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CompletedNCT03408808Updated Jun 24, 2021Results posted

Dorsal Wrist Ganglia; Aspiration Alone vs Aspiration and Injection of Platelet Rich Plasma

An interventional study of Platelet rich plasma and Aspiration alone in Ganglion of Wrist, sponsored by University of Aberdeen. Completed at 1 site in United Kingdom. Open to participants aged 16 Years and older. Per ClinicalTrials.gov, last updated 2021-06-24.

Sponsored by University of Aberdeen · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
17
Allocation
Randomized
Ages
16 Years and older
Sex
All
01

Study summary

Study to examine the efficacy of Platelet Rich Plasma (PRP) to reduce recurrence in dorsal wrist ganglia (DWG). We will compare aspiration alone and aspiration with injection of PRP.

We plan to recruit a maximum of 200 patients. We will assess the efficacy by contacting the patients by email or telephone at 6 weeks and 12 months. They will be asked to complete a questionnaire and a Patient Evaluated Measure score (PEMS). Adverse events will be screened for/ managed by a telephone call +/- review as necessary between 7 and 14 days.

Read the detailed description
  1. Patient selection All hand referrals vetted by Mr Lawrie or Miss Miller, those for dorsal wrist ganglia sent a letter of invitation and patient information. Patients responding to the letter with interested given an appointment at a special trial clinic.

    Contact details will be provided to allow any issues to be clarified discussed before attendance at clinic if the patient desires.

  2. Assess eligibility/ enrolment in study - clinic visit 1

    1. All patients assessed by the chief investigator Mr David Lawrie (DFML) or Miss Katharine Hamlin (KH).
    2. Clinical assessment of presence of ganglion.
    3. Ensure not meeting exclusion criteria.
    4. If eligible and willing to complete study commitments discuss study and answer questions.
    5. Once we are happy the patient has understanding of the study and its risks then the patient will be asked if they wish to enrol or if they would like more time to consider.
    6. If they are willing to participate they will then be offered treatment in the same visit or a return visit
  3. Intervention - clinic visit 1 or 2

    1. Check understanding and continuing desire to participate in study if 2nd visit.
    2. Complete consent form.
    3. Patient fills out a PEM score and demographics collected on SOS (Surgical Outcomes System - Arthrex).
    4. Randomisation.
    5. If in PRP group 15ml blood sample taken with Arthrex ACP double syringe and processed (see processing instructions in Appendix.9.
    6. Aspiration.
    7. If in PRP group - Injection of PRP (the same volume as aspirated).
    8. Pressure dressing with gauze, wool and crepe for 48 hours.
  4. Adverse event screening/ management Patients are offered two options at the treatment visit.
  1. Routine review at 10 - 14 days at the clinic or 2. Telephone review at 7 days by Miss Katharine Hamlin who will have performed the procedure.

On telephone review if the patient is entirely happy that there are no concerns then follow up will proceed by email or telephone as below.

If any concerns are raised, or if the patient desires, a face to face review will be arranged ideally within 24 hours but no longer than 72 hours. Recurrence or other outcomes will not be assessed at this time.

  1. SOS/ Email/ Telephone interview - 1 (6 weeks)

a) Ganglion questionnaire b) PEM score c) Note any adverse events

  1. SOS/ Email /Telephone interview - 2 (12 months)
  1. Ganglion questionnaire
  2. PEM score
  3. Note any adverse events
02

Conditions studied

  • Ganglion of Wrist

Keywords

  • wrist
  • ganglion
  • platelet rich plasma
  • aspiration
03

Who can participate

Ages eligible
16 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Solitary dorsal wrist ganglion.

Exclusion criteria

Exclusion Criteria:

  • Underlying wrist or ipsilateral arm pathology.
  • Unable to consent to treatment.
  • Unable or unwilling to attend follow up visits.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
17 participants (actual)

Study arms

  • Active comparator
    Aspiration alone

    The patients will have their dorsal wrist ganglion aspirated and then pressure dressing for 48 hours.

    Procedure: Aspiration alone

  • Experimental
    Aspiration plus platelet rich plasma

    The patients will have their dorsal wrist ganglion aspirated, and then injected with platelet rich plasma (derived from a blood sample taken at the same visit) and then pressure dressing for 48 hours.

