Metacarpophalangeal Joint Reconstruction Using a Vascularized Cartilage and Bone Graft

Study Overview
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Brief Summary
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Traumatic cartilage loss of the joint is central to the development of joint failure in arthritis. The study on the use of a bone graft for reconstruction of metacarpophalangeal joint defects.

Detailed Description
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The metacarpophalangeal joint is vital for hand function. Cartilage loss of the joint is central to the development of joint failure in arthritis. Although various treatments have been proposed, the management remains a challenging problem.Previous anatomical studies have shown that, at the base of the metacarpal, there were nutrient arteries inserting into the dorsum of the metacarpal. The nutrient arteries arise from the distal and middle dorsal carpal arches that run distally to the first to fourth dorsal metacarpal arteries (DMAs. These studies prompt us to use a reverse vascularized cartilage and bone graft based on the DMA. The metacarpal consists of a widened proximal base. The joint surface to the capitate is convex anteriorly and dorsally concave, where it extends to the styloid process on the dorsolateral aspect of the metacarpal base. The unique contour stimulates our imagination and creativity to use a portion of the joint surface for reconstruction of metacarpophalangeal joint defects. The purpose of this study is to report the novel technique and to evaluate the effectiveness of the treatment.

Official Title
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Phase 1 Study for Reconstruction of Metacarpophalangeal Joint Using a Vascularized Cartilage and Bone Graft From the Third Metacarpal

Conditions
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Volar Plate Injury, Thumb, Metacarpophalangeal Joint

Intervention / Treatment
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* Procedure: MCP joint


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: a cartilage defect at either proximal or distal MCP joint; either an acute or old injury; loss of 1/4 of joint entire surface that seen on plain radiographs, CT scan, and intraoperative finding; and with or without MCP joint subluxation. Exclusion Criteria: large defects involved double joint surfaces; the size of the defect involving less than 1/4 of the joint surface; associate with infection or other diseases that restrict to use the technique.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: MCP joint<br>reconstruction of metacarpophalangeal (MCP) joint | Procedure: MCP joint<br>* reconstruction of metacarpophalangeal (MCP) joint using a bone graft<br>* Other names: MCP joint reconstruction;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Range of motion; Arm, Shoulder and Hand questionnaire | The active motions of the hand were measured by a goniometer. The patients rated their MCP joint pain, the donor joint pain, and scar pain using a line by a visual analogue scale (VAS). We used the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire to assess the hand function. | 4 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain | joint pain is assessed using visual analogue scale | 4 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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reconstruction, metacarpophalangeal joint, bone graft, MCP joint