Comparing Proximal Row Carpectomy and Four-corner Fusion Surgery for Wrist Osteoarthritis in Adults

What this Trial Is About

Researchers are comparing two surgical treatments for wrist osteoarthritis called proximal row carpectomy PRC and four-corner fusion FCA in patients with SLAC or SNAC type II-III osteoarthritis. This double-blinded randomized controlled study aims to evaluate which procedure leads to better wrist function and patient outcomes. Patients with confirmed wrist osteoarthritis will be randomly assigned to one of these two treatments and neither the patients nor assessors will know the treatment allocation until 12 months after surgery. Participants will undergo either PRC, which involves removing the proximal carpal row including the scaphoid, lunate, and triquetrum bones, or FCA, which includes scaphoid excision and fusion of the four remaining wrist bones using screws or plates. The study includes baseline assessments before surgery and follow-up visits at 2 and 6 weeks, then at 3, 6, 12 months, and long-term follow-ups at 5 and 10 years post-intervention. The treatment assignment will be revealed after the 12-month visit. Throughout the study, participants will be evaluated on wrist function using the Patient-Rated Wrist Evaluation at 12 months, along with other measures such as pain levels, grip strength, wrist range of motion, complications, quality of life, and cost-effectiveness. Follow-up visits include clinical assessments and questionnaires to monitor progress and safety. The total participation duration can extend up to 10 years with regular check-ins to assess long-term outcomes.

Proximal Row Carpectomy vs Four-corner Fusion for Osteoarthritis of the Wrist