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Six-month Performance of Meniscal Wall Infiltration Under Ultrasound to Treat Stable Degenerative Meniscal Injuries.

Phase 1
Recruiting
Conditions
Osteoarthritis, Knee
Interventions
Drug: Injection of corticosteroids (Diprostène®)
Registration Number
NCT05235854
Lead Sponsor
Centre Hospitalier Universitaire de Nīmes
Brief Summary

The main hypothesis of the study is that in situ infiltration of the meniscal lesion would provide patients with lasting and greater relief than intra-articular infiltration. A statistically significant difference would be if the Lysholm score of the meniscal wall group at 3 months is 9.5 points higher than that of the intra-articular infiltration group.

The aim is to evaluate the effectiveness of meniscal wall infiltration under ultrasound in the treatment of stable degenerative meniscal lesions versus intra-articular infiltration (Gold standard) at 3 months by Lysholm's algo-functional score.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
70
Inclusion Criteria
  • Patients with a symptomatic meniscal lesion of a degenerative nature, isolated or associated with early osteoarthritis or chondropathy (Ahlbach stages 1 and 2).
  • Indication for peri-meniscal infiltration under ultrasound control of the knee for a clinically stable degenerative meniscal lesion confirmed by MRI and radiography.
  • Patient who has given free and informed consent.
  • Patient who has signed the consent form.
  • Patient affiliated or beneficiary of a health insurance plan.
  • Adult patient (≥18 years of age).
Exclusion Criteria
  • No iconographic evidence of meniscal injury.
  • Associated lesions of the central pivot of the knee.
  • Knee pain of osteoarthritic origin strongly suggested by the clinic associated with an advanced radiological stage of osteoarthritis (Ahlbach stages 3 and 4).
  • Presence of a skin lesion at the infiltration sites.
  • Suspected soft tissue or joint infection.
  • Patient participating in research involving human subjects defined as Category 1.
  • Patient in an exclusion period as determined by another study.
  • Patient under court protection, guardianship or trusteeship.
  • Patient unable to give consent.
  • Patient for whom it is impossible to give informed information.
  • Pregnant, parturient or breastfeeding women.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Meniscal wall infiltration groupInjection of corticosteroids (Diprostène®)Administration of Diprostene: 1 ml syringe of Betamethasone 2 mg; injectable suspension in pre-filled syringe under ultrasound control.
Intra-articular infiltration groupInjection of corticosteroids (Diprostène®)The procedure is identical in all respects to the experimental group, except that the ultrasound procedure is mimicked and the infiltration of dexamethasone 2 mg (Diprostene®) is performed intra-articularly. Administration Diprostene: 1 ml syringe of Betamethasone 2 mg; injectable suspension in pre-filled syringe.
Primary Outcome Measures
NameTimeMethod
Lysholm score before infiltration (intra-articular group)15 days before infiltration

The Lysholm score will be used to evaluate functionality 15 days before infiltration.The Lysholm Tegner score (Lysholm and Gillquist 1982) is a validated questionnaire for assessing knee functionality. The Lysholm score is rated from 0 to 100 (100 being the maximum functional score) and its repeatability is excellent (0.88 to 0.95). The scale has eight items: instability (/25), pain (/25), locking (/15), swelling (/10), stairs (/10), squatting (/5), limping (/5), use of a cane (/5). In 1985, Tegner added a scale of sports and occupational activity rated from 0 (occupational disability) to 10 (high level sport), hence the name Lysholm-Tegner score (Tegner and Lysholm 1985)

Lysholm score before infiltration (meniscal wall group)15 days before infiltration

The Lysholm score will be used to evaluate functionality 15 days before infiltration.The Lysholm Tegner score (Lysholm and Gillquist 1982) is a validated questionnaire for assessing knee functionality. The Lysholm score is rated from 0 to 100 (100 being the maximum functional score) and its repeatability is excellent (0.88 to 0.95). The scale has eight items: instability (/25), pain (/25), locking (/15), swelling (/10), stairs (/10), squatting (/5), limping (/5), use of a cane (/5). In 1985, Tegner added a scale of sports and occupational activity rated from 0 (occupational disability) to 10 (high level sport), hence the name Lysholm-Tegner score (Tegner and Lysholm 1985)

Lysholm score after infiltration (intra-articular group)3 months after infiltration

The Lysholm score will be used to evaluate functionality 3 months after infiltration.The Lysholm Tegner score (Lysholm and Gillquist 1982) is a validated questionnaire for assessing knee functionality. The Lysholm score is rated from 0 to 100 (100 being the maximum functional score) and its repeatability is excellent (0.88 to 0.95). The scale has eight items: instability (/25), pain (/25), locking (/15), swelling (/10), stairs (/10), squatting (/5), limping (/5), use of a cane (/5). In 1985, Tegner added a scale of sports and occupational activity rated from 0 (occupational disability) to 10 (high level sport), hence the name Lysholm-Tegner score (Tegner and Lysholm 1985)

Lysholm score after infiltration (meniscal wall group)3 months after infiltration

The Lysholm score will be used to evaluate functionality 3 months after infiltration.The Lysholm Tegner score (Lysholm and Gillquist 1982) is a validated questionnaire for assessing knee functionality. The Lysholm score is rated from 0 to 100 (100 being the maximum functional score) and its repeatability is excellent (0.88 to 0.95). The scale has eight items: instability (/25), pain (/25), locking (/15), swelling (/10), stairs (/10), squatting (/5), limping (/5), use of a cane (/5). In 1985, Tegner added a scale of sports and occupational activity rated from 0 (occupational disability) to 10 (high level sport), hence the name Lysholm-Tegner score (Tegner and Lysholm 1985)

Secondary Outcome Measures
NameTimeMethod
Return to physical activity (intra-articular infiltration group)Day 0 to Month 6

The number of days taken for the patient to return to physical activity

Pain evaluated by the patient (intra-articular group)12 weeks after infiltration

Pain will be evaluated by the patient on a visual analog scale (0-10) once a week up to 3 months after infiltration.

Adverse events in the intra-articular infiltration groupDay 0 to 3 months after infiltration

Collection of all possible adverse events from D0 to M3. Qualitative

Adverse events in the meniscal wall infiltration groupDay 0 to 3 months after infiltration

Collection of all possible adverse events from D0 to M3. Qualitative

Arthroscopy required within six months of infiltration: (intra-articular group)6 months after infiltration

Yes/No and, if so, the date of the arthroscopy will be recorded.

Arthroscopy required within six months of infiltration: (meniscal wall group)6 months after infiltration

Yes/No and, if so, the date of the arthroscopy will be recorded.

Return to physical activity (meniscal wall infiltration group)Day 0 to Month 6

The number of days taken for the patient to return to physical activity

Pain evaluated by the patient (meniscal wall group)12 weeks after infiltration

Pain will be evaluated by the patient on a visual analog scale (0-10) once a week up to 3 months after infiltration.

Trial Locations

Locations (1)

Chu Nimes

🇫🇷

Nimes, France

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