Blind and Ultrasound Guided Injection in Morton Neuroma

NCT ID: NCT03046108

Last Updated: 2017-10-18

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-01-31

Study Completion Date

2018-08-31

Brief Summary

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The aim of this work trial is to compare the effectiveness of blind and ultrasound guided injection for Morton neuroma in order to determine which is more appropriate as the initial procedure in conservative treatment

Detailed Description

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This is a evaluator-blinded randomized trial. The final sample size has been calculated to be 100 patients. 50 of group 1 are going to be injected by an experimented orthopaedic surgeon based on anatomic landmark. 50 of group 2 are going to be injected by an experimented musculoskeletal radiologist under ultrasound guidance.

The inclusion criteria are clinical suspicion of Morton neuroma confirmed in ultrasound scan. Included patients are assessed clinically by VAS score, the Manchester Foot Pain and Disability Schedule (MFPDS), and a generic quality-of-life instrument, the EQ-5D.

Injection includes 1 cc of 2% mepivacaine and 40 mg of triamcinolone in each web space with Morton Neuroma. According evolution until 4 injections were allowed the first 2 months of follow-up, Follow up was performed by phone calls and/or scheduled consultations at 15 days, 1 month, 45 days, 2 months, 3 months, 6 months and 1 year.

Statistical analysis was performed by unpaired Student's t test

Conditions

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Morton Neuroma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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blind injection of Morton neuroma

Percoutaneous blind injection in Morton neuroma by subcutaneous needle group 1 are going to be injected by an experimented orthopaedic surgeon based on anatomic landmark. There is no internal control of the needle placement.

Mixture of 1 cc of 2% mepivacaine (Mepivacaina Normon 2%® )+ 40 mg of triamcinolone (Trigon Depot®) in each of the web spaces affected with Morton neuroma is injected.

Up to 4 injections are allow in the first three months of follow-up

Group Type ACTIVE_COMPARATOR

blind injection of Morton neuroma

Intervention Type DEVICE

Introduction of a needle based in anatomical landmark

blind injection of Mepivacaine

Intervention Type DRUG

blind injection of 1 cc of Mepivacaine Normon 2% ®

blind injection of Triamcinolone

Intervention Type DRUG

blind injection of 40 mg of triamcinolone (trigon depot ®)

blind injection of Mepivacaine

1 cc of 2% mepivacaine (Mepivacaina Normon 2%® )+ 40 mg of triamcinolone (Trigon Depot®) in each of the web spaces affected with Morton neuroma is injected.

Up to 4 injections are allow in the first three months of follow-up

Group Type ACTIVE_COMPARATOR

blind injection of Morton neuroma

Intervention Type DEVICE

Introduction of a needle based in anatomical landmark

blind injection of Mepivacaine

Intervention Type DRUG

blind injection of 1 cc of Mepivacaine Normon 2% ®

blind injection of Triamcinolone

Intervention Type DRUG

blind injection of 40 mg of triamcinolone (trigon depot ®)

blind injection of Triamcinolone

40 mg of triamcinolone (Trigon Depot®) in each of the web spaces affected with Morton neuroma is injected. Up to 4 injections are allow in the first three months of follow-up

Group Type ACTIVE_COMPARATOR

blind injection of Morton neuroma

Intervention Type DEVICE

Introduction of a needle based in anatomical landmark

blind injection of Mepivacaine

Intervention Type DRUG

blind injection of 1 cc of Mepivacaine Normon 2% ®

blind injection of Triamcinolone

Intervention Type DRUG

blind injection of 40 mg of triamcinolone (trigon depot ®)

ultrasound guided injection

US guided injection in Morton neuroma by subcutaneous needle. group 2 are going to be injected by an experimented musculoskeletal radiologist under ultrasound guidance. There is internal control of needle placement by ultrasound.

Group Type EXPERIMENTAL

ultrasound guided injection

Intervention Type DEVICE

Introduction of a needle based guided by ultrasound

guided injection of mepivacaine

Intervention Type DRUG

ultrasound guided injection of 1 cc of Mepivacaine Normon 2% ®

guided injection of Triamcinolone

Intervention Type DRUG

ultrasound guided injection of 40 mg of triamcinolone (trigon depot ®)

guided injection of mepivacaine

2% mepivacaine (Mepivacaina Normon 2%® ) in each of the web spaces affected with Morton neuroma is injected.

