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Arthroscopic Debridement vs Arthroscopic Hemi-Trapeziectomy on Patients With Thumb Carpometacarpal Joint Osteoarthritis

Not Applicable
Conditions
Osteoarthritis Thumb
Interventions
Procedure: Arthroscopic Debridement
Procedure: Arthroscopic Hemi-Trapeziectomy with Mini TightRope
Registration Number
NCT04217928
Lead Sponsor
Chinese University of Hong Kong
Brief Summary

Patients with thumb carpometacarpal joint osteoarthritis usually suffer from pain, joint enlargement, inflammation, deformity and loss of function. Conservative treatments usually are the first-line interventions, unfortunately some of the patients do not response to such treatments and surgical treatment will then be considered.

Compare to other traditional surgical techniques, arthroscopic techniques has resulted in the potential to treat osteoarthritis in a minimally invasive approach, avoiding the need for a larger incision. Other advantages of arthroscopy include less scarring and joint contracture, less risk of neurovascular injury, improved appearance, limited morbidity and quicker recovery. Although arthroscopic methods have been proved to be effective, there is lack of high-level evidence based studies to conclude one operation is superior to another. Hence, this study is designed to investigate outcomes of the two arthroscopic surgical methods (arthroscopic debridement vs arthroscopic hemi-trapeziectomy with Mini TightRope). The result of this study is expected to provide significant evidence based clinical data for surgeons worldwide on treating the thumb carpometacarpal joint osteoarthritis.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
60
Inclusion Criteria
  • Patients with Eaton and Glickel stage II and III of thumb carpometacarpal joint osteoarthritis
  • Age≥18 years old
  • Failed to response to nonsurgical/conservative treatments including orthoses/splinting, activity modification, oral analgesics (e.g. nonsteroidal anti-inflammatory drugs), strengthening/flexibility exercises, and injections of corticosteroid or hyaluronic acid
  • Willing to receive surgery
Exclusion Criteria
  • Patients received previous thumb surgery proximal to the interphalangeal joint (IPJ)
  • Patients with prior traumatic thumb injuries (e.g. fracture, dislocation)
  • Patients with significant metacarpophalangeal joint (MCPJ) pain
  • With concurrent procedures on the thumb, e.g. ganglion removal, trigger thumb release

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Arthroscopic DebridementArthroscopic DebridementPatients who are randomized into this arm will receive arthroscopic debridement
Arthroscopic Hemi-Trapeziectomy with Mini TightRopeArthroscopic Hemi-Trapeziectomy with Mini TightRopePatients who are randomized into this arm will receive arthroscopic hemi-trapeziectomy with mini tightrope
Primary Outcome Measures
NameTimeMethod
Short-Form Survey (SF-36)Post-op 24 months

Generic health status instrument to assess quality of life

Key and Tip PinchPost-op 24 months

Will be measured in kg

Range of Motion (ROM)Post-op 24 months

ROM of interphalangeal joint and metacarpal joint of thumb will be measured

Kapandji ScorePost-op 24 months

A tool for assessing the opposition of the thumb

ComplicationsPost-operative up to 2 years

Any complications related to the surgery will be documented

Disability of Arm, Shoulder and Hand (DASH) questionnairePost-op 24 months

Specially designed tool to assess upper extremity disability and symptoms

Patients' Satisfaction ScorePost-op 24 months

To grade the subjects' satisfaction regarding to their thumb conditions (0=totally not satisfied; 10=fully satisfied)

Visual Analogue Scale (VAS) Pain Score at Rest and ExertionPost-op 24 months

VAS pain score at rest and exertion will be measured post-operatively

Grip StrengthPost-op 24 months

Will be measured in kg

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Prince of Wales Hospital

🇭🇰

Shatin, Hong Kong

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