Surgical Treatment of Pelvic Joint Instability in Patients With Severe Pelvic Girdle Pain After Pregnancy and Trauma
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Purpose
Pelvic girdle pain (PGP) related to pregnancy is a common reason to sick leave during pregnancy. Low back pain and PGP affects about 50% of women during pregnancy. Most of the women recover, however about 10% of the women still have complaints after birth. Most patients have positive effect from conservative treatment, but unfortunately some do still have much pain despite intensive conservative rehabilitation. Surgery has been tried on these women with various results. Surgical treatment is controversial and there is a lack of documentation. The investigators will operate 20 patients with arthrodesis to the sacroiliac joint and symphysis. Radiostereometric analysis (RSA) will be used to evaluate the joint movement in different part of the process.
Hypothesis: Severe pelvic girdle pain is caused by pelvic joint instability in some cases and surgically fixation of the affected joints can help these women to get back to a normal life.
| Condition | Intervention |
|---|---|
|
Pelvic Joint Instability Pelvic Pain |
Procedure: Arthrodesis to the sacroiliac joint and symphysis |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Surgical Treatment of Pelvic Joint Instability in Patients With Severe Pelvic Girdle Pain After Pregnancy and Trauma - A Study to Measure Effect of Surgery, Analysis of Clinical Tests and Detection of Sacroiliac Instability Using RSA. |
- Oswestry Disability Index (ODI) [ Time Frame: 3,6,12 months ] [ Designated as safety issue: No ]
- Visual Analogue Scale (VAS) 0 to 10 [ Time Frame: 3,6,12 months ] [ Designated as safety issue: No ]
- SF-36 [ Time Frame: 3,6,12 months ] [ Designated as safety issue: No ]
- Healing measured by CT [ Time Frame: 3,6,12 months ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 20 |
| Study Start Date: | January 2007 |
| Study Completion Date: | June 2011 |
| Primary Completion Date: | June 2011 (Final data collection date for primary outcome measure) |
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Procedure: Arthrodesis to the sacroiliac joint and symphysis
Standard surgical procedures will be used. When the patient has isolated pain in the symphysis isolated fixation will be performed. A 2x2 cm large bone block will be removed and replaced with spongy bone. For fixation the Matta-plate will be applied.
To the sacroiliac joint we use an anterior approach. A 2x1,5 cm large bone block will be removed and replaced with spongy bone from the iliac crest. For joint fixation we either use 2 plates or sacroiliac screws. The same procedure will be used on the other side in the cases with bilateral symptoms. Only one side will be operated at a time. After one year it will be decided if it's necessary to perform contralateral surgery.
Eligibility| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Pain in one or more pelvic joints.
- Minimum 2 positive clinical tests.
- High pain and disability score
- Tried adequate physiotherapy without effect.
Exclusion Criteria:
- Known psychiatric diagnosis
- Other spine pathology
- CT verified ankylosis
- BMI>30
Contacts and Locations| Norway | |
| Oslo university hospital - Ulllevaal | |
| Oslo, Norway, 0407 | |
| Principal Investigator: | Thomas J Kibsgaard, PhD student | Oslo university hosptal - Ullevaal |
More Information
No publications provided
| Responsible Party: | Thomas Johan Kibsgaard, Oslo university hospital - Ullevaal |
| ClinicalTrials.gov Identifier: | NCT00900601 History of Changes |
| Other Study ID Numbers: | UUS nr: 28125409, REK: 1.2006.1574 |
| Study First Received: | May 11, 2009 |
| Last Updated: | August 8, 2011 |
| Health Authority: | Norway:National Committee for Medical and Health Research Ethics |
Keywords provided by Oslo University Hospital:
|
Sacroiliac pain Sacroiliac instability Pelvic girdle pain |
Sacroiliac arthrodesis Arthrodesis Surgery |
Additional relevant MeSH terms:
|
Joint Instability Pelvic Pain Joint Diseases |
Musculoskeletal Diseases Pain Signs and Symptoms |
ClinicalTrials.gov processed this record on May 21, 2013