Clinical trial NCT01467752: Metacarpophalangeal Joint Reconstruction Using a Vascularized Cartilage and Bone Graft
Official title: Phase 1 Study for Reconstruction of Metacarpophalangeal Joint Using a Vascularized Cartilage and Bone Graft From the Third Metacarpal
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Volar Plate Injury, Thumb, Metacarpophalangeal Joint
Keywords: reconstruction
metacarpophalangeal joint
bone graft
MCP joint
Lead sponsor: The Second Hospital of Qinhuangdao
Sponsor class: OTHER
First posted: 2011-11-09
Enrollment: 15
Sex: ALL
Minimum age (years): 18
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: 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: 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.

Eligibility criteria: Inclusion Criteria:

1. a cartilage defect at either proximal or distal MCP joint;
2. either an acute or old injury;
3. loss of 1/4 of joint entire surface that seen on plain radiographs, CT scan, and intraoperative finding;
4. and with or without MCP joint subluxation.

Exclusion Criteria:

1. large defects involved double joint surfaces;
2. the size of the defect involving less than 1/4 of the joint surface;
3. associate with infection or other diseases that restrict to use the technique.

Primary outcomes:
measure: Range of motion; Arm, Shoulder and Hand questionnaire
timeFrame: 4 years
Secondary outcomes:
measure: Pain
timeFrame: 4 years
Other outcomes:
Locations:
city: Qinhuangdao
country: China
facility: The second hospital of Qinhuangdao
state: Hebei
Study officials:
affiliation: The Second Hospital of Qinhuangdao
name: Xu Zhang, MD
role: STUDY_CHAIR
References:
citation: Sebastin SJ, Mendoza RT, Chong AKS, Peng YP, Ono S, Chung KC, Lim AYT. Application of the dorsal metacarpal artery perforator flap for resurfacing soft-tissue defects proximal to the fingertip. Plast Reconstr Surg. 2011 Sep;128(3):166e-178e. doi: 10.1097/PRS.0b013e318221ddfa.