What we do
About our project
Background and Motivation
Thumb base (CMC 1) osteoarthritis is a common condition that can severely limit hand function and quality of life. When conservative treatment fails, trapeziectomy is the standard surgical option, but it involves prolonged immobilization and rehabilitation. Denervation is a minimally invasive alternative that preserves joint anatomy and allows immediate movement. This project is motivated by the need for effective treatments with faster recovery and lower societal and health care costs.
Aim of the Project
The aim of this study is to evaluate whether denervation of the thumb CMC 1 joint is non inferior to trapeziectomy in reducing pain one year after surgery. In addition, the study assesses recovery speed, hand function, quality of life, grip strength, and cost effectiveness.
Study Design and Execution
This is an open label, multicenter randomized controlled trial conducted in five hospitals in the Netherlands. Adult patients with radiological CMC 1 osteoarthritis and persistent pain despite maximal conservative treatment are randomized to denervation or trapeziectomy. Outcomes are primarily patient reported, with pain as the main endpoint.
Potential Impact
If denervation proves to be non inferior to trapeziectomy, it may offer patients a less invasive surgical option with faster recovery and reduced costs. This could lead to changes in clinical practice, improved patient experience, and lower societal burden due to reduced rehabilitation time and faster return to work.
Thumb base (CMC 1) osteoarthritis is a common condition that can severely limit hand function and quality of life. When conservative treatment fails, trapeziectomy is the standard surgical option, but it involves prolonged immobilization and rehabilitation. Denervation is a minimally invasive alternative that preserves joint anatomy and allows immediate movement. This project is motivated by the need for effective treatments with faster recovery and lower societal and health care costs.
Aim of the Project
The aim of this study is to evaluate whether denervation of the thumb CMC 1 joint is non inferior to trapeziectomy in reducing pain one year after surgery. In addition, the study assesses recovery speed, hand function, quality of life, grip strength, and cost effectiveness.
Study Design and Execution
This is an open label, multicenter randomized controlled trial conducted in five hospitals in the Netherlands. Adult patients with radiological CMC 1 osteoarthritis and persistent pain despite maximal conservative treatment are randomized to denervation or trapeziectomy. Outcomes are primarily patient reported, with pain as the main endpoint.
Potential Impact
If denervation proves to be non inferior to trapeziectomy, it may offer patients a less invasive surgical option with faster recovery and reduced costs. This could lead to changes in clinical practice, improved patient experience, and lower societal burden due to reduced rehabilitation time and faster return to work.
Our research focus
Clinical Focus: Thumb CMC 1 Osteoarthritis
This project focuses on surgical treatment of thumb CMC 1 osteoarthritis, a common condition causing pain, functional limitations, and high societal costs. When conservative treatment fails, trapeziectomy is standard care but involves prolonged immobilization and rehabilitation.
Innovative Approach: Denervation
Denervation is a minimally invasive technique that interrupts sensory nerve branches to the CMC 1 joint while preserving joint structure and hand function. It allows immediate mobilization and does not limit future surgical options.
Comparative Effectiveness
The study compares denervation with trapeziectomy in a multicenter randomized controlled trial, focusing on pain reduction after one year, recovery, function, quality of life, return to work, and costs.
Clinical and Societal Impact
By generating high quality comparative evidence, this project aims to clarify the role of denervation as a less invasive alternative, potentially improving patient outcomes and reducing healthcare and productivity costs.
This project focuses on surgical treatment of thumb CMC 1 osteoarthritis, a common condition causing pain, functional limitations, and high societal costs. When conservative treatment fails, trapeziectomy is standard care but involves prolonged immobilization and rehabilitation.
Innovative Approach: Denervation
Denervation is a minimally invasive technique that interrupts sensory nerve branches to the CMC 1 joint while preserving joint structure and hand function. It allows immediate mobilization and does not limit future surgical options.
Comparative Effectiveness
The study compares denervation with trapeziectomy in a multicenter randomized controlled trial, focusing on pain reduction after one year, recovery, function, quality of life, return to work, and costs.
Clinical and Societal Impact
By generating high quality comparative evidence, this project aims to clarify the role of denervation as a less invasive alternative, potentially improving patient outcomes and reducing healthcare and productivity costs.
Our team
Irene Zaalberg; i.zaalberg@erasmusmc.nl
Principal Investigators
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M. (Max) Reijman, PhD
Associate professor
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J. W. (Joost) Colaris, MD PhD
Orthopaedic surgeon, Associate professor
