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Effect of Botulinum Toxin to Hallux Valgus in Addition to Total Contact Insole

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ClinicalTrials.gov Identifier: NCT01501500
Recruitment Status : Completed
First Posted : December 29, 2011
Last Update Posted : September 6, 2013
Sponsor:
Collaborator:
National Science Council, Taiwan
Information provided by (Responsible Party):
Chang Gung Memorial Hospital

Brief Summary:
The investigators propose a new therapeutic approach by injecting Botulinum Toxin Type A (BTA) to the oblique and transverse heads of adductor muscle of the great toe. BTA works by binding presynaptically to high-affinity recognition sites on the cholinergic nerve terminals and decrease the release of acetylcholine, causing a neuromuscular blocking effect. The investigators hypothesize that BTA injection may help to decrease the hallux valgus angle by decrease adductor hallucis muscle activation. Thereby enhance the therapeutic result of hallux valgus treated with total contact insole. The outcome measurement may shed light in treating patient with painful hallux valgus and document evidence for plantar pressure changes in acute, sub-acute and chronic stage.

Condition or disease Intervention/treatment Phase
Hallux Valgus Drug: BOTOX Drug: Normal Saline (0.9% NaCl) Phase 4

Detailed Description:

This is a randomized, double-blind, placebo-controlled prospective study to assess the influence and efficacy of intramuscular (IM) Botulinum Toxin Type A (BTA) injection in patients with painful hallux valgus with the use of total contact insole.

Fifty feet with painful hallux valgus will be collected. Informed consent is obtained according to the hospital's medical ethics and the human clinical trial committee. The feet will be randomized into 2 groups: Group A (n=25, treatment group) and Group B (n=25, control group). Clinical diagnosis of hallux valgus is made based on observation of great toe lateral deviation. Inclusion criteria were hallux valgus with angle of at least 20°, single or bilateral hallux valgus. To obtain the hallux valgus angle, foot roentgenography in AP and sesamoid views under the weight bearing condition will be obtained. The angle formed by lines drawn to bisect the first metatarsal bone and the proximal phalanx of the great toe will be measured. The exclusion criteria include history of foot operations, rheumatoid and gouty arthritis, and any contraindication to BTA administration. Subjective data such as the Foot Function Index will be collected.


Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 25 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Therapeutic Effect of Botulinum Toxin Type A in Addition to Total Contact Insole in Treating Painful Hallux valgus-a Pilot Study
Study Start Date : August 2010
Actual Primary Completion Date : August 2013
Actual Study Completion Date : August 2013

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Botox

Arm Intervention/treatment
Active Comparator: botulinum toxin type A. HV angle
intramuscular injection of BTA into target muscle
Drug: BOTOX
once injection of BTA 3oU into hallux oblique and transverse heads each
Other Name: BOTOX (Allergan, Irvine, CA)

Placebo Comparator: Normal saline, HV angle
intramuscular injection of normal saline into target muscle
Drug: Normal Saline (0.9% NaCl)
Normal saline 0.3ml to oblique and transverse heads each




Primary Outcome Measures :
  1. hallux valgus angle [ Time Frame: up to 18 months ]
    radiological assessment before and after the intervention


Secondary Outcome Measures :
  1. foot function index for quality of life [ Time Frame: up to 18 months ]
    Foot Function Index before and after the intervention



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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • hallux valgus with angle of at least 20°,
  • single or bilateral hallux valgus.

Exclusion Criteria:

  • history of foot operations,
  • rheumatoid arthritis and gouty arthritis.
  • Any contraindication on BTA administration

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01501500


Locations
Taiwan
Chang Gung MH
Gueishan, Taoyuan, Taiwan, 333
Sponsors and Collaborators
Chang Gung Memorial Hospital
National Science Council, Taiwan
Investigators
Principal Investigator: Katie P Wu, MD Chang Gung Memorial Hospital

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Chang Gung Memorial Hospital
ClinicalTrials.gov Identifier: NCT01501500     History of Changes
Other Study ID Numbers: NSC 99-2314-B-182A-020
First Posted: December 29, 2011    Key Record Dates
Last Update Posted: September 6, 2013
Last Verified: March 2010

Keywords provided by Chang Gung Memorial Hospital:
botulinum toxin type A
hallux valgus angle
foot function index
VAS pain scale

Additional relevant MeSH terms:
Hallux Valgus
Bunion
Foot Deformities
Musculoskeletal Diseases
Foot Deformities, Acquired
Botulinum Toxins
onabotulinumtoxinA
Botulinum Toxins, Type A
abobotulinumtoxinA
Acetylcholine Release Inhibitors
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action
Cholinergic Agents
Neurotransmitter Agents
Physiological Effects of Drugs
Neuromuscular Agents
Peripheral Nervous System Agents