Protocol summary

Study aim
Comparative effect of intra-articular Ozone injections with suprapatellar lateral and inferomedial approaches for pain control in patients with knee osteoarthritis
Design
Double blind randomized clinical trial with control group, 60 patients sample size, Trial phase 2-3
Settings and conduct
In the tertiary regional and teaching hospital,among patients, candidates for ozone injection with suprapatellar lateral and inferomedial approaches refer to the Akhtar Hospital, after randomization, all procedures are performed using spinal needle 27 Gage.With ultrasonography guidanc,10 ml of ozone (15 μg / ml) is injected.Ozone injection is given up to three weeks, once a week.In these patients, pain in the portal area is measured by VAS (0-10). Disability based on Knee injury and Osteoarthritis Outcome Score questionnaire, is measured, which is completed in two steps before the start of treatment and three months after the last injection by the patient. Patients are asked to determine their pain levels before, one month and three months after the last injection. Complications are recorded.
Participants/Inclusion and exclusion criteria
Major eligibility criteria: Patients older than 40 years; The pain of knee osteoarthritis. Major exclusion criteria: Degenerative Disc Herniation; History of Lumbar Spine Surgery
Intervention groups
Control group (inferomedial): The patient is placed in a supine position, It is characterized by knee flexion of about 45 to 30 degrees on the lateral side of the knee, landmark of the injection area is determined. Intervention group (suprapatellar lateral): The patient is placed in a supine position, Insert the needle one centimeter high and one cm in the lateral portion of the super pellet margin with an angle of 45 ° in the direction of the cephalo lateral to the quadomedial, landmark of the injection area is determined.
Main outcome variables
Pain Level; Disability.

General information

Reason for update
Acronym
IRCT registration information
IRCT registration number: IRCT20131124015515N5
Registration date: 2019-03-14, 1397/12/23
Registration timing: registered_while_recruiting

Last update: 2019-03-14, 1397/12/23
Update count: 0
Registration date
2019-03-14, 1397/12/23
Registrant information
Name
Masoud Hashemi
Name of organization / entity
Shahid Beheshti University of Medical Sciences
Country
Iran (Islamic Republic of)
Phone
+98 21 2261 2252
Email address
dr.hashemi@sbmu.ac.ir
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2019-03-10, 1397/12/19
Expected recruitment end date
2019-07-20, 1398/04/29
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Comparative effect of intra-articular Ozone injections with suprapatellar lateral and inferomedial approaches for pain control in patients with knee osteoarthritis
Public title
The effect of ozone injection with two different injection methods to control knee pain
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Patients older than 40 years The pain of knee osteoarthritis for more than three months Radiological findings confirming knee osteoarthritis based on the American College of Rheumatology Osteoarthritis with Grade II-III based on Kellgren-Lawrence radiology grading No effusion Signed written informed consent to participate in the study
Exclusion criteria:
Patients with history of knee surgery Deformity and lower limb contraction Lower limb neovascular disease Acute lumbosacral pathology Injection of steroid drugs over the past two months History of inflammatory rheumatoid arthritis Infection Diabetes Pregnancy Breast feeding Body Mass Index >35 kg/m2 Patients undergoing knee surgery Knee deviation (verrucous or valgus more than 5 degrees) confirmed by three joint view Radicular pain Knee pain Anticoagulant therapy Post-traumatic arthritis History of intraArticular or ozone therapy during 12 Last month Systemic or psychiatric illness Severe osteoarthritis with Grade over III
Age
From 40 years old
Gender
Both
Phase
2-3
Groups that have been masked
  • Participant
  • Outcome assessor
Sample size
Target sample size: 60
Randomization (investigator's opinion)
Randomized
Randomization description
Simple randomization based on random numbers table
Blinding (investigator's opinion)
Double blinded
Blinding description
Participant and clinical outcomes evaluator are not aware of the code assigned to each of the groups.
Placebo
Not used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Ethics committee of Shahid Beheshti University of Medical Sciences and Health Services
Street address
Tabnak St.,Tehran, Tehran, Iran, Islamic Republic Of
City
Tehran
Province
Tehran
Postal code
1985717443
Approval date
2018-06-29, 1397/04/08
Ethics committee reference number
IR.SBMU.RETECH.REC.1397.286

