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The aim of the study is to compare the therapeutic effects of hyaluronic acid versus steroid injections in treating trigger fingers using ultrasound guidance
A prospective randomized controlled study designed to compare the outcomes of injecting patients with trigger finger with hyaluronic acid versus corticosteroid under ultrasound guidance
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Hyaluronic acid | Experimental | 1mL of hyaluronic acid (20 mg/2 mL; Hyalgan, Fidia, Abano Terme, Italy) infiltration at A1-Pulley under ultrasound guidance after subcutaneous 2% lidocaine without epinephrine infiltration of the skin overlying the A1-pulley. |
|
| Triamcinolone acetonide | Active Comparator | 1 mL of Triamcinolone acetonide 10mg/ml infiltration at A1-Pulley under ultrasound guidance after subcutaneous 2% lidocaine without epinephrine infiltration of the skin overlying the A1 pulley. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| hyaluronic acid (20 mg/2 mL) | Drug | A1-Pulley infiltration for trigger finger |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in Quinnell trigger finger grading system: | Change in Quinnell grading overtime within 3 months after injection. Trigger fingers are rated as follows: Grade 0: normal finger movements, Grade 1: uneven finger movements, Grade 2: actively correctable triggering, Grade 3: passively correctable triggering, and Grade 4: locked digit. | 1 and 3 months post-injection |
| Measure | Description | Time Frame |
|---|---|---|
| Visual analogue scale (VAS) of pain | Change in pain Visual analogue scale will be recorded. The patient marks on the 100 mm in length line the point that he/she feels to represent his/her perception of pain at the current state. The VAS score is determined by measuring in millimetres from the left hand end of the line to the point that the patient marks ( a higher score indicates greater pain intensity). Categorization of none, mild, moderate and severe pain will be also used (none = 0, mild = 1-4, moderate = 5-6, and severe = 7-10). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sahar S Khalil, SSR | Contact | 00971557557453 | sskhalil@dha.gov.ae | |
| Mohamed M Abdulla, Consultant | Contact | 00971506584352 | mmabdulla@dha.gov.ae |
| Name | Affiliation | Role |
|---|---|---|
| Sahar S Khalil, SSR | Specialist Senior Registrar- Physical Medicine and rehabilitation Department- Dubai hospital | Principal Investigator |
| Mohamed M Abdulla, Consultant | Consultant and Head of Physical Medicine and rehabilitation Department- Dubai hospital |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dubai Hospital- Dubai Health Authority | Recruiting | Dubai | United Arab Emirates |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26340807 | Background | Liu DH, Tsai MW, Lin SH, Chou CL, Chiu JW, Chiang CC, Kao CL. Ultrasound-Guided Hyaluronic Acid Injections for Trigger Finger: A Double-Blinded, Randomized Controlled Trial. Arch Phys Med Rehabil. 2015 Dec;96(12):2120-7. doi: 10.1016/j.apmr.2015.08.421. Epub 2015 Sep 1. | |
| 21545190 | Background | Callegari L, Spano E, Bini A, Valli F, Genovese E, Fugazzola C. Ultrasound-guided injection of a corticosteroid and hyaluronic acid: a potential new approach to the treatment of trigger finger. Drugs R D. 2011;11(2):137-45. doi: 10.2165/11591220-000000000-00000. |
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| ID | Term |
|---|---|
| D052582 | Trigger Finger Disorder |
| ID | Term |
|---|---|
| D053682 | Tendon Entrapment |
| D052256 | Tendinopathy |
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D006820 | Hyaluronic Acid |
| D014222 | Triamcinolone Acetonide |
| ID | Term |
|---|---|
| D006025 | Glycosaminoglycans |
| D011134 | Polysaccharides |
| D002241 | Carbohydrates |
| D014221 | Triamcinolone |
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| Triamcinolone acetonide 10mg/ml | Drug | A1-Pulley infiltration for trigger finger |
|
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| 1 and 3 months post-injection |
| Frequency of tender trigger nodules | Identifying the presence of tender nodules at A1-pulley of the affected finger by palpation | 1 and 3 months post-injection |
| The Quick Disability of the Arm, Shoulder and Hand score | Patients will be asked to fill a questionnaire form. It is an 11-item form that assesses the upper limb function on a scale of 1-5, with scores ranging from 11 to 55, with the higher scores representing more disability and worse upper limb function. | 1 and 3 months post-injection |
| Changes in Grip strength | Measured by the dynamometer strength test (Jamar grip dynamometer) | 1 and 3 months post-injection |
| Patient satisfaction with therapy | Participating patients will be asked to classify their result into 1 of 4 categories: (1) complete resolution of symptoms, (2) improved result, but incomplete resolution of symptoms, not warranting further treatment, (3) partial response, but unsatisfactory, warranting further treatment, and (4) no response. | 1 and 3 months post-injection |
| Ultrasound evaluation of A1-Pulley | Detailed ultrasonography evaluation of A1-Pulley. Comparing the A1-Pulley ultrasonographic parameters over 3 months after injection (at the follow-up appointment) | 1 and 3 months post-injection |
| 24895610 | Background | Abate M, Schiavone C, Salini V. The use of hyaluronic acid after tendon surgery and in tendinopathies. Biomed Res Int. 2014;2014:783632. doi: 10.1155/2014/783632. Epub 2014 May 8. |
| D011245 |
| Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D013259 | Steroids, Fluorinated |