Trapeziectomy Suspensionplasty Versus Carpometacarpal Joint Replacement in Treatment of Basal Thumb Osteoarthritis

NCT ID: NCT04588961

Last Updated: 2021-01-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-06-01

Study Completion Date

2024-12-31

Brief Summary

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This study compares and evaluates differences in movement analysis, patient-reported outcome, radiological assesment and muscular function between patients undergoing carpometacarpal joint arthroplasty with use of modern implants and trapeziectomy with suspensionplasty

Detailed Description

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Osteoarthritis of first carpometacarpal joint is the most common degenerative disease of upper limb. According to data available in literature, it affects about 30% of women and 6% of men at the age of 45. Increasing with age, it rises up to 90% in people by the age of 80. Due to more widely spread electronic devices in offices, at work, at home which requires usage of thumb, increase in numbers mentioned above is strongly probable. The main symptoms are: pain, loose of grip strength and loose of function. The latter is most important fact, since about 50% of hand function is possible only with healthy thumb.

In many cases osteoarthritis can be treated by combined NSAIDs and splinting with rehabilitation. Sometimes when symptoms do not respond to non-operative treatment, there is a need for surgery. Trapeziectomy is the most common choice for operative treatment for end-stage basal thumb osteoarthritis. However, many other techniques were developed, there is continuous dispute over selecting the optimal . One of the most promising is arthroplasty using prosthesis. Last years many important advances were made in a design of implant and materials. Moreover the investigators now have many longer outcomes of such operation made in the past. All this data make us think more about using this technique often, since there are papers which show superiority over classical trapeziectomy. Even though there are several studies comparing functional and objective outcome of those techniques, there is a lack of evidence in terms of biomechanical analysis, thenar muscle activity and changes in movement patterns. Moreover there is no study published so far which considers modern implants and trapeziectomy with suspensionplasty. The aim of the study is to examine relationships between movement analysis (kinematic and functional outcomes), patient reported outcome measures (PROMS) and X-ray measurement, electromyography both pre- and post-operatively.

Conditions

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Carpometacarpal Osteoarthritis Rhizarthrosis Thumb Osteoarthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Patients would be assigned randomly to 2 different groups
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Outcomes Assessor will not be informed which type of prosthesis was used in particular patient.

Study Groups

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Control group

Patients undergoing trapeziectomy with suspensionplasty for primary basal thumb osteoarthritis

Group Type ACTIVE_COMPARATOR

Trapeziectomy with suspensionplasty

Intervention Type PROCEDURE

Surgical removal of trapezium bone and ligamentoplasty of first metacarpal bone using abductor pollicis tendon

Study group

Patients undergoing joint alloplasty using prothesis for primary basal thumb osteoarthritis

Group Type ACTIVE_COMPARATOR

Joint alloplasty

Intervention Type PROCEDURE

Surgical removal of degenerated joint surfaces nad replacement using modern designed prothesis

Interventions

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Trapeziectomy with suspensionplasty

Surgical removal of trapezium bone and ligamentoplasty of first metacarpal bone using abductor pollicis tendon

Intervention Type PROCEDURE

Joint alloplasty

Surgical removal of degenerated joint surfaces nad replacement using modern designed prothesis

Intervention Type PROCEDURE

Other Intervention Names

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Joint replacement

Eligibility Criteria

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Inclusion Criteria

* osteoarthritis of carpometacarpal joint III or III/IV in Eaton classification assessed by two different radiologists
* symptoms that do not respond to non-operative treatment for 8 weeks
* no counterindications for anaesthesia
* signed agreement for taking a part into trial

Exclusion Criteria

* patient do not agree to take a part into study
* problems with communication with patient
* unstable cardiac disease
* reoperations
* previous surgical interventions in hand
* neuro-muscular diseases
* rheumatological background of disease
* diagnosed cervical spine disorders
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University of Warsaw

