Botox Injection for Lower Extremity Lengthening and Deformity Correction Surgery

NCT ID: NCT00412035

Last Updated: 2014-12-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

125 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-01-31

Study Completion Date

2012-12-31

Brief Summary

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The purpose of this six site multi-center study is to determine if BTX-A can alleviate the post-operative pain and improve the functional and quality of life outcomes of children with limb length discrepancy or angular deformity undergoing limb lengthening or deformity correction.

Detailed Description

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The specific aims are to determine if BTX-A will:

* 1a. Reduce pain post operatively and during the distraction and consolidation process,
* 1b. Reduce the amount, frequency and duration of narcotics taken in the postoperative period.
* 2\. Improve the quality of life during the distraction and consolidation process.
* 3 Decrease muscular spasm and subsequent muscle contracture during the distraction and consolidation process and accelerate earlier return to pre-operative mobility function including earlier weight bearing.
* 4\. To develop clinical practice guidelines for the interdisciplinary care of children undergoing limb lengthening or deformity correction.

Methodology: A randomization process for this one time injection will be used to determine who will receive the BTX-A or the placebo. 150 subjects will be recruited; 75 to the BTX-A group and 75 to the placebo group. There will be an equal number of subjects in each group at each site. The medication will be injected intraoperatively into specific major muscles in the lower limb adjacent to the bone or soft tissue being lengthened or corrected at a dose of 10 U/kg with a maximum of 50 U per site, not to exceed a total maximum dose of 400 units. Pain scores, medication dosages, range of motion and an ambulation scale will be measured post-operatively and during the distraction and consolidation phases.

In addition families will be asked to complete six different questionnaires related to pain, quality of life and psycho-social issues at various times during the process. The children will receive standard nursing care and physical therapy and will be followed for three months after the external fixator is removed, for a total time of approximately one year.

Conditions

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Unequal Length of Limbs; Congenital Lower Extremity Deformities, Congenital

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Botox

Botulinum toxin A injection

Group Type ACTIVE_COMPARATOR

Botulinum toxin A injection

Intervention Type DRUG

10 units per kilo to maximum of 400 units

Placebo

saline injection

Group Type PLACEBO_COMPARATOR

saline injection

Intervention Type DRUG

10 units per kilo to maximum of 400 units

Interventions

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Botulinum toxin A injection

10 units per kilo to maximum of 400 units

Intervention Type DRUG

saline injection

10 units per kilo to maximum of 400 units

Intervention Type DRUG

Other Intervention Names

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botox salt water

Eligibility Criteria

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Inclusion Criteria

* Age: 5 to 21 years.
* Aetiology of the deformity: congenital or acquired.
* Amount of lengthening or deformity correction: any amount.
* Site of lengthening or deformity correction: lower extremity.
* Type of fixator: circular or uniplanar.

Exclusion Criteria

* Children younger than 5 years of age.
* Associated neuromuscular conditions that may hinder weight bearing.
* Individuals on aminoglycosides, as aminoglycosides can potentiate the effect of Botulinum toxin A.
Minimum Eligible Age

5 Years

Maximum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shriners Hospitals for Children

OTHER

Sponsor Role lead

Responsible Party

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Reggie Hamdy, MD

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Reggie Hamdy, MD

Role: PRINCIPAL_INVESTIGATOR

Shriners Hospital for Children-Canadian Unit, Montreal, Quebec

Locations

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Alfred I.duPont Hospital for Children

Wilmington, Delaware, United States

Site Status

Shriners Hospital for Children

Honolulu, Hawaii, United States

Site Status

Shriners Hospital for Children

Portland, Oregon, United States

Site Status

Shriners Hospital for Children

Philadelphia, Pennsylvania, United States

Site Status

The Hospital for Sick Children

Toronto, Ontario, Canada

Site Status

Shriners Hospital for Children

Montreal, Quebec, Canada

Site Status

Countries

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United States Canada

References

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Hamdy RC, Montpetit K, Ruck-Gibis J, Thorstad K, Raney E, Aiona M, Platt R, Finley A, Mackenzie W, McCarthy J, Narayanan U. Safety and efficacy of botox injection in alleviating post-operative pain and improving quality of life in lower extremity limb lengthening and deformity correction. Trials. 2007 Sep 28;8:27. doi: 10.1186/1745-6215-8-27.

Reference Type BACKGROUND
PMID: 17903262 (View on PubMed)

Montpetit K, Hamdy RC, Dahan-Oliel N, Zhang X, Narayanan UG. Measurement of health-related quality of life in children undergoing external fixator treatment for lower limb deformities. J Pediatr Orthop. 2009 Dec;29(8):920-6. doi: 10.1097/BPO.0b013e3181c1e2e2.

Reference Type BACKGROUND
PMID: 19934710 (View on PubMed)

Hamdy RC, Montpetit K, Raney EM, Aiona MD, Fillman RR, MacKenzie W, McCarthy J, Chafetz RS, Thomas SS, Tamayo CM, Littleton AG, Ruck-Gibis J, Takahashi SN, Rinaldi M, Finley GA, Platt RW, Dahan-Oliel N. Botulinum toxin type A injection in alleviating postoperative pain and improving quality of life in lower extremity limb lengthening and deformity correction: a pilot study. J Pediatr Orthop. 2009 Jul-Aug;29(5):427-34. doi: 10.1097/BPO.0b013e3181aad628.

Reference Type RESULT
PMID: 19568011 (View on PubMed)

Other Identifiers

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9142

Identifier Type: -

Identifier Source: org_study_id