- ICH GCP
- US-Register für klinische Studien
- Klinische Studie NCT02867904
Intra-Operative Corticosteroid Injection During Arthroscopic Shoulder Surgery
2. Mai 2021 aktualisiert von: Peter Chang
Efficacy of Intra-operative Subacromial Corticosteroid Injections on Surgical Outcomes After Arthroscopic Shoulder Surgery
The purpose of this study is to assess the efficacy of intra-operative subacromial corticosteroid injections in patients undergoing arthroscopic shoulder surgery on quality of life scores and activity level when compared to a control group.
Studienübersicht
Status
Beendet
Bedingungen
Detaillierte Beschreibung
This study is designed to assess whether a subacromial injection of corticosteroids at the time of arthroscopic shoulder surgery influences quality of life scores and activity level when compared to a control group.
The hypothesis is that intra-operative subacromial corticosteroid injection after arthroscopic subacromial decompression surgery will provide a more rapid improvement in quality of life scores and activity levels in the post-operative period compared with controls.
The study will be a placebo-controlled, double-blind prospective study.
All patients necessitating arthroscopic shoulder surgery presenting to Dr. Keith Baumgarten's clinics are eligible for participation.
If the patient meets the inclusion criteria, then informed consent will be obtained for participation in this study.
Each patient will undergo a standard shoulder exam to assess active range of motion and complete demographics and pre-operative patient determined outcomes surveys (1.
Disabilities of the Arm, Shoulder, and Hand (DASH) 2. Simple Assessment Numeric Evaluation (SANE) 3. Western Ontario Rotator Cuff (WORC)) and the Marx shoulder activity level survey (MARX).
Patients will then undergo arthroscopic shoulder surgery.
After arthroscopic surgery the experimental group will undergo a subacromial corticosteroid injection + marcaine while the control group will undergo a subacromial marcaine injection.
Outcomes will be assessed using the same quality of life surveys and an activity level survey at post-operative visits at the time intervals: 2 weeks and 3 months and by U.S. mail at 5 months and 1 year.
Active range of motion will be assessed at post-operative visits: 2 weeks, 6 weeks, and 3 months.
Subjects that meet criteria to undergo arthroscopic shoulder surgery will be provided informed consent to receiving either a subacromial corticosteroid injection or placebo injection at the end of surgery.
Patients will be expected to complete all pre- and post-operative quality of life surveys and activity level surveys.
It will take less than 20 minutes to complete all listed surveys at each pre- and post-operative visit.
Active range of motion will be assessed at each post-operative visit and subjects will be expected to take part in this physical examination as well.
The duration of subject participation is 1 year from the date of initial surgery.
Studientyp
Interventionell
Einschreibung (Tatsächlich)
12
Phase
- Phase 4
Kontakte und Standorte
Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.
Studienorte
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South Dakota
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Sioux Falls, South Dakota, Vereinigte Staaten, 57105
- Orthopedic Institute
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Teilnahmekriterien
Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.
Zulassungskriterien
Studienberechtigtes Alter
18 Jahre und älter (Erwachsene, Älterer Erwachsener)
Akzeptiert gesunde Freiwillige
Nein
Studienberechtigte Geschlechter
Alle
Beschreibung
Inclusion Criteria:
- Patients aged 18 years-old or older
- Male patients
- Female patients
- Patients able to speak and understand written English
- Patients presenting to the orthopedic institute clinic with shoulder pain and necessitating the procedure of arthroscopic shoulder surgery
- Specific arthroscopic procedures include: intra-articular debridement, decompression, acromioplasty, and acromioclavicular joint resection
Exclusion Criteria:
- Patients undergoing arthroscopic shoulder surgery that includes other interventions (i.e. rotator cuff repair; labral repair, etc)
- Patients with adhesive capsulitis
- Patients with significant cervical spine symptoms and/or pathology
- Patients having a history of receiving chronic pain treatment
- Patients who are currently pregnant or who become pregnant before surgery
- Patients who cannot speak or understand written english
- Patients who are under the age of 18 years of age
- As per exclusionary criteria if a subject is pregnant they will not be eligible for participation.
Studienplan
Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Verdreifachen
Waffen und Interventionen
Teilnehmergruppe / Arm |
Intervention / Behandlung |
---|---|
Placebo-Komparator: Group A
After arthroscopic surgery the control group (Group A) will undergo a subacromial marcaine injection (standard of care).
|
Control
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Experimental: Group B
After arthroscopic surgery the experimental group (Group B) will undergo a subacromial corticosteroid injection+marcaine.
