Partial Wrist Fusion Techniques for Wrist Arthritis
(PARTE Trial)
Recruiting in Palo Alto (17 mi)
+7 other locations
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Alberta
Disqualifiers: Other wrist arthritis, Major joint trauma, others
No Placebo Group
Trial Summary
What is the purpose of this trial?This randomized clinical trial (RCT) aims to compare clinical and radiographic outcomes of different partial wrist fusion techniques in participants with post-traumatic wrist arthritis. Participants with stage II or III scapholunate advanced collapse (SLAC) or scaphoid nonunion advanced collapse (SNAC) who meet the eligibility criteria will be randomly assigned to one of two parallel groups: Group A (partial wrist arthrodesis without triquetral excision i.e. four-corner arthrodesis), or Group B (partial wrist arthrodesis with triquetral excision i.e. three-corner or capitolunate arthrodesis with triquetral excision). The results of this study will provide evidence to guide surgeons in determining the ideal wrist fusion technique in the management of patients with post-traumatic wrist arthritis requiring surgery.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What data supports the effectiveness of the treatment Partial Wrist Fusion Techniques for Wrist Arthritis?
Research shows that procedures like scaphoid excision with four-corner arthrodesis and capitolunate arthrodesis can effectively reduce pain and maintain wrist movement in patients with wrist arthritis. These treatments have been found to provide good midterm outcomes, preserving wrist function and strength.
12345Is partial wrist fusion generally safe for humans?
The research articles provided do not contain specific safety data for partial wrist fusion techniques like Four-Corner Arthrodesis or related procedures. Therefore, no relevant safety information is available from these sources.
678910How does the treatment for wrist arthritis using partial wrist fusion techniques differ from other treatments?
Partial wrist fusion techniques like Four-Corner Arthrodesis and Three-Corner Arthrodesis with Triquetral Excision are unique because they focus on relieving pain while preserving wrist movement by fusing specific wrist bones and removing others. This approach is different from other treatments that might involve more extensive bone removal or different fusion techniques, offering a balance between stability and mobility.
1231112Eligibility Criteria
This trial is for people with stage II or III wrist arthritis from SLAC or SNAC who need surgery. It's not for those who can't read English, lack a stable address, won't do follow-ups, have other wrist arthritis types, mental/physical issues preventing consent, major hand joint problems, past major wrist surgery, infections or neuromuscular conditions affecting the arm.Inclusion Criteria
I have a stage II or III wrist condition and am eligible for surgery.
Exclusion Criteria
My surgeon decided that typical repair methods won't work for my surgery due to the nature of my injury or other wrist issues.
I have been diagnosed with a form of wrist arthritis that is not SLAC or SNAC.
I am unwilling to attend required follow-up visits.
+4 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Pre-operative Assessment
Participants undergo a pre-operative study assessment including baseline measurements
1 week
1 visit (in-person)
Treatment
Participants undergo partial wrist arthrodesis surgery according to their assigned group
Surgery day
1 visit (in-person)
Post-operative Follow-up
Participants are monitored for safety and effectiveness with assessments at 6-weeks, 3-, 6-, and 12-months post-surgery
12 months
4 visits (in-person)
Participant Groups
The study compares two partial wrist fusion surgeries in treating post-traumatic wrist arthritis: Group A gets four-corner arthrodesis without removing a bone called the triquetrum; Group B has three-corner arthrodesis with triquetral excision.
2Treatment groups
Active Control
Group I: Group A: Partial Wrist Arthrodesis without Triquetral ExcisionActive Control1 Intervention
Four-Corner Arthrodesis
Group II: Group B: Partial Wrist Arthrodesis with Triquetral ExcisionActive Control1 Intervention
Three-Corner or Capitolunate Arthrodesis with Triquetral Excision
Four-Corner Arthrodesis is already approved in United States, Canada, European Union for the following indications:
🇺🇸 Approved in United States as Four-Corner Arthrodesis for:
- Post-traumatic wrist arthritis
- Scapholunate advanced collapse (SLAC)
- Scaphoid nonunion advanced collapse (SNAC)
🇨🇦 Approved in Canada as Four-Corner Arthrodesis for:
- Post-traumatic wrist arthritis
- Scapholunate advanced collapse (SLAC)
- Scaphoid nonunion advanced collapse (SNAC)
🇪🇺 Approved in European Union as Four-Corner Arthrodesis for:
- Post-traumatic wrist arthritis
- Scapholunate advanced collapse (SLAC)
- Scaphoid nonunion advanced collapse (SNAC)
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Western Upper Limb Facility, Sturgeon Community HospitalSt. Albert, Canada
Peter Lougheed CentreCalgary, Canada
South Health CampusCalgary, Canada
The Ottawa Hospital - Civic CampusOttawa, Canada
More Trial Locations
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Who Is Running the Clinical Trial?
University of AlbertaLead Sponsor
Arthritis Society CanadaCollaborator
Wrist Evaluation Canada (WECAN)Collaborator
References
Clinical outcomes of scaphoid and triquetral excision with capitolunate arthrodesis versus scaphoid excision and four-corner arthrodesis. [2016]To compare the clinical outcomes of scaphoid and triquetral excision combined with capitolunate arthrodesis versus 4-corner (capitate, hamate, lunate, triquetrum) intercarpal arthrodesis.
