Intraosseous Morphine Administration During Anterior Cruciate Ligament Reconstruction

NCT ID: NCT06511232

Last Updated: 2024-11-01

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-08-19

Study Completion Date

2029-07-31

Brief Summary

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The purpose of this study is to determine if intraosseous (IO) morphine decreases pain and post-operative opioid use in patients undergoing anterior cruciate ligament (ACL) reconstruction.

Detailed Description

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Conditions

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Anterior Cruciate Ligament Tear Anterior Cruciate Ligament Injuries Anterior Cruciate Ligament Rupture

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This study is a single-blind randomized controlled trial with two arms, 1) Intervention and 2) control. The intervention group will receive an intraosseous (IO) injection of 10mg of morphine mixed with up to 100mg of saline into the tibial tubercle. The control group will receive the standard of care treatment, which is no IO injection. The subjects' post-operative pain levels, pain medication consumption, side effects to pain medications, and range of motion will be recorded for 14 days following surgery. Additionally, patient reported outcomes will be tracked via surveys prior to surgery and 2, 6, and 12-weeks following surgery.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Participants

Study Groups

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Intraosseous Injection of Morphine

The intervention group will receive an intraosseous (IO) injection of 10mg of morphine mixed with up to 100mg of saline into the tibial tubercle during a standard ACL reconstruction.

Group Type EXPERIMENTAL

Intraosseous Morphine

Intervention Type DRUG

More recently, intraosseous infusion of analgesics and antibiotics has gained traction in the total joint arthroplasty literature. In knee arthroplasty patients, the combination of a spine and adductor canal block with an intraosseous infusion of morphine into the tibial tubercle prior to incision yielded lower pain in the immediate postoperative period and at 2 weeks, less pain medication use, and significantly better patient-reported outcomes while also reducing systemic opioid exposure in the early postoperative period compared to the spine and adductor block alone.3 No study to date in the available literature has evaluated the efficacy of intraosseous morphine infusion in managing acute postoperative pain in patients undergoing ACL reconstruction with bone-patellar tendon-bone autograft, so that is the intended evaluation point with this project.

Standard of Care Morphine Administration

The control group will receive the standard of care treatment, which is no IO injection during a standard ACL reconstruction.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Intraosseous Morphine

More recently, intraosseous infusion of analgesics and antibiotics has gained traction in the total joint arthroplasty literature. In knee arthroplasty patients, the combination of a spine and adductor canal block with an intraosseous infusion of morphine into the tibial tubercle prior to incision yielded lower pain in the immediate postoperative period and at 2 weeks, less pain medication use, and significantly better patient-reported outcomes while also reducing systemic opioid exposure in the early postoperative period compared to the spine and adductor block alone.3 No study to date in the available literature has evaluated the efficacy of intraosseous morphine infusion in managing acute postoperative pain in patients undergoing ACL reconstruction with bone-patellar tendon-bone autograft, so that is the intended evaluation point with this project.

Intervention Type DRUG

Other Intervention Names

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Duramorph Astramorph PF Infumorph

Eligibility Criteria

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Inclusion Criteria

* Patients of the IRB approved surgeon(s) undergoing ACL reconstruction with bone-to-bone (BTB) autograft
* Patients aged between 18-40 years old at the time of surgery

Exclusion Criteria

* Patients undergoing ACL reconstruction with any other type of autograft or allograft other than BTB
* Patients younger than 18 years old or older than 40 years old
* Patients undergoing meniscal root repair or any other repair that changes their weight-bearing status
* Patients with a history of substance abuse
* Vulnerable populations
* Patients on chronic pain medication within the last 6 months
* BMI \>/= 35
* Allergy to morphine
* Unwilling to participate
* Any additional reason the PI deems reasonable
Minimum Eligible Age

18 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Methodist Hospital Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Robert A. Jack

Assistant Professor of Clinical Orthopedic Surgery, Academic Institute

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Robert Jack, MD

Role: PRINCIPAL_INVESTIGATOR

The Methodist Hospital Research Institute

Locations

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Houston Methodist Research Institute

Houston, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Haley Goble, MHA

Role: CONTACT

713-441-3930

Facility Contacts

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Haley Goble

Role: primary

Other Identifiers

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PRO00037918

Identifier Type: -

Identifier Source: org_study_id

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