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Trial registered on ANZCTR
Registration number
ACTRN12605000775617
Ethics application status
Approved
Date submitted
1/12/2005
Date registered
2/12/2005
Date last updated
4/04/2008
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effectiveness of Botulinum toxin Type A injection (Dysport®) to restore quadriceps muscle balance and improve chronic knee pain
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Scientific title
A double blind randomized controlled trial of the efficacy of Botulinum toxin Type A injection (Dysport®) to restore quadriceps muscle balance in patients with chronic patello-femoral pain syndrome
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic anterior knee pain?
931
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Condition category
Condition code
Musculoskeletal
1000
1000
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
1. Single occasion intramuscular injection of Botulinum toxin Type A injection (500U Dysport®) to distal third of vastus lateralis [VL] muscle. 2. Exercise programme for knee extensor muscles
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Intervention code [1]
784
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Rehabilitation
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Comparator / control treatment
1. Single occasion intramuscular injection of 500U saline (placebo). 2. Exercise programme for knee extensor muscles
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Self-reported knee related disability and quality of life [Anterior Knee Pain Scale]
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Assessment method [1]
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Timepoint [1]
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Comparison of AKPS scores at 12 week and 24 weeks with average of 3 baseline measures
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Primary outcome [2]
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Timing of muscle onsets of VM/VL and ratio of VL:VM amplitude during a standardized stepping task [EMG]?
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Assessment method [2]
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Timepoint [2]
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Comparison of timing of onsets at 12 week and 24 weeks with average of 3 baseline measures
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Secondary outcome [1]
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Isometric knee extension force at 30° and 90° knee flexion [digital force dynamometry].
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Assessment method [1]
2375
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Timepoint [1]
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At 2, 6, 12, 18 and 24 weeks post injection, final measures at 1 year post entry to study.
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Secondary outcome [2]
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Patella congruence and VM/VL cross sectional area [CT imaging]
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Assessment method [2]
2376
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Timepoint [2]
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At 12 weeks compared with baseline measures.
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Eligibility
Key inclusion criteria
Anterior or retropatellar pain on at least two of the following: prolonged sitting, stairs, squat, running, kneeling and hopping/jumping unrelated to a recent traumatic incident no surgical intervention (arthroscopic investigation or menisectomy allowed).
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Minimum age
15
Years
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Maximum age
55
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
History of recurrent patella dislocation/subluxationClinical evidence of meniscal lesion, ligamentous instability, traction apophysitis around the patello-femoral complex, or patellar tendon pathology Radiographically determined osteoarthrotic changes of the PFJ Obesity BMI >30Previous BTXA injection within 3 months or any history of adverse reaction to BTXADisorders producing disturbed neuromuscular transmission (eg.myasthenia gravis)Concurrent use of aminoglycosides (potential for interaction with BTXA)History of infectious diseases or active rheumatoid arthritis.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Same volume colourless solution drawn up by admin assistant and provided to blinded physician for injection.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Random number sequence to allocate subjects. Block randomisation is used to ensure approximately equal in trial numbers at each time point.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 1
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
31/07/2005
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
25
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Raine Medical Research Foundation
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Address [1]
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Raine Medical Research Foundation
Suite 24, Hollywood Soecialist Centre
95 Monash Ave, Nedlands, WA 6009
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Country [1]
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Australia
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Funding source category [2]
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Commercial sector/Industry
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Name [2]
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Ipsen Pharmaceuticals
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Address [2]
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Suite 6,40 Montclair Ave
Glen Waverley 3150
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Country [2]
2670
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Australia
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Primary sponsor type
Individual
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Name
Dr BJ Singer, School of Surgery and Pathology, The University of Western AustraliaMedical Research Foundation Building, Level 2, Rear 50 Murray Street, Perth, WA 6000
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Address
Level 2, MRF Building., Rear 50, Murray Street, Perth, Western Australia 6000
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Country
Australia
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Secondary sponsor category [1]
960
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Individual
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Name [1]
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Professor KP Singer
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Address [1]
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School of Surgery and Pathology
The University of Western Australia
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Country [1]
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Australia
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Secondary sponsor category [2]
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Individual
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Name [2]
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Dr Peter Silbert
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Address [2]
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Department of Neurology
Royal Perth Hospital
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Country [2]
961
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Australia
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Secondary sponsor category [3]
962
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Individual
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Name [3]
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Dr John Dunne
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Address [3]
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Department of Neurology
Royal Perth Hospital
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Country [3]
962
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Australia
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Secondary sponsor category [4]
963
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Individual
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Name [4]
963
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Dr Swithin Song
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Address [4]
963
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Department of Radiology
Royal Perth Hospital
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Country [4]
963
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
2400
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Royal Perth Hospital
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Ethics committee address [1]
2400
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Perth, Western Australia
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Ethics committee country [1]
2400
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Australia
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Date submitted for ethics approval [1]
2400
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Approval date [1]
2400
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07/02/2006
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Ethics approval number [1]
2400
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2005/096
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Summary
Brief summary
Abnormal tracking of the patella during knee joint movement, associated with imbalance of the pull of the inner quadriceps muscle (VM) and the outer quadriceps muscles (VL), has been proposed as a primary factor in anterior knee pain. Botulinum toxin (BTXA) can be used to reduce the relative overactivity in the VL muscle in addition to an exercise programme to strengthen the VM muscle in subjects with chronic anterior knee pain who had failed conservative management. We hypothesise that the combination of these therapies (BTXA and specific exercise for VM muscle control) has the potential to facilitate restoration of normal patello-femoral joint mechanics, particularly by restoring timing of onset of the VM muscle compared with VL, and consequently to reduce anterior knee pain and associated disability.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Barbara Singer
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Address
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School of Surgery and Pathology
The University of Western Australia
Level 2
Medical Research Foundation Building
Rear 50 Murray Street
Perth WA 6000
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Country
9973
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Australia
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Phone
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+61 8 92240229
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Fax
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+61 8 92240204
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Barbara Singer
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Address
901
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School of Surgery and Pathology
The University of Western Australia
Level 2
Medical Research Foundation Building
Rear 50 Murray Street
Perth WA 6000
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Country
901
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Australia
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Phone
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+61 8 92240229
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Fax
901
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+61 8 92240204
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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