Actively Recruiting

Age: 21Years +
All Genders
ID04458584

Restoration of Thumb Strength and Function in Basal Joint Arthritis: A Comparative Effectiveness Trial (RESTART)

Led by Dartmouth-Hitchcock Medical Center · Updated on 2025-04-13

165

Participants Needed

1

Research Sites

26 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are evaluating three common beliefs about surgical treatments for thumb basal joint arthritis, focusing on how different surgical methods affect strength, pain, and function. The study compares procedures involving ligament reconstruction and metacarpal stabilization with simpler trapeziectomy surgery, aiming to understand which approach best improves grip, pinch strength, and overall hand function. It also explores how preserving the joint space and controlling joint extension impacts recovery and outcomes. Participants will undergo one of three surgical procedures: trapeziectomy with ligament reconstruction-tendon interposition (LRTI), trapeziectomy with suture suspensionplasty (SS), or arthroscopic trapeziectomy with temporary K-wire fixation (AT). Before surgery, patients receive a lidocaine injection to the joint to assess pain and strength changes. Follow-up assessments occur at three and six months post-surgery, including strength measurements, pain and function surveys, and clinical evaluations. During the study, participants complete questionnaires measuring pain, arm and hand function, and overall health, alongside grip and pinch strength tests. Surgeons assess sensitivity and complications at follow-up visits. X-rays and joint measurements help evaluate joint space and alignment changes. The study tracks patient-reported outcomes and clinical data before surgery, shortly after lidocaine injection, and at 3 and 6 months after surgery to understand recovery and effectiveness of each procedure.

CONDITIONS

Brief Title

Restoration of Thumb Strength and Function in Basal Joint Arthritis: A Comparative Effectiveness Trial (RESTART)

Who Can Participate

Age: 21Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Males and females 21 years of age or older
  • Undergoing elective non-prosthetic, primary basal joint arthroplasty
  • Have the mental capacity to participate and follow the study protocol
  • Willing and able to give informed consent
  • Willing to participate under the care of their chosen surgeon
Not Eligible

You will not qualify if you...

  • Diagnosis of rheumatoid arthritis, systemic lupus erythematosis, psoriatic arthritis, or other related inflammatory arthritis
  • Undergoing simultaneous bilateral hand procedures
  • Women who are pregnant or breastfeeding
  • Women of reproductive potential without a negative pregnancy test on the day of surgery
  • Vulnerable populations including prisoners and institutionalized individuals

AI-Screening

AI-Powered Screening

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Your Study Journey

Screening

Duration - Up to 4 weeks before surgery

Participants are screened for eligibility to participate in the trial.

1 visit (in-person) to collect baseline clinical and demographic information and complete questionnaires

Surgery and Immediate Post-operative Care

Duration - Day of surgery

Participants undergo one of three thumb basal joint arthroplasty procedures to treat osteoarthritis: trapeziectomy with ligament reconstruction-tendon interposition (LRTI), trapeziectomy with suture suspensionplasty, or arthroscopic trapeziectomy with temporary K-wire fixation. Local anesthetic is used before surgery to assess pain and function.

1 visit (in-person) on surgery day including anesthesia and procedure

Post-operative Follow-up

Duration - Up to 6 months after surgery

Participants follow routine postoperative rehabilitation and hand therapy protocols as directed by their surgeon. Protective splinting and exercise programs are used as appropriate.

Follow-up visits scheduled by the surgeon according to routine care and clinical indication

Monitoring

Duration - 3 and 6 months post surgery

Participants are assessed at 3 and 6 months after surgery for pain, function, and strength using surveys and physical measurements. The surgeon or hand therapist also evaluates sensitivity and any complications.

2 visits (in-person) at 3 months and 6 months post surgery

Trial Site Locations

Total: 1 location

1

Dartmouth-Hitchcock Medical Center

Lebanon, New Hampshire, United States, 03756

Actively Recruiting

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Research Team

V

Vincent D Pellegrini, MD

How is the study designed?

Study Type

OBSERVATIONAL

Masking

N/A

Allocation

N/A

Model

N/A

Primary Purpose

N/A

Number of Arms

3

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