The Role of Referred Pain From the Retro Trochanteric Region in Patients With Knee Pain
NCT ID: NCT02560259
Last Updated: 2015-09-25
Study Results
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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UNKNOWN
NA
40 participants
INTERVENTIONAL
2015-10-31
2017-08-31
Brief Summary
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Detailed Description
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This group is often characterized by having symptoms ranging from months to years, having seen several physicians, gone through several x-rays/mri´s, and various treatment with no help.
The investigators find ever more suspicion towards specific mechanisms in the hip region as a source of knee pain. It is well known in pediatric medicine that children with serious disease in the hip often debut with knee pain. This relationship is not so well established in adults.
Pain in the lower extremity can arise from inflammation or strain of the retro trochanteric muscles, and/or more indirectly if these processes impact the sciatic nerve. The later explanation is commonly known as the piriformis syndrome.
Professor Oddmund Johansen has studied this type of pain extensively. In the later years he has found interest in patients with knee pain.
These patients will often have pain with deep palpation to the posterior hip region, when tightening the hip rotators with flexion and adduction, and they will often respond with pain relief, within minutes, when local anesthesia is placed on the distal attachment of the hip rotators on the posterior margin of the greater trochanter. Afterwards, lasting pain relief can be seen with a specified stretching regiment for these muscles.
The investigators will recruit suiting patients from a knee referral list. Inclusion will be based on clinical examination and whether they respond to the injection. After inclusion they will be scored with pain and quality of life forms, randomised in two groups, one with a stretching regime and one with conservative and symptomatic treatment.
There is interest in defining and quantifying this sub group of knee patients. They will be followed up after 3 months, with a new examination and scoring to evaluate the effect of the intervention.
The study will examine how the patients react and comply with the proposed diagnosis and treatment. A cost analysis will also be considered.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Physiotherapy Group
Physiotherapy
Physiotherapy
Physiotherapy
Conservative group
Conservative treatment
Conservative treatment
Conservative treatment
Interventions
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Physiotherapy
Physiotherapy
Conservative treatment
Conservative treatment
Eligibility Criteria
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Inclusion Criteria
* Failure to understand the pain with more conventional diagnosis
* Symptoms and retrotrochanteric pain with examination
* Pain relief with retro trochanteric local anaesthetic injection
Exclusion Criteria
* Failure to cooperate
* Not adequate Norwegian language skills
* Other well known disease explaining symptoms
18 Years
70 Years
ALL
Yes
Sponsors
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University Hospital of North Norway
OTHER
Responsible Party
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Oddmund Johansen
Professor
Principal Investigators
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Oddmund Johansen, Professor
Role: PRINCIPAL_INVESTIGATOR
University Hospital og North Nprway, ortopedic department
Locations
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University Hospital of Northern Norway
Tromsø, , Norway
Countries
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Central Contacts
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Facility Contacts
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References
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Meknas K, Kartus J, Letto JI, Flaten M, Johansen O. A 5-year prospective study of non-surgical treatment of retro-trochanteric pain. Knee Surg Sports Traumatol Arthrosc. 2009 Aug;17(8):996-1002. doi: 10.1007/s00167-009-0750-z. Epub 2009 Mar 5.
Meknas K, Johansen O, Kartus J. Retro-trochanteric sciatica-like pain: current concept. Knee Surg Sports Traumatol Arthrosc. 2011 Nov;19(11):1971-85. doi: 10.1007/s00167-011-1573-2. Epub 2011 Jun 16.
Meknas K, Kartus J, Letto JI, Christensen A, Johansen O. Surgical release of the internal obturator tendon for the treatment of retro-trochanteric pain syndrome: a prospective randomized study, with long-term follow-up. Knee Surg Sports Traumatol Arthrosc. 2009 Oct;17(10):1249-56. doi: 10.1007/s00167-009-0787-z. Epub 2009 Apr 18.
Meknas K, Christensen A, Johansen O. The internal obturator muscle may cause sciatic pain. Pain. 2003 Jul;104(1-2):375-80. doi: 10.1016/s0304-3959(03)00045-9.
Other Identifiers
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2015/157(REK)
Identifier Type: -
Identifier Source: org_study_id
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