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The Efficacy of Hypertonic Dextrose Injection to Anterior Talofibular Ligament Sprain

Not Applicable
Conditions
Ankle Sprains
Interventions
Procedure: Sham injection
Procedure: Tendon injection
Registration Number
NCT03868995
Lead Sponsor
Taipei Medical University WanFang Hospital
Brief Summary

Anterior talofibular ligament is the most injured ligament in ankle sprain. Investigators will include ankle sprain patients who have ankle pain or instability more than 3 months. Ultrasonography will be done for confirm ligament injury. Participants will be randomized into two groups. Participants in dextrose injection group will accept dextrose 15% injection to tendon and enthesis. In the other hand, subcutaneous sham injection to control group. Pain condition, stability test and function test, will be evaluated in 1 week, 4 weeks and 12 weeks after injection.

Detailed Description

Background: Sprains constitute most of ankle injury and 85% ankle sprain is inversion injury. The conventional treatment includes medication, physical therapy, bracing and steroid injection. Anterior talofibular ligament is the most injured ligament in ankle sprain. Although the response of acute ligament sprain is usually quickly, treatment of chronic ligament sprain is difficult. Chronic pain and ankle instability is the most common symptom in chronic ankle sprain. Dextrose prolotherapies been used for treating soft tissue injury such as osteoarthritis, tendinopathy and ligament sprain. However, there is not randomized control trial for hypertonic dextrose injection to chronic ankle sprain.

Methods: Investigators will include 40 ankle sprain patients who have ankle pain or instability sensation more than 3 months. Ultrasonography will be done for confirm ligament injury. Participants will be randomized into two groups. Dextrose injection group will accept dextrose 15% injection to tendon and enthesis. Otherwise, investigators will do subcutaneous sham injection to control group. Investigators will measure pain threshold and peak pressure by algometer, the degree of ankle instability by ultrasound, the proprioception by single leg standing, and foot and ankle questionnaire. The examination will be done before injection, immediately after injection, 1 week, 4 weeks and 12 weeks after injection.To our hypothesis, investigators suggest dextrose prolotherapy injection could decrease pain and improved proprioception.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
20
Inclusion Criteria
  1. 20-70 age
  2. Chronic ankle sprain more than 3months with chronic ankle pain or instability sensation
  3. Ultrasound diagnosed anterior talofibular ligament sprain
Exclusion Criteria
  1. Acute ankle sprain less than 3 months
  2. Lower limb fracture history
  3. Cognitive impairment
  4. Other neurological or muscular disorders
  5. Sever pain could not tolerate examination

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Sham injectionSham injectionDextrose water injection to subcutaneous layer at tender point
Tendon injectionTendon injectionDextrose water injection to injured tendon
Primary Outcome Measures
NameTimeMethod
Ankle painChange from baseline VAS at 12 week

visual analogue scale(VAS), range 0-10, the higher scale the worsen pain

Secondary Outcome Measures
NameTimeMethod
Ankle proprioceptionChange from baseline of difference of ankle degree at 12 weeks

The accuracy of ankle range of motion at 0 degree, half of dorsiflexion and half of plantar flexion

Ankle functionChange from baseline FADI at 12 weeks

Foot \& Ankle Disability Index (FADI), range 0-136, the higher the worse

Trial Locations

Locations (1)

Taipei medical university

🇨🇳

Taipei, Taiwan

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