Extracorporal Shock Wave Treatment to Improve Nerve Regeneration

NCT ID: NCT03147313

Last Updated: 2021-09-05

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

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-04-18

Study Completion Date

2023-06-30

Brief Summary

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This study evaluates the impact of extracorporeal shock wave treatment after microsurgical coaptation of finger nerves. Participants will be randomized into two treatment groups with different settings and a sham group. The participants will thereafter followed-up in a prospective, double-blind study design.

Detailed Description

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Extracorporeal shock wave treatment is CE certified in Austria, Europe and licensed for indications like achillodynia, epicondylitis, or tendinitis calcanea. The Orthogold 100 device by MTS Medical UG will be used for this study.

Defocused low-energy extracorporeal shock wave therapy (ESWT) has gained acceptance as a therapeutic tool in different medical settings. It has been shown, that shock waves stimulate of the metabolic activity of different cell type, including osteoblasts, tenocytes, endothelial cells and chondrocytes. Furthermore, it has proved effective in clinical applications relating to bone and wound healing and myocardial ischaemia. Until now, no studies have been performed regarding the effects of ESWT on regeneration of peripheral nerve injuries in humans.

Conditions

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Peripheral Nerve Injury

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomized into three groups: Two treatment groups with different treatment settings and one sham group.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors
The participant will be wearing an acoustic and visual masking. The outcome assessor won't know if the participant was treated or if he was assigned to the sham group.

Study Groups

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Sham

Group Type SHAM_COMPARATOR

Sham

Intervention Type DEVICE

Extracorporeal shock wave treatment will be faked.

Shockwave 300 pulses

300 pulses of extracorporeal shock wave will be applied

Group Type ACTIVE_COMPARATOR

MTS Medical UG Orthogold 100

Intervention Type DEVICE

300 or 500 pulses, frequency 3Hz, energy 1 (0,1mJ/mm2)

Shockwave 500 pulses

500 pulses of extracorporeal shock wave will be applied

Group Type ACTIVE_COMPARATOR

MTS Medical UG Orthogold 100

Intervention Type DEVICE

300 or 500 pulses, frequency 3Hz, energy 1 (0,1mJ/mm2)

Interventions

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MTS Medical UG Orthogold 100

300 or 500 pulses, frequency 3Hz, energy 1 (0,1mJ/mm2)

Intervention Type DEVICE

Sham

Extracorporeal shock wave treatment will be faked.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* complete lossless transection of one or more digital nerves distal to the branching out of the commune median or ulnar nerves
* direct, tension-free coaptation of the nerve stumps

Exclusion Criteria

* segment loss of the nerve
* tension after direct coaptation
* diabetic neuropathy or other peripheral neuropathies
* other disease with reduced sensibility of the fingers
* injuries in the course of the nerve (plexus brachialis, median or ulnar nerve)
* chronic inflammatory disease
* rheumatoid arthritis
* pregnancy
* patients not able to give written consent
* patients with an implantable cardiac defibrillator or pacemaker
* patients which are sensitive to electromagnetic radiance
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ludwig Boltzmann Gesellschaft

OTHER

Sponsor Role lead

Responsible Party

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Rudolf Rosenauer

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Meidling Trauma Hospital

Vienna, , Austria

Site Status RECRUITING

Lorenz Böhler Trauma Hospital

Vienna, , Austria

Site Status RECRUITING

Countries

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Austria

Central Contacts

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Rudolf Rosenauer, M.D.

Role: CONTACT

0043 59393 41270

Facility Contacts

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Rainer Mittermayr, M.D.

Role: primary

0043 5 939345263

Rudolf Rosenauer, M.D.

Role: primary

0043 59393 41270

Stefan Quadlbauer, M.D.

Role: backup

0043 59393 41000

References

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Bosch G, Lin YL, van Schie HT, van De Lest CH, Barneveld A, van Weeren PR. Effect of extracorporeal shock wave therapy on the biochemical composition and metabolic activity of tenocytes in normal tendinous structures in ponies. Equine Vet J. 2007 May;39(3):226-31. doi: 10.2746/042516407x180408.

Reference Type BACKGROUND
PMID: 17520973 (View on PubMed)

Corson MA, James NL, Latta SE, Nerem RM, Berk BC, Harrison DG. Phosphorylation of endothelial nitric oxide synthase in response to fluid shear stress. Circ Res. 1996 Nov;79(5):984-91. doi: 10.1161/01.res.79.5.984.

Reference Type BACKGROUND
PMID: 8888690 (View on PubMed)

Fleming I, Bauersachs J, Fisslthaler B, Busse R. Ca2+-independent activation of the endothelial nitric oxide synthase in response to tyrosine phosphatase inhibitors and fluid shear stress. Circ Res. 1998 Apr 6;82(6):686-95. doi: 10.1161/01.res.82.6.686.