Three-Corner Arthrodesis With Scaphoid and Triquetrum Excision for Wrist Arthritis. [2016]To report the clinical and radiographic results of a consecutive series of patients who underwent the 3-corner arthrodesis (3CA) (arthrodesis of capitate, hamate, and lunate with scaphoid and triquetrum excision) procedure for wrist arthritis.
Treatment Outcomes of All Arthroscopic 4-Corner Arthrodesis Techniques With 2 Headless Screws. [2023]Scaphoid excision with 4-corner arthrodesis is a safe procedure that relieves pain while also preserving the functional movements of the wrist. Different techniques have been described with successful results. In this study, we present the midterm clinical outcomes of 17 patients who underwent treatment with our arthroscopic 4-corner arthrodesis technique.
Results of four-corner arthrodesis using dorsal circular plate fixation. [2022]Four-corner arthrodesis with scaphoid excision has been used to reduce pain and preserve functional range of motion for patients with radioscaphoid arthritis. Early results of 4-corner arthrodesis with scaphoid excision using dorsal circular plate fixation are compared with reported results in the literature.
Capitolunate arthrodesis with scaphoid and triquetrum excision. [2016]A retrospective two-center outcome study was designed to evaluate the results of capitolunate arthrodesis with scaphoid and triquetrum excision mainly for scapholunate advanced collapse patterns of arthritis. Fourteen wrists in 14 patients were evaluated objectively by standard parameters and subjectively by the Short Musculoskeletal Functional Assessment at an average of 28 months after surgery (range, 14-51 months). All patients were men between the ages of 20 and 70 years (average, 49 years). Two patients had a painful nonunion and one had persistent pain despite conversion to a solid wrist arthrodesis. One patient had x-ray evidence of progressive radiolunate narrowing, but only occasional pain. Postoperative wrist flexion-extension arc was 53 degrees and radioulnar deviation arc was 18 degrees. Grip and pinch strengths were 71% and 75%, respectively, of the normal contralateral wrist. The results of our study indicate that capitolunate arthrodesis with scaphoid and triquetrum excision is comparable to other motion-preserving operative procedures for scapholunate advance collapse.
[The Facet Wedge: a minimally invasive technique for posterior segmental intra-articular fusion]. [2020]Minimally invasive posterior segmental instrumentation and intra-articular fusion with the Facet Wedge device.
Single sagittal craniosynostosis surgical treatment with the "Peau d́ours" technique. Single-center experience in Mexico. [2022]Scaphocephaly (SC) is defined as an elongation of the anteroposterior axis of the skull resulting from the abnormal fusion of the sagittal suture. This study describes the "Peau d'ours" technique and results for correcting SC. We conducted a consecutive and retrospective analysis of patients treated from 2011 to 2016. We evaluated the gender, age, and surgical outcomes. A total of 53 patients were enrolled with a mean age of 19 months old. The advantages of this technique are healthy coronal and lambdoid suture preservation and symmetrical parietal bone flap opening. This technique is safe and simple to reproduce, allowing good surgical outcomes with a low incidence of secondary craniosynostosis. This technique is ideal for patients older than six months old.
Periosteal turndown flap for posterior occipitocervical fusion: a technique review. [2018]Recently, several authors have proposed techniques for improving the fusion rate in pediatric posterior occipitocervical fusion including a variety of implants and the use of bone morphogenetic protein. A technique by Koop et al. using a periosteal flap for occipitocervical arthrodesis was described in 1984.
Atlantoaxial arthrodesis: a clinical analysis of 22 cases treated at Henry ford hospital. [2014]The indications for our 22 cases of atlantoaxial arthrodesis include rupture of transverse ligament, fracture of odontoid process, and absence of odontoid process. The surgical techniques of H-shaped unicortical and bicortical iliac grafts have been described. All our patients experienced satisfactory relief of their symptoms and reversal of their neurological deficits. In spite of the relatively minor postoperative complications, we feel that atlantoaxial fusion is a safe and effective method in treating various diseases of the atlantoaxial region.
The Venetian blind technique: modification of the Pi procedure for the surgical correction of sagittal synostosis. [2022]Numerous methods of surgical repair for scaphocephaly (sagittal synostosis) have been reported in the literature, from strip craniectomies to more complex methods of calvarial vault remodeling. While good cosmesis and restoration of a normal anteroposterior diameter may be obtained with these methods, a more rounded contour of the biparietal areas is often more difficult to achieve. We describe a modification of the Pi technique, described by Jane in 1976, that results in a more rounded contour of the biparietal areas. We report our experience on cranial vault remodeling for the correction of scaphocephaly in 51 patients from 1998 to 2011.
Four-corner fusion of the wrist: clinical and radiographic outcome of 31 patients. [2019]Four-corner fusion is a rational surgical option for the management of degenerative conditions of the wrist. Most related studies have compared four-corner fusion with scaphoid excision or proximal row carpectomy, with a variety of reported results. To enhance the literature, we performed this study to evaluate a series of patients with degenerative conditions of the wrist treated with four-corner fusion using 3 surgical techniques and to discuss the clinical and radiographic outcome of the patients.
Four-corner arthrodesis using a circular plate and distal radius bone grafting: a consecutive case series. [2022]Four-corner arthrodesis with scaphoid excision has been shown to be an acceptable method for treating wrist degenerative changes. Some recent studies have identified higher complication rates when circular plates are used. This study examined a consecutive case series with defined technique for outcome and complications.