NCT03046108

Brief Summary

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

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
100

participants targeted

Target at P50-P75 for phase_4

Timeline
Completed

Started Jan 2016

Typical duration for phase_4

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

January 1, 2016

Completed
11 months until next milestone

First Submitted

Initial submission to the registry

November 20, 2016

Completed
3 months until next milestone

First Posted

Study publicly available on registry

February 8, 2017

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

August 1, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

August 1, 2018

Completed
Last Updated

October 18, 2017

Status Verified

October 1, 2017

Enrollment Period

2.6 years

First QC Date

November 20, 2016

Last Update Submit

October 17, 2017

Conditions

Outcome Measures

Primary Outcomes (1)

  • Pain (VAS score)

    Pain relieve

    1 year

Secondary Outcomes (2)

  • Manchester foot pain and disability index

    1 year

  • Generic quality-of-life instrument, the EQ-5D

    1 year

Study Arms (6)

blind injection of Morton neuroma

ACTIVE COMPARATOR

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

Device: blind injection of Morton neuromaDrug: blind injection of MepivacaineDrug: blind injection of Triamcinolone

blind injection of Mepivacaine

ACTIVE COMPARATOR

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

Device: blind injection of Morton neuromaDrug: blind injection of MepivacaineDrug: blind injection of Triamcinolone

blind injection of Triamcinolone

ACTIVE COMPARATOR

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

Device: blind injection of Morton neuromaDrug: blind injection of MepivacaineDrug: blind injection of Triamcinolone

ultrasound guided injection

EXPERIMENTAL

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.

Device: ultrasound guided injectionDrug: guided injection of mepivacaineDrug: guided injection of Triamcinolone

guided injection of mepivacaine

EXPERIMENTAL

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

Device: ultrasound guided injectionDrug: guided injection of mepivacaineDrug: guided injection of Triamcinolone

guided injection of Triamcinolone

EXPERIMENTAL

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

Device: ultrasound guided injectionDrug: guided injection of mepivacaineDrug: guided injection of Triamcinolone

Interventions

Introduction of a needle based in anatomical landmark

Also known as: Blind introduction of the needle
blind injection of Mepivacaineblind injection of Morton neuromablind injection of Triamcinolone

blind injection of 1 cc of Mepivacaine Normon 2% ®

blind injection of Mepivacaineblind injection of Morton neuromablind injection of Triamcinolone

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

Also known as: Blind introduction of Triamcinolone
blind injection of Mepivacaineblind injection of Morton neuromablind injection of Triamcinolone

Introduction of a needle based guided by ultrasound

Also known as: guided introduction of the needle
guided injection of Triamcinoloneguided injection of mepivacaineultrasound guided injection

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

Also known as: guided perineural injection
guided injection of Triamcinoloneguided injection of mepivacaineultrasound guided injection

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

Also known as: guided perineural injection
guided injection of Triamcinoloneguided injection of mepivacaineultrasound guided injection

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • 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.

You may not qualify if:

  • 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

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Complejo Hospitalario Universitario Granada

Granada, SPA, 18014, Spain

RECRUITING

Related Publications (4)

  • 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.

  • 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.

  • 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.

  • 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.

MeSH Terms

Conditions

Morton Neuroma

Condition Hierarchy (Ancestors)

MetatarsalgiaFoot DiseasesMusculoskeletal DiseasesJoint DiseasesNeuralgiaPeripheral Nervous System DiseasesNeuromuscular DiseasesNervous System DiseasesPainNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Study Officials

  • FERNANDO RUIZ SANTIAGO, PhD

    COMPLEJO HOSPITALARIO UNIVERSITARIO GRANADA

    STUDY DIRECTOR

Central Study Contacts

PABLO TOMAS MUÑOZ, PhD

CONTACT

ANA MARIA DEL VALLE DIAZ DE LA GUARDIA, MD

CONTACT

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
PhD, section chief musculoskeletal radiology

Study Record Dates

First Submitted

November 20, 2016

First Posted

February 8, 2017

Study Start

January 1, 2016

Primary Completion

August 1, 2018

Study Completion

August 1, 2018

Last Updated

October 18, 2017

Record last verified: 2017-10

Data Sharing

IPD Sharing
Will share

our idea is to publish the short term results and the long term results in order to influence management of this pathology. Tables and statistical analysis will be available for review and metaanalysis.

Locations