A prospective randomised study of carpometacarpal joint replacement and trapezectomy in the treatment of trapeziometacarpal osteoarthritis

Department of Health (UK)0 个研究点目标入组 0 人开始时间: 2003年9月12日最近更新: 2016年10月17日

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•Patients referred to the Pulvertaft Hand Centre for treatment of symptomatic carpometacarpal osteoarthritis.
•1. Patients entering the study will be drawn from those people presenting to The Pulvertaft Hand Centre for treatment of symptomatic osteoarthritis affecting the trapeziometacarpal joint of one or both thumbs. It is proposed that those centres in the Trent Region that currently refer patients to The Pulvertaft Hand Unit should be informed of this study and that some of their patients may be considered suitable to participate.
•2. Patients should be willing to participate in the study after consulting the patient information document and having had the opportunity to discuss the nature of the study with one of the investigators. They will have signed their consent to this effect.
•3. Patients entering the study will have exhausted non-operative forms of treatment.
•4. Patients must be suitable to undergo both procedures.

•1. Unsuitable to undergo both procedures. Preoperative x-rays show that degenerative change is not confined to the trapeziometacarpal joint but is more widespread, especially where the scaphotrapezial and scaphotrapezoid joints are involved. Patients, while suitable for trapezectomy, would not be considered suitable for carpometacarpal joint replacement. The extent of degenerative change will be defined as follows.
•1.1 Any intercarpal joint, particularly the scaphotrapezial and scaphotrapezoid joints where the radiographic joint space is reduced to less than 50% of normal.
•1.2 Any clinical or radiographic evidence of radiocarpal joint degeneration.
•1.3 Rare occasions when the extent of bony collapse affecting the trapezium and signifying osteonecrosis may be such as to preclude carpometacarpal joint replacement.
•2. 55 years of age or younger
•3. Current or previous history of septic arthritis involving the affected wrist.
•4. Suffering from rheumatoid arthritis or other inflammatory arthritides.
•5. Patients not willing to participate.
•6. Suffering from mental illness precluding their participation in the consent process.

发起方

Department of Health (UK)