Health conditions studied

1

Description of health condition studied
Knee Osteoartritis
ICD-10 code
M17.10
ICD-10 code description
Unilateral primary osteoarthritis, unspecified knee

Primary outcomes

1

Description
Pain Level by visual analog scale
Timepoint
In the portal area during the first, second, third and fourth injections and knee pain before treatment, one month and three months after the last injection
Method of measurement
Visual analog scale (VAS) (0 None; 1-3 Mild; 4-7 Moderate; 8-10 Severe)

2

Description
Disability Level by Oswestry Low Back Disability Questionnaire
Timepoint
Before starting treatment and three months after the last injection
Method of measurement
Oswestry Low Back Disability Questionnaire that disability is measured with 10 items. Each item is scored from 5-0, which indicates a higher score for the disability.

Secondary outcomes

empty

Intervention groups

1

Description
Intervention group: suprapatellar lateral approach، the patient is placed in a supine position, Insert the needle one centimeter high and one cm in the lateral portion of the super pellet margin with an angle of 45 ° in the direction of the cephalo lateral to the quadomedial, landmark of the injection area is determined.
Category
Treatment - Other

2

Description
Control group: Inferomedial approach، the patient is placed in a supine position, It is characterized by knee flexion of about 45 to 30 degrees on the lateral side of the knee, landmark of the injection area is determined.
Category
Treatment - Other

Recruitment centers

1

Recruitment center
Name of recruitment center
Akhtar Hospital
Full name of responsible person
Seyed Masoud Hashemi MD
Street address
Pain Clinic, Akhtar Hospital, Sharifi Manesh st.
City
Tehran
Province
Tehran
Postal code
1964714953
Phone
+98 21 2261 2252
Fax
+98 21 2260 8246
Email
dr.hashemi@sbmu.ac.ir

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Shahid Beheshti University of Medical Sciences
Full name of responsible person
Afshin Zarghi MD
Street address
Shahid Arabi st., Yaman St., Shahid Chamran Expressway
City
Tehran
Province
Tehran
Postal code
1985717443
Phone
+98 21 2243 9781
Email
zarghi@sbmu.ac.ir
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Shahid Beheshti University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Shahid Beheshti University of Medical Sciences
Full name of responsible person
Seyed Masoud Hashemi MD
Position
Associate Professor
Latest degree
Subspecialist
Other areas of specialty/work
Anesthesiology
Street address
Akhtar Hospital, Sharifi Manesh st
City
Tehran
Province
Tehran
Postal code
1964714953
Phone
+98 21 2261 2252
Email
dr.hashemi@sbmu.ac.ir

Person responsible for scientific inquiries

Contact
Name of organization / entity
Shahid Beheshti University of Medical Sciences
Full name of responsible person
Seyed Masoud Hashemi MD
Position
Associate professor
Latest degree
Subspecialist
Other areas of specialty/work
Anesthesiology
Street address
Akhtar Hospital, Sharifi Manesh st.
City
Tehran
Province
Tehran
Postal code
1964714953
Phone
+98 21 2261 2252
Fax
Email
dr.hashemi@sbmu.ac.ir

Person responsible for updating data

Contact
Name of organization / entity
Shahid Beheshti University of Medical Sciences
Full name of responsible person
Seyed Masoud Hashemi MD
Position
Associate professor
Latest degree
Subspecialist
Other areas of specialty/work
Anesthesiology
Street address
Akhtar Hospital, Sharifi Manesh st.
City
Tehran
Province
Tehran
Postal code
1964714953
Phone
+98 21 2261 2252
Email
dr.hashemi@sbmu.ac.ir

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Yes - There is a plan to make this available
Study Protocol
Yes - There is a plan to make this available
Statistical Analysis Plan
Yes - There is a plan to make this available
Informed Consent Form
Yes - There is a plan to make this available
Clinical Study Report
Yes - There is a plan to make this available
Analytic Code
Yes - There is a plan to make this available
Data Dictionary
Yes - There is a plan to make this available
Title and more details about the data/document
The whole data can be shared after unidentifiable people.
When the data will become available and for how long
Start the access period 12 months after printing the results
To whom data/document is available
Only available to scholars working in academic and academic institutions
Under which criteria data/document could be used
Employed in research centers
From where data/document is obtainable
Person responsible for scientific inquiries
What processes are involved for a request to access data/document
Send email to person responsible for scientific inquiries
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