    Procedure: Platelet rich plasma

Interventions

  • ProcedurePlatelet rich plasma

    Aspiration of ganglion and injection with platelet rich plasma.

    Also known as: PRP

  • ProcedureAspiration alone

    Aspiration of the ganglion

05

What researchers measure

Primary outcomes

  1. Number of Participants With a Recurrence of Ganglia

    Has the ganglion returned?

    Time frame: 6 weeks

  2. Number of Participants With a Recurrence of Ganglia

    Has the ganglion returned?

    Time frame: 12 months

Secondary outcomes

  1. PEM Score

    The Patient Evaluation Measure (PEM) (Macey and Burke, 1995) is used to measure outcomes in hand surgery. It consists of a series of 18 questions, which address different aspects of symptoms pertaining to the hand and hand function. The questions have been split into three sections, the first being five questions on treatment. The second section contains ten questions on the condition of your hand at this moment in time (Feeling, Cold intolerance, Pain, Dexterity, Movement, Grip, ADL, Work, Appearance and Hand in general) and the third section is an overall assessment containing three questions. Each question from sections two and three are marked from 1-7, 7 being the worst outcome and 1 being the best outcome. The answers are expressed as a percentage disability ranging from zero to 100, with lower scores indicating less disability and are therefore better. This questionnaire is reliable, valid and responsive for assessing wrist disorders (Dias et al., 2001).

    Time frame: 6 weeks

  2. PEM Score

    The Patient Evaluation Measure (PEM) (Macey and Burke, 1995) is used to measure outcomes in hand surgery. It consists of a series of 18 questions, which address different aspects of symptoms pertaining to the hand and hand function. The questions have been split into three sections, the first being five questions on treatment. The second section contains ten questions on the condition of your hand at this moment in time (Feeling, Cold intolerance, Pain, Dexterity, Movement, Grip, ADL, Work, Appearance and Hand in general) and the third section is an overall assessment containing three questions. Each question from sections two and three are marked from 1-7, 7 being the worst outcome and 1 being the best outcome. The answers are expressed as a percentage disability ranging from zero to 100, with lower scores indicating less disability and are therefore better. This questionnaire is reliable, valid and responsive for assessing wrist disorders (Dias et al., 2001).

    Time frame: 12 months

06

Results

Posted Jun 24, 2021

Participant flow

Participant flow — Overall Study
MilestoneAspiration AloneAspiration Plus Platelet Rich Plasma
Started89
Completed88
Not completed01

Outcome measures

PrimaryNumber of Participants With a Recurrence of Ganglia

Has the ganglion returned?

Time frame:
6 weeks
Reported as:
Count of participants · Participants
Number of Participants With a Recurrence of Ganglia
ParticipantsAspiration AloneAspiration Plus Platelet Rich Plasma
Number of Participants With a Recurrence of Ganglia85
PrimaryNumber of Participants With a Recurrence of Ganglia

Has the ganglion returned?

Time frame:
12 months
Reported as:
Count of participants · Participants
Number of Participants With a Recurrence of Ganglia
ParticipantsAspiration AloneAspiration Plus Platelet Rich Plasma
Number of Participants With a Recurrence of Ganglia37
SecondaryPEM Score

The Patient Evaluation Measure (PEM) (Macey and Burke, 1995) is used to measure outcomes in hand surgery. It consists of a series of 18 questions, which address different aspects of symptoms pertaining to the hand and hand function. The questions have been split into three sections, the first being five questions on treatment. The second section contains ten questions on the condition of your hand at this moment in time (Feeling, Cold intolerance, Pain, Dexterity, Movement, Grip, ADL, Work, Appearance and Hand in general) and the third section is an overall assessment containing three questions. Each question from sections two and three are marked from 1-7, 7 being the worst outcome and 1 being the best outcome. The answers are expressed as a percentage disability ranging from zero to 100, with lower scores indicating less disability and are therefore better. This questionnaire is reliable, valid and responsive for assessing wrist disorders (Dias et al., 2001).

