatment) with follow-ups after 6 weeks, 12 weeks and again after 24 weeks prior to baseline to see any possible changes and differences between groups (HVI, ACP and Plc)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Chronic Achilles tendinopathy (AT) is a common and impairing disorder. Only sparse scientific evidence exists for the present used treatments and no golden standard treatment exists so far.
Aim: The aim of the study is in AT patients to examine and compare the effect of high volume injection (HVI) or autologous conditioned plasma (ACP) in combination with eccentric training to placebo treatment (sham treatment and eccentric exercises).
Materials and methods: Healthy males (21-59 years; n=60) with AT is randomly assigned to either 1) HVI (50 mls;10 mls 0.5% bupivacaine hydrochloride and 20 mg of Depomedrol followed by 40 mls saline), 2) ACP (~ 4 mls) or 3) placebo (Plc) treatment. Participants will treated on 4 successive occasions with 2 weeks (wks) interval (HVI will only be injected once at baseline, the 3 following injections will be placebo). The injections will be performed under ultrasound guidance. All subjects will undergo a 12-wk eccentric training program. Clinical effects will be assessed as changes in symptoms and pain (VISA-A and VAS score), tendon ultrasound thickness and muscle function (one-legged heel-rise test). All outcome measures will be recorded at baseline and again at 6 weeks, 12 week and 6 month follow-up.
Results: Will se the changes and differences between groups (HVI, ACP and Placebo) in VISA-A scores, VAS scores, ultrasound (tendon thickness) and muscle function.
Statistics: All data will be analyzed in SigmaPlot v11 using two-way repeated measures ANOVA with Student-Newman-Keuls Post-hoc test. This is used to see changes over time in all groups (time effect) and differences between groups within time-points (group effect). All data will be presented as mean ± SEM time.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Clinically and ultrasound diagnosed unilateral midt-tendinous achilles tendinopathy
- Symptoms > 3 month
- No steroid injections < 6 month
- 60 males with BMI <30 between 18-60 years.
Exclusion Criteria:
- Bilateral achilles tendinopathy
- Insertional tendinopathy
- Steroid injections < 6 month
- Diabetes or cardiovascular disease
- Smoking
- Treatment with fluoroquinolones < 6 month
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: FACTORIAL
- Masking: DOUBLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: High Volume injection
A total volume of 50 ml:
|
The skin was penetrated with a needle and few drops of saline injected in the soft tissue away from the tendon
Other Names:
Injection with 4 mls of ACP around the tendon
Other Names:
|
ACTIVE_COMPARATOR: Autologous conditioned plasma (ACP)
Whole blood was drawn from the patients using arthrex system (total of 10 mls whole blood). After that the whole blood is spined for 5 minutes and ACP with platelets and growth factors is separated from the red and white blood cells (4 mls). The ACP is injected 4 times (at baseline, 2 weeks, 4 weeks and after 6 weeks) |
The skin was penetrated with a needle and few drops of saline injected in the soft tissue away from the tendon
Other Names:
Injection with10 mls 0.5% bupivacaine hydrochloride and 20 mg of Depomedrol 40 mls saline (NaCl) around the tendon
Other Names:
|
SHAM_COMPARATOR: Placebo
A few drops of saline is injected in the soft tissue away from the tendon.
|
Injection with 4 mls of ACP around the tendon
Other Names:
Injection with10 mls 0.5% bupivacaine hydrochloride and 20 mg of Depomedrol 40 mls saline (NaCl) around the tendon
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
VISA-A score
Time Frame: Baseline, 6 weeks, 12 weeks and 24 weeks
|
See the changes in VISA-A score over time due to the effect of treatment between groups (HVI, ACP and Plc)
|
Baseline, 6 weeks, 12 weeks and 24 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
VAS score
Time Frame: Baseline, 6 weeks, 12 weeks and 24 weeks
|
See the changes in VAS score over time due to the effect of treatment between groups (HVI, ACP and Plc)
|
Baseline, 6 weeks, 12 weeks and 24 weeks
|
Ultrasound tendon thickness and doppler activity
Time Frame: Baseline, 6 weeks, 12 weeks and 24 weeks
|
See the changes in tendon thickness over time due to the effect of treatment between groups (HVI, ACP and Plc)
|
Baseline, 6 weeks, 12 weeks and 24 weeks
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Muscle function performance test (total workload)
Time Frame: Baseline, 6 weeks, 12 weeks and 24 weeks
|
See the muscle function performance (total workload- heel raise test) performed over time due to the effect of treatment between groups (HVI, ACP and Plc)
|
Baseline, 6 weeks, 12 weeks and 24 weeks
|
Collaborators and Investigators
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- H-1-2010-052a
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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