- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04954391
Pulsed Radiofrequency One or Three Nerves for Chronic Shoulder Pain. A Prospective, Randomized, Double-blind Study
Pulsed Radiofrequency of the Suprascapular, Axillary Nerve and Articular Branch of the Lateral Pectoral Nerve vs Pulsed Radiofrequency of the Suprascapular Nerve Only for Chronic Shoulder Pain. A Prospective Randomized Double-blind Study
Study Overview
Status
Conditions
Detailed Description
Background: It's believed that PRf of the suprascapular nerve is a safe and reliable treatment for shoulder pain. But PRF of the suprascapular nerve may be less effective than intra-articular steroid injections (Eyigor et al., 2010). There is also evidence that even test, diagnostic suprascapular nerve blockade in some patients may not give a satisfactory analgesic effect (Sinha et al., 2020). Probably, the unsatisfactory results of PRF suprascapular nerve as a search for a solution force the use of standard thermal RF ablation. (Bone et al., 2013) It is possible to expect a greater clinical effect from the combination of PRF of the three main articular nerves of the suprascapular, axillary and lateral pectoral nerves than from PRF of the suprascapular nerve alone. Nevertheless, having the task of obtaining the maximum effect from PRF, it seems important to maintain a balance between inevitable intervention and excessive intervention, considering that any intervention is associated with the risk of complications.
Methods: The study is planned to include 142 adult patients who are planned to have PRF of the suprascapular nerve due to the presence of chronic shoulder pain.The study is planned as a prospective randomized double-blind controlled trial. According to inclusion / exclusion criteria, written informed consent signing, patients will be randomized in a 1: 1 ratio into two groups: PRF of the suprascapular nerve (n=71) and PRF of the suprascapular, axillary and lateral pectoral nerves (n=71). Patients will be evaluated by a physician 4 weeks and 16 weeks after discharge to receive information on treatment results.
Sample size assessment: To identify differences of 5 points on the SPADI scale at a 5% significance level with 80% power, assuming an expected mean SPADI of 25.5 points and SD - 10.1 according to the study by Korkmaz et al 2010, 64 people will be required for each group. The number 128 was increased to 142 in the sample in order to compensate for observation losses.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Konstantin Trukhin
- Phone Number: 89213351044
- Email: k_truhin_dok@mail.ru
Study Contact Backup
- Name: Andrey Povaliy
- Phone Number: 89218746479
- Email: povandrey23@gmail.com
Study Locations
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Saint Petersburg, Russian Federation
- Recruiting
- Saint Petersburg State University
-
Contact:
- Konstantin Trukhin
- Phone Number: 89213351044
- Email: k_truhin_dok@mail.ru
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Contact:
- Andrey Povaliy
- Phone Number: 89218746479
- Email: povandrey23@gmail.com
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Chronic pain (existing for more than three months at the time of examination) in the shoulder associated with the following pathology:
- rotator cuff injury
- adhesive capsulitis
- arthrosis of the shoulder joint
- arthrosis of the acromioclavicular joint
- subacromial impingement syndrome
- a history of arthroscopic surgery
- Signed informed consent to participate in the study
- Lack of indications for shoulder surgery
- Age> 18 years old 5 The positive effect of the test blockade of the suprascapular, axillary and lateral thoracic nerves with a local anesthetic (reduction of the pain level from the baseline according to NRS by at least 50%)
Exclusion Criteria:
- Rotator cuff calcific tendinopathy
- infectious arthritis
- Instability of the shoulder joint
- cervical radiculopathy
- contraindications to local anesthetics
- coagulopathy and anticoagulant therapy
- pregnancy
- oncology
- the impossibility of subjective assessment of the level of pain and function of the joint
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: PRF one nerve
Ultrasound guided PRF neuromodulation of suprascapular nerve and block axillary nerve, and articular branch of the lateral pectoral nerve with ropivacaine and dexamethasone
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PRF stimulation of the suprascapular nerve under ultrasound navigation in the notch of the scapula using the Cosman G4 apparatus with the introduction of stimulation: sensory: 50 Hz; 1 ms; up to 0.5 V; motor: 2 Hz; 1 ms; voltage - twice the sensory threshold, but not less than 1V; after introduction of 1 ml of 0.75% ropivacaine, PRF is performed: 42 С, 45V, 2Hz, 20 ms, 1 cycle - 480 sec. Before removing the cannula, local administration of 0.75% ropivacaine 2 ml, dexamethasone 4 mg. Under the US navigation, an RF cannula will be placed sequentially at the axillary nerve in the quadrilateral foramen and at the lateral pectoral nerve. After confirmatory sensory and motor stimulation and local administration of 0.75% ropivacaine 1 ml PRF session imitation lasting 480 sec will be carried out. After that local administration of 0.75% ropivacaine 2 ml, dexamethasone 4 mg will follow. The total dose for the entire procedure is ropivacaine 0.75% - 9 ml, dexamethasone 12 mg
Other Names:
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Active Comparator: PRF three nerves
Ultrasound guided PRF neuromodulation of suprascapular, axillary nerves, and articular branch of the lateral pectoral nerve
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Under ultrasound navigation an RF cannula will be placed sequentially at the suprascapular nerve, at the axillary nerve and at the lateral pectoral nerve.
