Dorsal Wrist Ganglia; Aspiration Alone vs Aspiration and Injection of Platelet Rich Plasma

NCT ID: NCT03408808

Last Updated: 2021-06-24

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

17 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-12-05

Study Completion Date

2021-02-05

Brief Summary

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Study to examine the efficacy of Platelet Rich Plasma (PRP) to reduce recurrence in dorsal wrist ganglia (DWG). We will compare aspiration alone and aspiration with injection of PRP.

We plan to recruit a maximum of 200 patients. We will assess the efficacy by contacting the patients by email or telephone at 6 weeks and 12 months. They will be asked to complete a questionnaire and a Patient Evaluated Measure score (PEMS). Adverse events will be screened for/ managed by a telephone call +/- review as necessary between 7 and 14 days.

Detailed Description

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1. Patient selection All hand referrals vetted by Mr Lawrie or Miss Miller, those for dorsal wrist ganglia sent a letter of invitation and patient information. Patients responding to the letter with interested given an appointment at a special trial clinic.

Contact details will be provided to allow any issues to be clarified discussed before attendance at clinic if the patient desires.
2. Assess eligibility/ enrolment in study - clinic visit 1

1. All patients assessed by the chief investigator Mr David Lawrie (DFML) or Miss Katharine Hamlin (KH).
2. Clinical assessment of presence of ganglion.
3. Ensure not meeting exclusion criteria.
4. If eligible and willing to complete study commitments discuss study and answer questions.
5. Once we are happy the patient has understanding of the study and its risks then the patient will be asked if they wish to enrol or if they would like more time to consider.
6. If they are willing to participate they will then be offered treatment in the same visit or a return visit
3. Intervention - clinic visit 1 or 2

1. Check understanding and continuing desire to participate in study if 2nd visit.
2. Complete consent form.
3. Patient fills out a PEM score and demographics collected on SOS (Surgical Outcomes System - Arthrex).
4. Randomisation.
5. If in PRP group 15ml blood sample taken with Arthrex ACP double syringe and processed (see processing instructions in Appendix.9.
6. Aspiration.
7. If in PRP group - Injection of PRP (the same volume as aspirated).
8. Pressure dressing with gauze, wool and crepe for 48 hours.
4. Adverse event screening/ management Patients are offered two options at the treatment visit.

1\. Routine review at 10 - 14 days at the clinic or 2. Telephone review at 7 days by Miss Katharine Hamlin who will have performed the procedure.

On telephone review if the patient is entirely happy that there are no concerns then follow up will proceed by email or telephone as below.

If any concerns are raised, or if the patient desires, a face to face review will be arranged ideally within 24 hours but no longer than 72 hours. Recurrence or other outcomes will not be assessed at this time.

5\. SOS/ Email/ Telephone interview - 1 (6 weeks)

a) Ganglion questionnaire b) PEM score c) Note any adverse events

6\. SOS/ Email /Telephone interview - 2 (12 months)

1. Ganglion questionnaire
2. PEM score
3. Note any adverse events

Conditions

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Ganglion of Wrist

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomised controlled trial with two arms. Control - Aspiration alone. Intervention - aspiration plus injection of platelet righ plasma.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
The outcomes assessor will be blinded to the treatment received.

Study Groups

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Aspiration alone

The patients will have their dorsal wrist ganglion aspirated and then pressure dressing for 48 hours.

Group Type ACTIVE_COMPARATOR

Aspiration alone

Intervention Type PROCEDURE

Aspiration of the ganglion

Aspiration plus platelet rich plasma

The patients will have their dorsal wrist ganglion aspirated, and then injected with platelet rich plasma (derived from a blood sample taken at the same visit) and then pressure dressing for 48 hours.

Group Type EXPERIMENTAL

Platelet rich plasma

Intervention Type PROCEDURE

Aspiration of ganglion and injection with platelet rich plasma.

Interventions

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Platelet rich plasma

Aspiration of ganglion and injection with platelet rich plasma.

Intervention Type PROCEDURE

Aspiration alone

Aspiration of the ganglion

Intervention Type PROCEDURE

Other Intervention Names

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PRP

Eligibility Criteria

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Inclusion Criteria

* Solitary dorsal wrist ganglion.

Exclusion Criteria

* Underlying wrist or ipsilateral arm pathology.
* Unable to consent to treatment.
* Unable or unwilling to attend follow up visits.
Minimum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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NHS Grampian

OTHER_GOV

Sponsor Role collaborator

Arthrex, Inc.

INDUSTRY

Sponsor Role collaborator

University of Aberdeen

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Katharine Hamlin, MBChB

Role: PRINCIPAL_INVESTIGATOR

NHS Grampian

Locations

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NHS Grampian

Aberdeen, , United Kingdom

Site Status

Countries

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United Kingdom

References

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Meena S, Gupta A. Dorsal wrist ganglion: Current review of literature. J Clin Orthop Trauma. 2014 Jun;5(2):59-64. doi: 10.1016/j.jcot.2014.01.006. Epub 2014 Jun 3.

Reference Type BACKGROUND
PMID: 25983472 (View on PubMed)

Janzon L, Niechajev IA. Wrist ganglia. Incidence and recurrence rate after operation. Scand J Plast Reconstr Surg. 1981;15(1):53-6. doi: 10.3109/02844318109103412.

Reference Type BACKGROUND
PMID: 7268314 (View on PubMed)

Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004 Apr;62(4):489-96. doi: 10.1016/j.joms.2003.12.003. No abstract available.

Reference Type BACKGROUND
PMID: 15085519 (View on PubMed)

Freymiller EG, Aghaloo TL. Platelet-rich plasma: ready or not? J Oral Maxillofac Surg. 2004 Apr;62(4):484-8. doi: 10.1016/j.joms.2003.08.021. No abstract available.

Reference Type BACKGROUND
PMID: 15085518 (View on PubMed)

Yu W, Wang J, Yin J. Platelet-rich plasma: a promising product for treatment of peripheral nerve regeneration after nerve injury. Int J Neurosci. 2011 Apr;121(4):176-80. doi: 10.3109/00207454.2010.544432. Epub 2011 Jan 19.

Reference Type BACKGROUND
PMID: 21244302 (View on PubMed)

Valente Duarte de Sousa IC, Tosti A. New investigational drugs for androgenetic alopecia. Expert Opin Investig Drugs. 2013 May;22(5):573-89. doi: 10.1517/13543784.2013.784743. Epub 2013 Apr 4.

Reference Type BACKGROUND
PMID: 23550739 (View on PubMed)

Marx RE. Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dent. 2001;10(4):225-8. doi: 10.1097/00008505-200110000-00002. No abstract available.

Reference Type BACKGROUND
PMID: 11813662 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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1/091/17

Identifier Type: -

Identifier Source: org_study_id

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