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Trial registered on ANZCTR
Registration number
ACTRN12610001020077
Ethics application status
Approved
Date submitted
18/11/2010
Date registered
22/11/2010
Date last updated
9/02/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
Autologous Blood Injection for Treatment of Achilles Tendinopathy? A Randomised Controlled Trial
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Scientific title
In patients with achilles tendinopathy what is the short-term efficacy of adding autologous blood injection to conservative treatment compared with that of conservative treatment alone?
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Secondary ID [1]
253119
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None
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Universal Trial Number (UTN)
U1111-1118-2075
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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:
Achilles tendinopathy
258681
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Condition category
Condition code
Physical Medicine / Rehabilitation
258827
258827
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0
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Other physical medicine / rehabilitation
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Musculoskeletal
258833
258833
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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
Autologous blood injection - injection of 2ml of patients own blood around their injured Achilles tendon - added to standard conservative treatment program.
All patients in the treatment group received an initial injection following enrolment in the study. Depending on the response to the initial injection, a second injection following the 6 week follow-up was performed in almost half of these patients.
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Intervention code [1]
257640
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Treatment: Other
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Comparator / control treatment
Standard conservative treatment based on eccentric strengthening program
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Control group
Active
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Outcomes
Primary outcome [1]
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Victorian Institute of Sport Assessment for Achilles (VISA-A) score
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Assessment method [1]
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Timepoint [1]
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Baseline, 6 weeks and 12 weeks
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Secondary outcome [1]
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the treatment group was asked to rate the degree of discomfort experienced
a) during the injection procedure (no significant discomfort, mild discomfort, moderate discomfort, or severe pain) and
b) over the 48 hours following injection, relative to pre-injection (improved, no change, mild discomfort, moderate discomfort, or severe pain).
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Assessment method [1]
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Timepoint [1]
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As above
a) during the injection and
b) on average over the 48 hours following injection compared to before the injection
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Eligibility
Key inclusion criteria
Diagnosis of mid achilles tendinopathy (activity-related pain of gradual or semi-acute onset, post-inactivity stiffness, and tenderness, swelling and nodularity localised to the mid-tendon) with duration of symptoms of at least three months.
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Minimum age
16
Years
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Maximum age
No limit
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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
Diagnostic uncertainty or concurrent presence of insertional pathology,
Anticoagulant therapy,
Systemic disease that may contribute to pathology,
Elite level sportsperson, or
Having received any injection therapy for the tendon within the last three months.
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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)
Recruitment through a specialist sports medicine clinic.
If meets inclusion criteria and no exclusion criteria, and agrees to participate then randomized by random number selection to standard treatment plus autologous blood injection (treatment) or standard treatment alone (control).
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation plan generator. Available online at http://www.randomization.com [select first generator, use seed 21383, labels: “treatment” and “control”, 2 blocks of 20 subjects each]
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2 / Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
13/03/2008
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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
40
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
3054
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New Zealand
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State/province [1]
3054
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Wellington
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Funding & Sponsors
Funding source category [1]
258095
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Self funded/Unfunded
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Name [1]
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Jake Pearson
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Address [1]
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Wakefield Sports Med
Level 4 Wakefield Specialist Centre
99 Rintoul St
Newtown
Wellington 6242
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Country [1]
258095
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New Zealand
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Primary sponsor type
Individual
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Name
Jake Pearson
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Address
Wakefield Sports Med
Level 4 Wakefield Specialist Centre
99 Rintoul St
Newtown
Wellington 6242
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Country
New Zealand
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Secondary sponsor category [1]
257275
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Individual
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Name [1]
257275
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Ruth Highet
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Address [1]
257275
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Wakefield Sports Med
Level 4 Wakefield Specialist Centre
99 Rintoul St
Newtown
Wellington 6242
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Country [1]
257275
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New Zealand
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Other collaborator category [1]
251661
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Individual
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Name [1]
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David Rowlands
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Address [1]
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Division of Exercise and Sport Science
Institute of Food, Nutrition and Human Health
Massey University
Block 3, Room 3C18 Reception
Entrance C
Wallace St
Mt Cook
Wellington 6021
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Country [1]
251661
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Central Regional Ethics Committee
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Ethics committee address [1]
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C/- Ministry of Health 1-3 The Terrace Level 1 Wellington 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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22/11/2007
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Approval date [1]
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14/12/2007
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Ethics approval number [1]
260089
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CEN/07/12/083
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Summary
Brief summary
Abstract: Aim: To determine whether autologous blood injections added to standard management was effective in alleviating symptoms of achilles tendinopathy. Methods: Thirty three patients (18 female, 15 male) aged 50 years (SD 9) with 40 cases of achilles tendinopathy of 11 months (SD 7) duration were enrolled in the study. Participants were randomised to autologous blood injection added to standard treatment (eccentric-loading exercises) or standard treatment alone for 12 weeks. Victorian Institute of Sport Assessment for Achilles (VISA-A) score and ratings of discomfort during and following the injection were measured at baseline, six and 12 weeks. Analytically-derived effect-size thresholds of 5 (small) and moderate (15) were utilised as the reference values for clinical inference. Results: Improvements in VISA-A of 7.7 units (95%CL: +/-6.7) and 8.7 units (+/-8.8) were observed in the treatment and control groups respectively at six weeks relative to baseline with no clear effect of blood injection. At 12 weeks VISA-A score improved to 18.9 units (+/-7.4) in the treatment group revealing a clinically small blood injection effect of 9.6 units (+/-11.5), relative to a comparatively unchanged condition in control (9.4 units; +/-9.0). Predictors of response to treatment were unremarkable, and a 10% rate of post-injection flare was the only noteworthy side-effect. Most patients described the discomfort experienced during the baseline injection as mild, and while there was greater variability in the change in discomfort over the 48 hours following the injection this was on average mild to moderate discomfort. Conclusions: There is some evidence for small symptomatic improvements in the short-term with the addition of autologous blood injection to standard treatment for achilles tendinopathy, although confirmatory research is required to eliminate a possible placebo effect.
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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
31932
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Phone
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Fax
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Email
31932
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Contact person for public queries
Name
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Jake Pearson
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Address
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Wakefield Sports Med
Level 4 Wakefield Specialist Centre
99 Rintoul St
Newtown
Wellington 6242
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Country
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New Zealand
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Phone
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+64 4 381 8125
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Fax
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+64 4 381 8126
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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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Jake Pearson
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Address
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Wakefield Sports Med
Level 4 Wakefield Specialist Centre
99 Rintoul St
Newtown
Wellington 6242
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Country
6107
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New Zealand
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Phone
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+64 4 381 8125
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Fax
6107
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+64 4 381 8126
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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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