After confirmatory sensory and motor stimulation from RF generator and local administration of 0.75% ropivacaine 1 ml to each nerve, PRF neuromodulation session will be carried out: 42 С, 45V, 2Hz, 20 ms, 1 cycle - 480 sec to each nerve.
After that local administration of 0.75% ropivacaine 2 ml, dexamethasone 4 mg will follow to each nerve.
The total dose for the entire procedure is ropivacaine 0.75% - 9 ml, dexamethasone 12 mg
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
SPADI value
Time Frame: 16 weeks from the time of the procedure
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Scale value Shoulder Pain And Disability Index (SPADI) in points from minimum 0 to maximum 130, where a lower scores means a better outcome
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16 weeks from the time of the procedure
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Constant - Murley Shoulder Score
Time Frame: 16 weeks from the time of the procedure
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Scale value Constant - Murley Shoulder Score in points from minimum 0 to maximum 100, where a higher scores means the better of shoulder function.
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16 weeks from the time of the procedure
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Recovery in the functionality of the shoulder - DASH value
Time Frame: 16 weeks from the time of the procedure
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Scale value "Disabilities of the Arm, Shoulder and Hand." (DASH) Recovery in the functionality of the shoulder and performing basic activities of daily living from a minimum scale value - 0 (no disability, good functionality) to a maximum - 100 (total disability)
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16 weeks from the time of the procedure
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EQ-5D-5L value
Time Frame: 16 weeks from the time of the procedure
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Measuring health-related quality of life according to the EQ-5D-5L questionnaire.
Intergroup comparison and deviation from baseline are assessed at 16 weeks from the time of the procedure.
Form in the index.
Minimum 0 and maximum 1.
A higher indicator corresponds to a state of more complete health.
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16 weeks from the time of the procedure
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
NSAIDs and opiates needs
Time Frame: 16 weeks from the time of the procedure
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Analyzing in the need for analgesic medication (NSAIDs and opiates)
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16 weeks from the time of the procedure
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PRF complications
Time Frame: 16 weeks from the time of the procedure
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Evaluation of complications associated with the implementation of pulsed radiofrequency neuromodulation under ultrasound guidance (neurological, bleeding, hematoma, infection)
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16 weeks from the time of the procedure
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Surgical treatment needs
Time Frame: 16 weeks from the time of the procedure
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Evaluation of referral cases for surgical treatment
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16 weeks from the time of the procedure
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Collaborators and Investigators
Investigators
- Principal Investigator: Konstantin Trukhin, Saint Petersburg State University, Russia
Publications and helpful links
General Publications
- Korkmaz OK, Capaci K, Eyigor C, Eyigor S. Pulsed radiofrequency versus conventional transcutaneous electrical nerve stimulation in painful shoulder: a prospective, randomized study. Clin Rehabil. 2010 Nov;24(11):1000-8. doi: 10.1177/0269215510371417. Epub 2010 Aug 4.
- Eyigor C, Eyigor S, Korkmaz OK, Uyar M. Intra-articular corticosteroid injections versus pulsed radiofrequency in painful shoulder: a prospective, randomized, single-blinded study. Clin J Pain. 2010 Jun;26(5):386-92. doi: 10.1097/AJP.0b013e3181cf5981.
- Laumonerie P, Dalmas Y, Tibbo ME, Robert S, Faruch M, Chaynes P, Bonnevialle N, Mansat P. Sensory innervation of the human shoulder joint: the three bridges to break. J Shoulder Elbow Surg. 2020 Dec;29(12):e499-e507. doi: 10.1016/j.jse.2020.07.017. Epub 2020 Jul 23.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 06/21
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.
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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