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Piotr Stępiński, MD

Role: PRINCIPAL_INVESTIGATOR

Medical University of Warsaw

Locations

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Department of Othopedics and Rehabilitation, Medical University of Warsaw

Warsaw, Masovian Voivodeship, Poland

Site Status

Countries

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Poland

Central Contacts

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Piotr Stępiński, MD

Role: CONTACT

607 190 402 ext. +48

Bartosz M. Maciąg, MD

Role: CONTACT

881 568 144 ext. +48

References

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Sodha S, Ring D, Zurakowski D, Jupiter JB. Prevalence of osteoarthrosis of the trapeziometacarpal joint. J Bone Joint Surg Am. 2005 Dec;87(12):2614-2618. doi: 10.2106/JBJS.E.00104.

Reference Type BACKGROUND
PMID: 16322609 (View on PubMed)

Deiler S. [Basal joint osteoarthritis of the thumb]. Orthopade. 2019 Apr;48(4):351-366. doi: 10.1007/s00132-019-03707-8. German.

Reference Type BACKGROUND
PMID: 30843103 (View on PubMed)

Weiss AC, Goodman AD. Thumb Basal Joint Arthritis. J Am Acad Orthop Surg. 2018 Aug 15;26(16):562-571. doi: 10.5435/JAAOS-D-17-00374.

Reference Type BACKGROUND
PMID: 29969109 (View on PubMed)

Wajon A, Vinycomb T, Carr E, Edmunds I, Ada L. Surgery for thumb (trapeziometacarpal joint) osteoarthritis. Cochrane Database Syst Rev. 2015 Feb 23;2015(2):CD004631. doi: 10.1002/14651858.CD004631.pub4.

Reference Type BACKGROUND
PMID: 25702783 (View on PubMed)

Mahoney JD, Meals RA. Trapeziectomy. Hand Clin. 2006 May;22(2):165-9. doi: 10.1016/j.hcl.2006.02.003.

Reference Type BACKGROUND
PMID: 16701128 (View on PubMed)

Naram A, Lyons K, Rothkopf DM, Calkins ER, Breen T, Jones M, Shufflebarger JV. Increased Complications in Trapeziectomy With Ligament Reconstruction and Tendon Interposition Compared With Trapeziectomy Alone. Hand (N Y). 2016 Mar;11(1):78-82. doi: 10.1177/1558944715617215. Epub 2016 Jan 14.

Reference Type BACKGROUND
PMID: 27418894 (View on PubMed)

Sivakumar BS, Graham DJ. APL Lasso Suspensionplasty for Trapeziectomy. Tech Hand Up Extrem Surg. 2020 Sep;24(3):108-113. doi: 10.1097/BTH.0000000000000276.

Reference Type BACKGROUND
PMID: 31876776 (View on PubMed)

Wang T, Zhao G, Rui YJ, Mi JY. Outcomes of modified trapeziectomy with ligament reconstruction tendon interposition for the treatment of advanced thumb carpometacarpal arthritis: Two-year follow-up. Medicine (Baltimore). 2018 Mar;97(13):e0235. doi: 10.1097/MD.0000000000010235.

Reference Type BACKGROUND
PMID: 29595674 (View on PubMed)

Robles-Molina MJ, Lopez-Caba F, Gomez-Sanchez RC, Cardenas-Grande E, Pajares-Lopez M, Hernandez-Cortes P. Trapeziectomy With Ligament Reconstruction and Tendon Interposition Versus a Trapeziometacarpal Prosthesis for the Treatment of Thumb Basal Joint Osteoarthritis. Orthopedics. 2017 Jul 1;40(4):e681-e686. doi: 10.3928/01477447-20170503-03. Epub 2017 May 8.

Reference Type BACKGROUND
PMID: 28481387 (View on PubMed)

Degeorge B, Dagneaux L, Andrin J, Lazerges C, Coulet B, Chammas M. Do trapeziometacarpal prosthesis provide better metacarpophalangeal stability than trapeziectomy and ligamentoplasty? Orthop Traumatol Surg Res. 2018 Nov;104(7):1095-1100. doi: 10.1016/j.otsr.2018.07.008. Epub 2018 Aug 11.

