NCT04766918

Brief Summary

Recently, nerve hydrodissection is utilized to assist ultrasound-guided nerve injection and studies recommend its clinical benefit for peripheral entrapment neuropathy. Hyaluronic acid (HA) can decrease the post-surgery adhesion of soft tissue and nerve but its clinical application in clinical practice is very rare. We just proved that single HA injection have short-term effectiveness in mild-to-moderate carpal tunnel (CTS) cases and this finding may hint the therapeutic effectiveness of nerve hydrodissection for CTS depend on absorption time of solution. In addition, no study compare different weight of HA for nerve injection so far. Hence, the purpose of this study aim to compare different weight of HA for CTS and whether hydrodissection effect depend on the absorption time of solution or not.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
20

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Aug 2021

Typical duration for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

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

First Submitted

Initial submission to the registry

February 20, 2021

Completed
3 days until next milestone

First Posted

Study publicly available on registry

February 23, 2021

Completed
5 months until next milestone

Study Start

First participant enrolled

August 1, 2021

Completed
2.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 31, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 31, 2023

Completed
Last Updated

April 10, 2024

Status Verified

April 1, 2024

Enrollment Period

2.2 years

First QC Date

February 20, 2021

Last Update Submit

April 9, 2024

Conditions

Keywords

Hydrodissectionhyaluronic acid

Outcome Measures

Primary Outcomes (1)

  • Change from baseline of severity of symptoms and functional status on 2nd week, 1st, 3rd, 6th month after injection

    Boston carpal tunnel syndrome questionnaire (BCTQ) is a frequently used patient-based questionnaire for measurement of CTS which encompasses two components. In total, 11 questions and 8 items were evaluated to rate the symptom severity scale (SSS) and functional status scale (FSS), respectively. Both subscales range from 1 to 5 with a higher score indicating a higher degree of disability. The mean of total SSS and FSS divided with each item score were used for further analysis.

    Pre-treatment, 2nd week, 1st, 3rd, 6th month

Secondary Outcomes (4)

  • Change from baseline of pain on 2nd week, 1st, 3rd, 6th month after injection

    Pre-treatment, 2nd week, 1st, 3rd, 6th month

  • Change from baseline of cross-sectional area of the median nerve on 2nd week, 1st, 3rd, 6th month after injection

    Pre-treatment, 2nd week, 1st, 3rd, 6th month

  • Change from baseline of conduction velocity, amplitude of median nerve on 2nd week, 1st, 3rd, 6th month after injection

    Pre-treatment, 2nd week, 1st, 3rd, 6th month

  • Change from baseline of mobility of median nerve on 2nd week, 1st, 3rd, 6th month after injection

    Pre-treatment, 2nd week, 1st, 3rd, 6th month

Study Arms (2)

High molecular weight hyaluronic acid

EXPERIMENTAL

Ultrasound-guided hydrodissection with high molecular weight hyaluronic acid between carpal tunnel and median nerve (total 2 times with one-week interval)

Procedure: Sono-guided injection with high molecular weight hyaluronic acid

Low molecular weight hyaluronic acid

ACTIVE COMPARATOR

Ultrasound-guided hydrodissection with low molecular weight hyaluronic acid between carpal tunnel and median nerve (total 2 times with one-week interval)

Procedure: Sono-guided injection with low molecular weight hyaluronic acid

Interventions

Sono-guided injection with hyaluronic acid (Aragan Plus, 20 mg/2 ml, 3000kDa) between carpal tunnel and median nerve

High molecular weight hyaluronic acid

Sono-guided injection with hyaluronic acid (ARTZDispo, 25 mg/2 ml, 600-1200kDa) between carpal tunnel and median nerve

Low molecular weight hyaluronic acid

Eligibility Criteria

Age20 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age between 20-80 year-old.
  • Diagnosis was confirmed using an electrophysiological study

You may not qualify if:

  • Cancer
  • Coagulopathy
  • Pregnancy
  • Inflammation status
  • Cervical radiculopathy
  • Polyneuropathy, brachial plexopathy
  • Thoracic outlet syndrome
  • Previously undergone wrist surgery or steroid injection for CTS

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Tri-Service General Hospital, School of Medicine, National Defense Medical Center

Taipei, Neihu, 886, Taiwan

Location

Related Publications (4)

  • Ozgenel GY. Effects of hyaluronic acid on peripheral nerve scarring and regeneration in rats. Microsurgery. 2003;23(6):575-81. doi: 10.1002/micr.10209.

    PMID: 14705074BACKGROUND
  • Burns JW, Skinner K, Colt J, Sheidlin A, Bronson R, Yaacobi Y, Goldberg EP. Prevention of tissue injury and postsurgical adhesions by precoating tissues with hyaluronic acid solutions. J Surg Res. 1995 Dec;59(6):644-52. doi: 10.1006/jsre.1995.1218.

    PMID: 8538160BACKGROUND
  • Ozgenel GY, Filiz G. Effects of human amniotic fluid on peripheral nerve scarring and regeneration in rats. J Neurosurg. 2003 Feb;98(2):371-7. doi: 10.3171/jns.2003.98.2.0371.

    PMID: 12593625BACKGROUND
  • Atzei A, Calcagni M, Breda B, Fasolo G, Pajardi G, Cugola L. Clinical evaluation of a hyaluronan-based gel following microsurgical reconstruction of peripheral nerves of the hand. Microsurgery. 2007;27(1):2-7. doi: 10.1002/micr.20299.

    PMID: 17205576BACKGROUND

MeSH Terms

Conditions

Carpal Tunnel Syndrome

Condition Hierarchy (Ancestors)

Median NeuropathyMononeuropathiesPeripheral Nervous System DiseasesNeuromuscular DiseasesNervous System DiseasesNerve Compression SyndromesCumulative Trauma DisordersSprains and StrainsWounds and Injuries

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Attending Physician and associated professor of Department of Physical Medicine and Rehabilitation

Study Record Dates

First Submitted

February 20, 2021

First Posted

February 23, 2021

Study Start

August 1, 2021

Primary Completion

October 31, 2023

Study Completion

October 31, 2023

Last Updated

April 10, 2024

Record last verified: 2024-04

Data Sharing

IPD Sharing
Will share
Shared Documents
STUDY PROTOCOL

Locations