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Control
Experimental Drug
|
Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Zeitfenster |
---|---|
Disabilities of the Arm, Shoulder, and Hand Survey (DASH)
Zeitfenster: 1 year
|
1 year
|
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
---|---|---|
Active Range of Motion of Shoulder
Zeitfenster: Pre-operatively and Post-operatively at 2 weeks, 6 weeks, and 3 months
|
Change from baseline active range of motion will be assessed.
Range of motion of the shoulder joint will be examined by having the patient actively flex, extend, abduct, adduct, internally rotate, and externally rotate the shoulder
|
Pre-operatively and Post-operatively at 2 weeks, 6 weeks, and 3 months
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Simple Assessment Numeric Evaluation (SANE)
Zeitfenster: 1 year
|
1 year
|
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Western Ontario Rotator Cuff Survey (WORC)
Zeitfenster: 1 year
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1 year
|
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Marx Shoulder Activity Level Survey (MARX)
Zeitfenster: 1 year
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1 year
|
Mitarbeiter und Ermittler
Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.
Sponsor
Publikationen und hilfreiche Links
Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.
Allgemeine Veröffentlichungen
- Singelyn FJ, Lhotel L, Fabre B. Pain relief after arthroscopic shoulder surgery: a comparison of intraarticular analgesia, suprascapular nerve block, and interscalene brachial plexus block. Anesth Analg. 2004 Aug;99(2):589-92, table of contents. doi: 10.1213/01.ANE.0000125112.83117.49.
- Bhattacharjee DP, Biswas C, Haldar P, Ghosh S, Piplai G, Rudra JS. Efficacy of intraarticular dexamethasone for postoperative analgesia after arthroscopic knee surgery. J Anaesthesiol Clin Pharmacol. 2014 Jul;30(3):387-90. doi: 10.4103/0970-9185.137273.
- Kim YJ, Lee GY, Kim DY, Kim CH, Baik HJ, Heo S. Dexamathasone added to levobupivacaine improves postoperative analgesia in ultrasound guided interscalene brachial plexus blockade for arthroscopic shoulder surgery. Korean J Anesthesiol. 2012 Feb;62(2):130-4. doi: 10.4097/kjae.2012.62.2.130. Epub 2012 Feb 20.
- Stan T, Goodman EJ, Bravo-Fernandez C, Holbrook CR. Adding methylprednisolone to local anesthetic increases the duration of axillary block. Reg Anesth Pain Med. 2004 Jul-Aug;29(4):380-1. doi: 10.1016/j.rapm.2004.03.006. No abstract available.
- Attardi B, Takimoto K, Gealy R, Severns C, Levitan ES. Glucocorticoid induced up-regulation of a pituitary K+ channel mRNA in vitro and in vivo. Recept Channels. 1993;1(4):287-93.
- Cancienne JM, Gwathmey FW, Werner BC. Intraoperative Corticosteroid Injection at the Time of Knee Arthroscopy Is Associated With Increased Postoperative Infection Rates in a Large Medicare Population. Arthroscopy. 2016 Jan;32(1):90-5. doi: 10.1016/j.arthro.2015.09.003. Epub 2015 Nov 6.
- Arroll B, Goodyear-Smith F. Corticosteroid injections for osteoarthritis of the knee: meta-analysis. BMJ. 2004 Apr 10;328(7444):869. doi: 10.1136/bmj.38039.573970.7C. Epub 2004 Mar 23.
- Koyonos L, Yanke AB, McNickle AG, Kirk SS, Kang RW, Lewis PB, Cole BJ. A randomized, prospective, double-blind study to investigate the effectiveness of adding DepoMedrol to a local anesthetic injection in postmeniscectomy patients with osteoarthritis of the knee. Am J Sports Med. 2009 Jun;37(6):1077-82. doi: 10.1177/0363546508331204. Epub 2009 Mar 11.
- Highgenboten CL, Jackson AW, Meske NB. Arthroscopy of the knee. Ten-day pain profiles and corticosteroids. Am J Sports Med. 1993 Jul-Aug;21(4):503-6. doi: 10.1177/036354659302100404.
- Armstrong RW, Bolding F. Septic arthritis after arthroscopy: the contributing roles of intraarticular steroids and environmental factors. Am J Infect Control. 1994 Feb;22(1):16-8. doi: 10.1016/0196-6553(94)90086-8.
- Fontana C, Di Donato A, Di Giacomo G, Costantini A, De Vita A, Lancia F, Caricati A. Postoperative analgesia for arthroscopic shoulder surgery: a prospective randomized controlled study of intraarticular, subacromial injection, interscalenic brachial plexus block and intraarticular plus subacromial injection efficacy. Eur J Anaesthesiol. 2009 Aug;26(8):689-93. doi: 10.1097/eja.0b013e32832d673e.