Reference Type BACKGROUND
PMID: 9546377 (View on PubMed)

Fukumoto Y, Ito A, Uwatoku T, Matoba T, Kishi T, Tanaka H, Takeshita A, Sunagawa K, Shimokawa H. Extracorporeal cardiac shock wave therapy ameliorates myocardial ischemia in patients with severe coronary artery disease. Coron Artery Dis. 2006 Feb;17(1):63-70. doi: 10.1097/00019501-200602000-00011.

Reference Type BACKGROUND
PMID: 16374144 (View on PubMed)

Hausdorf J, Sievers B, Schmitt-Sody M, Jansson V, Maier M, Mayer-Wagner S. Stimulation of bone growth factor synthesis in human osteoblasts and fibroblasts after extracorporeal shock wave application. Arch Orthop Trauma Surg. 2011 Mar;131(3):303-9. doi: 10.1007/s00402-010-1166-4. Epub 2010 Aug 22.

Reference Type BACKGROUND
PMID: 20730589 (View on PubMed)

Martini L, Giavaresi G, Fini M, Torricelli P, de Pretto M, Schaden W, Giardino R. Effect of extracorporeal shock wave therapy on osteoblastlike cells. Clin Orthop Relat Res. 2003 Aug;(413):269-80. doi: 10.1097/01.blo.0000073344.50837.cd.

Reference Type BACKGROUND
PMID: 12897619 (View on PubMed)

Moretti B, Notarnicola A, Garofalo R, Moretti L, Patella S, Marlinghaus E, Patella V. Shock waves in the treatment of stress fractures. Ultrasound Med Biol. 2009 Jun;35(6):1042-9. doi: 10.1016/j.ultrasmedbio.2008.12.002. Epub 2009 Feb 25.

Reference Type BACKGROUND
PMID: 19243882 (View on PubMed)

Moretti B, Notarnicola A, Maggio G, Moretti L, Pascone M, Tafuri S, Patella V. The management of neuropathic ulcers of the foot in diabetes by shock wave therapy. BMC Musculoskelet Disord. 2009 May 27;10:54. doi: 10.1186/1471-2474-10-54.

Reference Type BACKGROUND
PMID: 19473538 (View on PubMed)

Murata R, Nakagawa K, Ohtori S, Ochiai N, Arai M, Saisu T, Sasho T, Takahashi K, Moriya H. The effects of radial shock waves on gene transfer in rabbit chondrocytes in vitro. Osteoarthritis Cartilage. 2007 Nov;15(11):1275-82. doi: 10.1016/j.joca.2007.04.001. Epub 2007 May 29.

Reference Type BACKGROUND
PMID: 17537650 (View on PubMed)

Nishida T, Shimokawa H, Oi K, Tatewaki H, Uwatoku T, Abe K, Matsumoto Y, Kajihara N, Eto M, Matsuda T, Yasui H, Takeshita A, Sunagawa K. Extracorporeal cardiac shock wave therapy markedly ameliorates ischemia-induced myocardial dysfunction in pigs in vivo. Circulation. 2004 Nov 9;110(19):3055-61. doi: 10.1161/01.CIR.0000148849.51177.97. Epub 2004 Nov 1.

Reference Type BACKGROUND
PMID: 15520304 (View on PubMed)

Schaden W, Fischer A, Sailler A. Extracorporeal shock wave therapy of nonunion or delayed osseous union. Clin Orthop Relat Res. 2001 Jun;(387):90-4. doi: 10.1097/00003086-200106000-00012.

Reference Type BACKGROUND
PMID: 11400900 (View on PubMed)

Schaden W, Thiele R, Kolpl C, Pusch M, Nissan A, Attinger CE, Maniscalco-Theberge ME, Peoples GE, Elster EA, Stojadinovic A. Shock wave therapy for acute and chronic soft tissue wounds: a feasibility study. J Surg Res. 2007 Nov;143(1):1-12. doi: 10.1016/j.jss.2007.01.009. Epub 2007 Sep 27.

Reference Type BACKGROUND
PMID: 17904157 (View on PubMed)

Zimpfer D, Aharinejad S, Holfeld J, Thomas A, Dumfarth J, Rosenhek R, Czerny M, Schaden W, Gmeiner M, Wolner E, Grimm M. Direct epicardial shock wave therapy improves ventricular function and induces angiogenesis in ischemic heart failure. J Thorac Cardiovasc Surg. 2009 Apr;137(4):963-70. doi: 10.1016/j.jtcvs.2008.11.006.

Reference Type BACKGROUND
PMID: 19327525 (View on PubMed)

Other Identifiers

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MPG 07/2016

Identifier Type: -

Identifier Source: org_study_id

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