Hand Osteoarthritis Clinical Trial
Official title:
Splinting to Treat Interphalangeal Joint Deformity in Hand Osteoarthritis(Splint OA Study)
Osteoarthritis (OA) is the most common form of arthritis and the hand is the most frequently
affected site.Interphalangeal (IP) joints (the small joints of the fingers) are often
involved causing pain, progressive loss of hand function and deformity. Deviation, or
bending to the side, of IP joints (IPJs) with significant functional and cosmetic
consequences for the individual is common. There are no drugs which can slow the disease
process so there is reliance on symptomatic treatment such as pain relief and hand therapy.
Joint thermoplastic splinting (moulded plastic splints that are custom-made) is employed by
hand therapists in other settings, but to the investigators knowledge no studies have
formally investigated the effect of splinting in IP OA.
By resting inflamed tissues and correcting joint alignment, a beneficial role for splinting
in IP OA is likely. In this study, the investigators want to test whether thermoplastic
splinting of deviated IP joints due to OA will 1) improve joint alignment 2) ameliorate soft
tissue inflammation, and whether as a consequence 3) pain and overall hand function will be
improved.
Adults with hand OA with 'affected' IP joints (symptoms from OA associated with deviation of
the joint on X-ray)will be recruited from a specialist hand osteoarthritis clinic. Initially
this will be for distal IP (DIP) joints. In the intervention group (30 patients), an
'intervention' joint for splinting will be identified as the most painful deviated DIP joint
in the past week leading up to enrolment. Up to 3 other 'affected' DIP joints on either hand
will not be splinted but will be monitored as 'control' joints. In the control group (15
patients), an affected joint will be monitored but not splinted. Assessment of joint pain,
hand function by a hand therapist, deformity (by X-ray)and joint inflammation will take
place at baseline, during and at the end of splinting period of 3 months, and also at 6
months,to assess whether any changes are persistent. In this way, the efficacy of splinting
of IP joints in OA will be assessed.
n/a
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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