- HOLLANDER JL, BROWN EM Jr, JESSAR RA, BROWN CY. Hydrocortisone and cortisone injected into arthritic joints; comparative effects of and use of hydrocortisone as a local antiarthritic agent. J Am Med Assoc. 1951 Dec 22;147(17):1629-35. doi: 10.1001/jama.1951.03670340019005. No abstract available.
- Sun Y, Chen J, Li H, Jiang J, Chen S. Steroid Injection and Nonsteroidal Anti-inflammatory Agents for Shoulder Pain: A PRISMA Systematic Review and Meta-Analysis of Randomized Controlled Trials. Medicine (Baltimore). 2015 Dec;94(50):e2216. doi: 10.1097/MD.0000000000002216.
- Tandoc MN, Fan L, Kolesnikov S, Kruglov A, Nader ND. Adjuvant dexamethasone with bupivacaine prolongs the duration of interscalene block: a prospective randomized trial. J Anesth. 2011 Oct;25(5):704-9. doi: 10.1007/s00540-011-1180-x. Epub 2011 Jun 17.
- Desmet M, Braems H, Reynvoet M, Plasschaert S, Van Cauwelaert J, Pottel H, Carlier S, Missant C, Van de Velde M. I.V. and perineural dexamethasone are equivalent in increasing the analgesic duration of a single-shot interscalene block with ropivacaine for shoulder surgery: a prospective, randomized, placebo-controlled study. Br J Anaesth. 2013 Sep;111(3):445-52. doi: 10.1093/bja/aet109. Epub 2013 Apr 15.
- Zheng XQ, Li K, Wei YD, Tie HT, Yi XY, Huang W. Nonsteroidal anti-inflammatory drugs versus corticosteroid for treatment of shoulder pain: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2014 Oct;95(10):1824-31. doi: 10.1016/j.apmr.2014.04.024. Epub 2014 May 16.
- Westermann RW, Pugely AJ, Ries Z, Amendola A, Martin CT, Gao Y, Wolf BR. Causes and Predictors of 30-Day Readmission After Shoulder and Knee Arthroscopy: An Analysis of 15,167 Cases. Arthroscopy. 2015 Jun;31(6):1035-1040.e1. doi: 10.1016/j.arthro.2015.03.029.
- Bjornholdt KT, Monsted PN, Soballe K, Nikolajsen L. Dexamethasone for pain after outpatient shoulder surgery: a randomised, double-blind, placebo-controlled trial. Acta Anaesthesiol Scand. 2014 Jul;58(6):751-8. doi: 10.1111/aas.12333. Epub 2014 May 13.
- Hagiwara Y, Sugaya H, Takahashi N, Kawai N, Ando A, Hamada J, Itoi E. Effects of intra-articular steroid injection before pan-capsular release in patients with refractory frozen shoulder. Knee Surg Sports Traumatol Arthrosc. 2015 May;23(5):1536-41. doi: 10.1007/s00167-014-2936-2. Epub 2014 Mar 19.
Studienaufzeichnungsdaten
Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.
Haupttermine studieren
Studienbeginn (Tatsächlich)
1. März 2016
Primärer Abschluss (Tatsächlich)
1. April 2020
Studienabschluss (Tatsächlich)
1. April 2020
Studienanmeldedaten
Zuerst eingereicht
20. Juli 2016
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
13. August 2016
Zuerst gepostet (Schätzen)
16. August 2016
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
6. Mai 2021
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
2. Mai 2021
Zuletzt verifiziert
1. Mai 2021
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
- Physiologische Wirkungen von Arzneimitteln
- Depressiva des zentralen Nervensystems
- Autonome Agenten
- Agenten des peripheren Nervensystems
- Agenten des sensorischen Systems
- Anästhetika
- Entzündungshemmende Mittel
- Antineoplastische Mittel
- Antiemetika
- Magen-Darm-Mittel
- Glukokortikoide
- Hormone
- Hormone, Hormonersatzstoffe und Hormonantagonisten
- Antineoplastische Mittel, hormonell
- Neuroprotektive Wirkstoffe
- Schutzmittel
- Anästhetika, lokal
- Prednisolon
- Methylprednisolonacetat
- Methylprednisolon
- Methylprednisolon Hemisuccinat
- Prednisolonacetat
- Prednisolonhemisuccinat
- Prednisolonphosphat
- Bupivacain
Andere Studien-ID-Nummern
- 2016.128
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