Metacarpophalangeal Joint Reconstruction Using a Vascularized Cartilage and Bone Graft

Phase 1

Completed

• Conditions: Volar Plate Injury, Thumb, Metacarpophalangeal Joint
• Interventions: Procedure: MCP joint

• Registration Number: NCT01467752
• Lead Sponsor: The Second Hospital of Qinhuangdao

Brief Summary

Traumatic cartilage loss of the joint is central to the development of joint failure in arthritis. The study on the use of a bone graft for reconstruction of metacarpophalangeal joint defects.

Detailed Description

The metacarpophalangeal joint is vital for hand function. Cartilage loss of the joint is central to the development of joint failure in arthritis. Although various treatments have been proposed, the management remains a challenging problem.Previous anatomical studies have shown that, at the base of the metacarpal, there were nutrient arteries inserting into the dorsum of the metacarpal. The nutrient arteries arise from the distal and middle dorsal carpal arches that run distally to the first to fourth dorsal metacarpal arteries (DMAs. These studies prompt us to use a reverse vascularized cartilage and bone graft based on the DMA. The metacarpal consists of a widened proximal base. The joint surface to the capitate is convex anteriorly and dorsally concave, where it extends to the styloid process on the dorsolateral aspect of the metacarpal base. The unique contour stimulates our imagination and creativity to use a portion of the joint surface for reconstruction of metacarpophalangeal joint defects. The purpose of this study is to report the novel technique and to evaluate the effectiveness of the treatment.

Study Timeline

• Study Start: 2005-01
• Primary Completion: 2005-01
• Study Completion: 2009-12
• Status Verified: 2011-11
• Study First Submitted: 2011-11-02
• Study First Submitted QC: 2011-11-08
• Last Update Submitted: 2011-11-08
• Study First Posted: 2011-11-09
• Last Update Posted: 2011-11-09

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 15

Inclusion Criteria

1. a cartilage defect at either proximal or distal MCP joint;
2. either an acute or old injury;
3. loss of 1/4 of joint entire surface that seen on plain radiographs, CT scan, and intraoperative finding;
4. and with or without MCP joint subluxation.

Exclusion Criteria

1. large defects involved double joint surfaces;
2. the size of the defect involving less than 1/4 of the joint surface;
3. associate with infection or other diseases that restrict to use the technique.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
MCP joint	MCP joint	reconstruction of metacarpophalangeal (MCP) joint

Primary Outcome Measures

Name	Time	Method
Range of motion; Arm, Shoulder and Hand questionnaire	4 years	The active motions of the hand were measured by a goniometer. The patients rated their MCP joint pain, the donor joint pain, and scar pain using a line by a visual analogue scale (VAS). We used the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire to assess the hand function.

Secondary Outcome Measures

Name	Time	Method
Pain	4 years	joint pain is assessed using visual analogue scale

Trial Locations

Locations (1)

The second hospital of Qinhuangdao; 🇨🇳 Qinhuangdao, Hebei, China