Dosage effects of extracorporeal shockwave therapy in early hip necrosis

ISRCTN ISRCTN74606904
DOI https://doi.org/10.1186/ISRCTN74606904
Secondary identifying numbers 98-2554A3
Submission date
29/04/2016
Registration date
09/05/2016
Last edited
02/09/2020
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Musculoskeletal Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Osteonecrosis is a disease caused by reduced blood flow to the bones in the joints. The bone starts to die and may break down. Osteonecrosis can affect the femoral head, which is the highest part of the thigh bone that “plugs into” the hip socket. Extracorporeal shockwave therapy (ESWT) is a procedure where a device passes sound waves through the skin to the affected bone, improving the blood flow. This study investigates the effects of different doses of ESWT on patients with early osteonecrosis of the femoral head (ONFH).

Who can participate?
Patients aged over 18 with ONFH

What does the study involve?
Participants are randomly allocated into three groups which receive different doses of ESWT. Participants are assessed with x-ray and MRI scans, and blood samples are taken.

What are the possible benefits and risks of participating?
ESWT may relieve pain and improve hip function.

Where is the study run from?
Kaohsiung Chang Gung Memorial Hospital (Taiwan)

When is the study starting and how long is it expected to run for?
August 2011 to July 2015

Who is funding the study?
Chang Gung Medical Foundation (Taiwan)

Who is the main contact?
Dr Ching-Jen Wang
w281211@adm.cgmh.org.tw

Contact information

Dr Ching-Jen Wang
Scientific

123, Ta Pei Road
Niao Sung District
Kaohsiung
83305
Taiwan

Phone +886 (0)7 7335279
Email w281211@adm.cgmh.org.tw

Study information

Study designRandomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titleExtracorporeal shockwave technology in hip necrosis: a dosage validation and systemic concentrations of serum NO levels of angiogenesis and osteogenesis factors and other biomarkers
Study objectivesThe etiology of osteonecrosis of the femoral head (ONFH) is multi-factorial, and the treatment is disease stage dependent. Core decompression with or without bone grafting for symptomatic early stage ONFH, and total hip replacement for late stage of the disease are considered the gold standards. However, the results of core decompression are inconsistent and unpredictable despite of good results reported in selective series, and many patients eventually undergo hip replacement surgery. Therefore, an effective non-invasive method of treatment is imperative and attractive for patients with early ONFH.

This study investigated the systemic and local effects of different dosages of extracorporeal shockwave therapy (ESWT) in early osteonecrosis of the femoral head (ONFH).
Ethics approval(s)The Institutional Review Board of Chang Gung Memorial Hospital, 25/03/2010, IRB no: 98-2554A3
Health condition(s) or problem(s) studiedOsteonecrosis of the femoral head
InterventionThe initial protocol intends to recruit 60 patients. Patients are randomly divided into three groups with 20 patients in group I who receive 2000 impulses of ESWT at 24 Kv; 20 patients in group II who receive 4000 impulses of ESWT at 24 Kv and 20 patients in group III who receive 6000 impulses of ESWT at 24 Kv.
Intervention typeDevice
Pharmaceutical study type(s)
Phase
Drug / device / biological / vaccine name(s)
Primary outcome measure1. The number of total hip arthroplasty (THA) performed during the study period (1 year)
2. Pain (VAS) score and Harris hip score
3. Changes on X-ray and MRI studies
Secondary outcome measuresTen milliliters of peripheral blood are obtained for measurements of serum NO level, VEGF and TGF-α; BMP-2, osteocalcin, DKK-1, IGF and IL-6 before treatment and at 1, 3, 6 and 12 months after treatment.
Overall study start date01/08/2011
Completion date31/07/2015

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants60
Total final enrolment33
Key inclusion criteria1. Over 18 years old
2. ONFH in stage I, stage II or stage III-a according to ARCO classification at initial presentation
Key exclusion criteria1. Patients with late stages of the disease (stages III-b, III-c or stage IV)
2. Patients under 18 years of age
3. Patients with cardiac arrhythmia or pacemaker
4. Patients on immunosuppressant drugs
5. Patients with infection or advanced arthritis
6. Patients with coagulopathy
7. Chronic renal failure
8. Pregnancy
9. Poor compliant patients
Date of first enrolment24/10/2011
Date of final enrolment24/07/2015

Locations

Countries of recruitment

  • Taiwan

Study participating centre

Kaohsiung Chang Gung Memorial Hospital
123, Ta Pei Road
Niao Sung District
Kaohsiung
83305
Taiwan

Sponsor information

Chang Gung Medical Foundation (Taiwan)
Hospital/treatment centre

123, Ta Pei Road
Niao Sung District
Kaohsiung
83305
Taiwan

ROR logo "ROR" https://ror.org/02verss31

Funders

Funder type

Hospital/treatment centre

Chang Gung Medical Foundation
Private sector organisation / Trusts, charities, foundations (both public and private)
Location
Taiwan

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planTo be confirmed at later date
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/11/2016 02/09/2020 Yes No

Editorial Notes

02/09/2020: Publication reference and total final enrolment number added.