Up to 4 injections are allow in the first three months of follow-up

Group Type EXPERIMENTAL

ultrasound guided injection

Intervention Type DEVICE

Introduction of a needle based guided by ultrasound

guided injection of mepivacaine

Intervention Type DRUG

ultrasound guided injection of 1 cc of Mepivacaine Normon 2% ®

guided injection of Triamcinolone

Intervention Type DRUG

ultrasound guided injection of 40 mg of triamcinolone (trigon depot ®)

guided injection of Triamcinolone

40 mg of triamcinolone (Trigon Depot®) in each of the web spaces affected with Morton neuroma is injected. Up to 4 injections are allow in the first three months of follow-up

Group Type EXPERIMENTAL

ultrasound guided injection

Intervention Type DEVICE

Introduction of a needle based guided by ultrasound

guided injection of mepivacaine

Intervention Type DRUG

ultrasound guided injection of 1 cc of Mepivacaine Normon 2% ®

guided injection of Triamcinolone

Intervention Type DRUG

ultrasound guided injection of 40 mg of triamcinolone (trigon depot ®)

Interventions

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blind injection of Morton neuroma

Introduction of a needle based in anatomical landmark

Intervention Type DEVICE

blind injection of Mepivacaine

blind injection of 1 cc of Mepivacaine Normon 2% ®

Intervention Type DRUG

blind injection of Triamcinolone

blind injection of 40 mg of triamcinolone (trigon depot ®)

Intervention Type DRUG

ultrasound guided injection

Introduction of a needle based guided by ultrasound

Intervention Type DEVICE

guided injection of mepivacaine

ultrasound guided injection of 1 cc of Mepivacaine Normon 2% ®

Intervention Type DRUG

guided injection of Triamcinolone

ultrasound guided injection of 40 mg of triamcinolone (trigon depot ®)

Intervention Type DRUG

Other Intervention Names

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Blind introduction of the needle Blind introduction of Triamcinolone guided introduction of the needle guided perineural injection guided perineural injection

Eligibility Criteria

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Inclusion Criteria

* Clinical suspicion of Morton neuroma confirmed in ultrasound scan
* Symptoms present more than six months
* The thickness of the nerve must be at least 2 mm in short axis and at least 5 mm in the longitudinal axis.

Exclusion Criteria

* Contraindication for the use of corticosteroids or local anesthetics
* Presence of inflammatory arthropathy or neuropathy
* Skin lesions in the area
* diabetes mellitus
* Infiltration or previous surgery in the area
* Refusal to participate in the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Complejo Hospitalario Universitario de Granada

OTHER

Sponsor Role lead

Responsible Party

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FERNANDO RUIZ SANTIAGO

PhD, section chief musculoskeletal radiology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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FERNANDO RUIZ SANTIAGO, PhD

Role: STUDY_DIRECTOR

COMPLEJO HOSPITALARIO UNIVERSITARIO GRANADA

Locations

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Complejo Hospitalario Universitario Granada

Granada, SPA, Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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PABLO TOMAS MUÑOZ, PhD

Role: CONTACT

Phone: +34617516708

Email: [email protected]

ANA MARIA DEL VALLE DIAZ DE LA GUARDIA, MD

Role: CONTACT

Phone: +34958895414

Email: [email protected]

Facility Contacts

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JUANA MARIA DE HARO CASTELLANO

Role: primary

JUAN MORALES ARCAS

Role: backup

References

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Saygi B, Yildirim Y, Saygi EK, Kara H, Esemenli T. Morton neuroma: comparative results of two conservative methods. Foot Ankle Int. 2005 Jul;26(7):556-9. doi: 10.1177/107110070502600711.

Reference Type RESULT
PMID: 16045848 (View on PubMed)

Thomson CE, Beggs I, Martin DJ, McMillan D, Edwards RT, Russell D, Yeo ST, Russell IT, Gibson JN. Methylprednisolone injections for the treatment of Morton neuroma: a patient-blinded randomized trial. J Bone Joint Surg Am. 2013 May 1;95(9):790-8, S1. doi: 10.2106/JBJS.I.01780.

Reference Type RESULT
PMID: 23636185 (View on PubMed)

Mahadevan D, Attwal M, Bhatt R, Bhatia M. Corticosteroid injection for Morton's neuroma with or without ultrasound guidance: a randomised controlled trial. Bone Joint J. 2016 Apr;98-B(4):498-503. doi: 10.1302/0301-620X.98B4.36880.

Reference Type RESULT
PMID: 27037432 (View on PubMed)

Hassouna H, Singh D, Taylor H, Johnson S. Ultrasound guided steroid injection in the treatment of interdigital neuralgia. Acta Orthop Belg. 2007 Apr;73(2):224-9.

Reference Type RESULT
PMID: 17515235 (View on PubMed)

Other Identifiers

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0565-N-16

Identifier Type: -

Identifier Source: org_study_id