Reference Type BACKGROUND
PMID: 30107277 (View on PubMed)

Lane JCE, Rodrigues JN, Furniss D, Burn E, Poulter R, Gardiner MD. Basal thumb osteoarthritis surgery improves health state utility irrespective of technique: a study of UK Hand Registry data. J Hand Surg Eur Vol. 2020 Jun;45(5):436-442. doi: 10.1177/1753193420909753. Epub 2020 Mar 12.

Reference Type BACKGROUND
PMID: 32162998 (View on PubMed)

Parker S, Riley N, Dean B; Oxford Upper Limb Collaborative. Management of osteoarthritis at the base of the thumb. Bone Joint J. 2020 May;102-B(5):600-605. doi: 10.1302/0301-620X.102B5.BJJ-2019-1464.R2.

Reference Type BACKGROUND
PMID: 32349588 (View on PubMed)

Al-Qattan MM, Al Mohrij SA. Mid-Term Results of Partial Trapeziectomy and Simple FCR Tendon Graft Interposition in a Selected Group of Patients with Thumb Carpometacarpal Joint Arthritis. J Hand Microsurg. 2020 Apr;12(1):43-46. doi: 10.1055/s-0039-1698356. Epub 2019 Nov 22.

Reference Type BACKGROUND
PMID: 32280181 (View on PubMed)

Shah DS, Middleton C, Gurdezi S, Horwitz MD, Kedgley AE. The Effect of Surgical Treatments for Trapeziometacarpal Osteoarthritis on Wrist Biomechanics: A Cadaver Study. J Hand Surg Am. 2020 May;45(5):389-398. doi: 10.1016/j.jhsa.2019.10.003. Epub 2019 Nov 14.

Reference Type BACKGROUND
PMID: 31733980 (View on PubMed)

Chug M, Williams N, Benn D, Brindley S. Outcome of uncemented trapeziometacarpal prosthesis for treatment of thumb carpometacarpal joint arthritis. Indian J Orthop. 2014 Jul;48(4):394-8. doi: 10.4103/0019-5413.136270.

Reference Type BACKGROUND
PMID: 25143644 (View on PubMed)

Wajngarten D, Campos JADB, Garcia PPNS. The Disabilities of the Arm, Shoulder and Hand scale in the evaluation of disability - A literature review. Med Lav. 2017 Aug 28;108(4):314-323. doi: 10.23749/mdl.v108i4.6336.

Reference Type BACKGROUND
PMID: 28853432 (View on PubMed)

Kroon FPB, Boersma A, Boonen A, van Beest S, Damman W, van der Heijde D, Rosendaal FR, Kloppenburg M. Performance of the Michigan Hand Outcomes Questionnaire in hand osteoarthritis. Osteoarthritis Cartilage. 2018 Dec;26(12):1627-1635. doi: 10.1016/j.joca.2018.07.018. Epub 2018 Aug 9.

Reference Type BACKGROUND
PMID: 30099114 (View on PubMed)

Rosales RS, Garcia-Gutierrez R, Reboso-Morales L, Atroshi I. The Spanish version of the Patient-Rated Wrist Evaluation outcome measure: cross-cultural adaptation process, reliability, measurement error and construct validity. Health Qual Life Outcomes. 2017 Aug 24;15(1):169. doi: 10.1186/s12955-017-0745-2.

Reference Type BACKGROUND
PMID: 28836994 (View on PubMed)

Lins L, Carvalho FM. SF-36 total score as a single measure of health-related quality of life: Scoping review. SAGE Open Med. 2016 Oct 4;4:2050312116671725. doi: 10.1177/2050312116671725. eCollection 2016.

Reference Type BACKGROUND
PMID: 27757230 (View on PubMed)

Other Identifiers

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WarsawMU/thumb

Identifier Type: -

Identifier Source: org_study_id

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