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

The Chinese University of Hong Kong

Status: Unknown

Conditions: Osteoarthritis Thumb

Treatments: Procedure: Arthroscopic Debridement; Procedure: Arthroscopic Hemi-Trapeziectomy with Mini TightRope

Study type: Interventional

Funder types: Other

Identifiers

NCT04217928

RCT CMCJOA_Protocol_v1

Details and patient eligibility

About

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.

Enrollment: 60 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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60 participants in 2 patient groups

Arthroscopic Debridement

Active Comparator group

Description:

Patients who are randomized into this arm will receive arthroscopic debridement

Treatment:

Procedure: Arthroscopic Debridement

Arthroscopic Hemi-Trapeziectomy with Mini TightRope

Active Comparator group

Description:

Patients who are randomized into this arm will receive arthroscopic hemi-trapeziectomy with mini tightrope

Treatment:

Procedure: Arthroscopic Hemi-Trapeziectomy with Mini TightRope