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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
60
Arthroscopic debridement will be performed under portal site local anaesthesia.
Anaesthesia, position and arthroscopy will be performed in the same way as for arthroscopic debridement, except the distal part of the trapezium will be resected to a depth of 3-4mm together with protruding osteophytes.
Prince of Wales Hospital
Shatin, Hong Kong
RECRUITINGVisual Analogue Scale (VAS) Pain Score at Rest and Exertion
Pre-operative VAS pain score at rest and exertion will be measured
Time frame: Pre-operative
Visual Analogue Scale (VAS) Pain Score at Rest and Exertion
VAS pain score at rest and exertion will be measured post-operatively
Time frame: Post-op 3 months
Visual Analogue Scale (VAS) Pain Score at Rest and Exertion
VAS pain score at rest and exertion will be measured post-operatively
Time frame: Post-op 6 months
Visual Analogue Scale (VAS) Pain Score at Rest and Exertion
VAS pain score at rest and exertion will be measured post-operatively
Time frame: Post-op 12 months
Visual Analogue Scale (VAS) Pain Score at Rest and Exertion
VAS pain score at rest and exertion will be measured post-operatively
Time frame: Post-op 24 months
Short-Form Survey (SF-36)
Generic health status instrument to assess quality of life
Time frame: Pre-operative
Short-Form Survey (SF-36)
Generic health status instrument to assess quality of life
Time frame: Post-op 3 months
Short-Form Survey (SF-36)
Generic health status instrument to assess quality of life
Time frame: Post-op 6 months
Short-Form Survey (SF-36)
Generic health status instrument to assess quality of life
Time frame: Post-op 12 months
Short-Form Survey (SF-36)
Generic health status instrument to assess quality of life
Time frame: Post-op 24 months
Disability of Arm, Shoulder and Hand (DASH) questionnaire
Specially designed tool to assess upper extremity disability and symptoms
Time frame: Pre-operative
Disability of Arm, Shoulder and Hand (DASH) questionnaire
Specially designed tool to assess upper extremity disability and symptoms
Time frame: Post-op 3 months
Disability of Arm, Shoulder and Hand (DASH) questionnaire
Specially designed tool to assess upper extremity disability and symptoms
Time frame: Post-op 6 months
Disability of Arm, Shoulder and Hand (DASH) questionnaire
Specially designed tool to assess upper extremity disability and symptoms
Time frame: Post-op 12 months
Disability of Arm, Shoulder and Hand (DASH) questionnaire
Specially designed tool to assess upper extremity disability and symptoms
Time frame: Post-op 24 months
Patients' Satisfaction Score
To grade the subjects' satisfaction regarding to their thumb conditions (0=totally not satisfied; 10=fully satisfied)
Time frame: Pre-operative
Patients' Satisfaction Score
To grade the subjects' satisfaction regarding to their thumb conditions (0=totally not satisfied; 10=fully satisfied)
Time frame: Post-op 3 months
Patients' Satisfaction Score
To grade the subjects' satisfaction regarding to their thumb conditions (0=totally not satisfied; 10=fully satisfied)
Time frame: Post-op 6 months
Patients' Satisfaction Score
To grade the subjects' satisfaction regarding to their thumb conditions (0=totally not satisfied; 10=fully satisfied)
Time frame: Post-op 12 months
Patients' Satisfaction Score
To grade the subjects' satisfaction regarding to their thumb conditions (0=totally not satisfied; 10=fully satisfied)
Time frame: Post-op 24 months
Grip Strength
Will be measured in kg
Time frame: Pre-operative
Grip Strength
Will be measured in kg
Time frame: Post-op 3 months
Grip Strength
Will be measured in kg
Time frame: Post-op 6 months
Grip Strength
Will be measured in kg
Time frame: Post-op 12 months
Grip Strength
Will be measured in kg
Time frame: Post-op 24 months
Key and Tip Pinch
Will be measured in kg
Time frame: Pre-operative
Key and Tip Pinch
Will be measured in kg
Time frame: Post-op 3 months
Key and Tip Pinch
Will be measured in kg
Time frame: Post-op 6 months
Key and Tip Pinch
Will be measured in kg
Time frame: Post-op 12 months
Key and Tip Pinch
Will be measured in kg
Time frame: Post-op 24 months
Range of Motion (ROM)
ROM of interphalangeal joint and metacarpal joint of thumb will be measured
Time frame: Pre-operative
Range of Motion (ROM)
ROM of interphalangeal joint and metacarpal joint of thumb will be measured
Time frame: Post-op 3 months
Range of Motion (ROM)
ROM of interphalangeal joint and metacarpal joint of thumb will be measured
Time frame: Post-op 6 months
Range of Motion (ROM)
ROM of interphalangeal joint and metacarpal joint of thumb will be measured
Time frame: Post-op 12 months
Range of Motion (ROM)
ROM of interphalangeal joint and metacarpal joint of thumb will be measured
Time frame: Post-op 24 months
Kapandji Score
A tool for assessing the opposition of the thumb
Time frame: Pre-operative
Kapandji Score
A tool for assessing the opposition of the thumb
Time frame: Post-op 3 months
Kapandji Score
A tool for assessing the opposition of the thumb
Time frame: Post-op 6 months
Kapandji Score
A tool for assessing the opposition of the thumb
Time frame: Post-op 12 months
Kapandji Score
A tool for assessing the opposition of the thumb
Time frame: Post-op 24 months
Complications
Any complications related to the surgery will be documented
Time frame: Post-operative up to 2 years
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