Pain Relief and Functional Outcome After Partial Denervation of the Wrist

Study Overview
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Brief Summary
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Prospective study on the effect of partial wrist denervation (ie combined anterior and posterior interosseous neurectomy) on pain relief on functional outcome in patient with wrist osteoarthritis. The impact of psychological factors on postoperative outcome will be studied.

Official Title
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A Prospective Study on Pain Relief and Functional Outcome After Partial Denervation of the Wrist

Conditions
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Wrist Arthritis

Intervention / Treatment
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* Procedure: Partial denervation of the wrist joint


Participation Criteria
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Eligibility Criteria
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Inclusion criteria Chronic wrist pain (≥6 months) due to posttraumatic arthritis after distal radius fracture or SLAC/SNAC arthritis or arthritis due to Mb Preiser/Mb Kienböck where surgical unloading of the bone isn't possible. Pain is refractory to nonsurgical management such as bracing, corticosteroid injection, oral analgesics, NSAIDs, physiotherapy. Exclusion criteria Rheumatoid or other inflammatory arthritis. Previous wrist surgery with simultaneous PIN/AIN neurectomy. Simultaneous arthritis or symptomatic instability of the distal radio ulnar (DRU) joint on the ipsilateral side. Inability to co-operate with the follow-up protocol (language difficulties, severe psychiatric disorder, cognitive impairment, drug addiction). Patient's wish for a definite procedure.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Partial denervation of the wrist joint<br>Patients will be operated with a partial denervation of the wrist through a single dorsal approach. | Procedure: Partial denervation of the wrist joint<br>* Partial denervation of the wrist (posterior and anterior interosseous neurectomy) through a single dorsal approach.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Disability of the Arm, Shoulder and Hand score (DASH) | questionnaire | peroperatively, 3, 6 and 12 months postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Patient Related Wrist Evaluation (PRWE) | questionnaire | peroperatively, 3, 6 and 12 months postoperatively | 
| Change in EQ5D | questionnaire | peroperatively, 3, 6 and 12 months postoperatively | 
| Change in Hospital Anxiety and Depression Scale (HADS) | questionnaire. Determines the levels of anxiety and depression. 14 item scale that generates ordinal data. Seven items relate to anxiety and seven to depression. Each item is scored from 0-3, which means that a person can score between 0-21 for either depression or anxiety. A score of 11 or above on either scale in considered to repressent depression or anxiety. | peroperatively, 3, 6 and 12 months postoperatively | 
| Change in range of motion, grip strength | objective physical function | peroperatively, 3, 6 and 12 months postoperatively | 
| Change in Sence Of Coherence -13 (SOC13) | Questionnaire | peroperatively, 3, 6 and 12 months postoperatively |