NSAID Injection Versus Corticosteroid Injection for Basilar Thumb Arthritis

Launched by MAYO CLINIC · Aug 7, 2023

Keywords

ClinConnect Summary

This clinical trial is comparing two types of injections to help relieve pain from basilar thumb arthritis, a condition that affects the base of the thumb and can cause discomfort when using the hand. The researchers are looking at ketorolac, which is a nonsteroidal anti-inflammatory drug (NSAID), and triamcinolone, a corticosteroid. Both injections will be given directly into the joint to see which one works better for reducing pain and improving function in people with moderate to advanced thumb arthritis.

To participate in this study, you need to be an adult over 40 years old who has experienced pain at the base of the thumb that hasn't improved with common treatments like over-the-counter pain relievers or splints. You should also have signs of arthritis visible on X-rays. If you qualify and choose to take part, you will receive one of the injections and be monitored for its effects. It's important to note that there are some exclusions, such as having certain other medical conditions or previous injuries to the thumb. Overall, this trial aims to provide better treatment options for those suffering from this painful condition.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Adults \>40 years of age
• • Pain at the thumb base brought on by direct pressure (grind test) and with movement
• • Pain resistant to previous conservative management (including over the counter medications (ibuprofen/acetaminophen), icing, splinting/braces, or topical analgesics)
• • Radiological observation indicative of arthritis based on the Eaton-Littler classification system (stages 1 through 4)
• • Patient understands the protocol and signed the informed consent
• • Patient is covered by health insurance
• Exclusion Criteria:
• • • Known allergy to either of the treatment products
• • Patient's analgesic treatment regimen or other modalities of managing symptoms/pain associated with their hand pathology was modified within four weeks before trial inclusion
• • Symptomatic Scaphoid-trapezial arthritis present
• • Localized or systemic infection
• • Previous thumb surgery on study thumb
• • Previous thumb injury on study thumb
• • Patient with inflammatory arthritis (e.g., rheumatoid arthritis, psoriatic arthritis)
• • Severe and/or uncontrolled hypertension
• • De Quervain tendinopathy present
• • History of injection to the trapeziometacarpal joint on study thumb within the previous 6 weeks
• • Uncontrolled diabetes
• • Pregnant or lactating females. Female participants of childbearing potential must have a negative pregnancy test before the injection. Women without childbearing potential (ie., surgically sterile with hysterectomy and/or bilateral oophorectomy and/or bilateral salpingectomy OR ≥ 12 months of amenorrhea and at least 50 years of age) are eligible to participate without completing a pregnancy test.
• • Immunodeficient patients
• • Patients that are currently using nicotine products, or who have quit in the last 12 months
• • Patients under guardianship, curatorship, or are otherwise not self-sufficient
• • Patients participating in another clinical research trial which interferes with this study protocol or outcomes
• • Patients unable to follow the protocol in the investigators' judgement.