Trapeziometacarpal osteoarthritis Musculoskeletal Diseases Arthrosis of first carpometacarpal joint
Conditions
Interventions
This study is designed as a prospective randomised comparison of carpometacarpal joint replacement with trapezectomy.
Consent Procedure:
This will be conducted in accordance with the guidelines iss
Sponsors
Department of Health (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 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.
Exclusion criteria
Exclusion criteria: 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.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Questionnaire-based assessment of disability 2. Quantitative assessment of function using BTE machine 3. Radiographic assessment with plain X-rays | — |
Secondary
| Measure | Time frame |
|---|---|
| Not provided at time of registration | — |
Countries
United Kingdom
Outcome results
None listed