Time frame:
6 weeks
Reported as:
Mean · score on a scale
PEM Score
score on a scaleAspiration AloneAspiration Plus Platelet Rich Plasma
PEM Score40.2 (27.8 to 58.6)38.7 (15.8 to 66.9)
SecondaryPEM Score

The Patient Evaluation Measure (PEM) (Macey and Burke, 1995) is used to measure outcomes in hand surgery. It consists of a series of 18 questions, which address different aspects of symptoms pertaining to the hand and hand function. The questions have been split into three sections, the first being five questions on treatment. The second section contains ten questions on the condition of your hand at this moment in time (Feeling, Cold intolerance, Pain, Dexterity, Movement, Grip, ADL, Work, Appearance and Hand in general) and the third section is an overall assessment containing three questions. Each question from sections two and three are marked from 1-7, 7 being the worst outcome and 1 being the best outcome. The answers are expressed as a percentage disability ranging from zero to 100, with lower scores indicating less disability and are therefore better. This questionnaire is reliable, valid and responsive for assessing wrist disorders (Dias et al., 2001).

Time frame:
12 months
Reported as:
Mean · score on a scale
PEM Score
score on a scaleAspiration AloneAspiration Plus Platelet Rich Plasma
PEM Score35 (14.3 to 66.2)40.6 (14.3 to 57.1)

Adverse events

Collected over 1 year. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Aspiration Alone0/8 (0%)0/8 (0%)0/8 (0%)
Aspiration Plus Platelet Rich Plasma0/9 (0%)0/9 (0%)0/9 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)Aspiration AloneAspiration Plus Platelet Rich PlasmaTotal
Mean33.9 (23 to 46)23.2 (18 to 29)28.6 (18 to 46)
Sex: Female, Male
Sex: Female, Male(Participants)Aspiration AloneAspiration Plus Platelet Rich PlasmaTotal
Female7714
Male123
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)Aspiration AloneAspiration Plus Platelet Rich PlasmaTotal
Count of participants——0
Region of Enrollment
Region of Enrollment(participants)Aspiration AloneAspiration Plus Platelet Rich PlasmaTotal
United Kingdom8917
07

Study locations

1 site
  • NHS Grampian
    Aberdeen, AB25 2ZB, United Kingdom
08

References and documents

Publications

  • Meena S, Gupta A. Dorsal wrist ganglion: Current review of literature. J Clin Orthop Trauma. 2014 Jun;5(2):59-64. doi: 10.1016/j.jcot.2014.01.006. Epub 2014 Jun 3. PubMed 25983472 ↗
  • Janzon L, Niechajev IA. Wrist ganglia. Incidence and recurrence rate after operation. Scand J Plast Reconstr Surg. 1981;15(1):53-6. doi: 10.3109/02844318109103412. PubMed 7268314 ↗
  • Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004 Apr;62(4):489-96. doi: 10.1016/j.joms.2003.12.003. No abstract available. PubMed 15085519 ↗
  • Freymiller EG, Aghaloo TL. Platelet-rich plasma: ready or not? J Oral Maxillofac Surg. 2004 Apr;62(4):484-8. doi: 10.1016/j.joms.2003.08.021. No abstract available. PubMed 15085518 ↗
  • Yu W, Wang J, Yin J. Platelet-rich plasma: a promising product for treatment of peripheral nerve regeneration after nerve injury. Int J Neurosci. 2011 Apr;121(4):176-80. doi: 10.3109/00207454.2010.544432. Epub 2011 Jan 19. PubMed 21244302 ↗
  • Valente Duarte de Sousa IC, Tosti A. New investigational drugs for androgenetic alopecia. Expert Opin Investig Drugs. 2013 May;22(5):573-89. doi: 10.1517/13543784.2013.784743. Epub 2013 Apr 4. Erratum In: Expert Opin Investig Drugs. 2015 May;24(5):735. doi: 10.1517/13543784.2015.1027859. PubMed 23550739 ↗
  • Marx RE. Platelet-rich plasma (PRP): what is PRP and what is not PRP? Implant Dent. 2001;10(4):225-8. doi: 10.1097/00008505-200110000-00002. No abstract available. PubMed 11813662 ↗

Study documents

  • Protocol and statistical analysis plan · Jun 3, 2018
  • Informed consent form · Jun 3, 2018

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03408808
Lead sponsor
University of Aberdeen
Collaborators
NHS Grampian, Arthrex, Inc.
Responsible party
Sponsor
First posted
Jan 24, 2018
Start date
Dec 5, 2018
Primary completion
Feb 5, 2021
Completion
Feb 5, 2021
Results posted
Jun 24, 2021
Last update
Jun 24, 2021

Study contacts

Katharine Hamlin, MBChB
principal investigator · NHS Grampian

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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