Wrist Denervation Vs Exercise in Wrist Osteoarthritis
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Self-managed exercise therapy program, Partial wrist denervation.
- Who it may be relevant to
- Registry conditions: Osteoarthritis Wrist. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Sweden
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Partial Wrist Denervation Versus Self-managed Exercise Therapy in Patients with Wrist Osteoarthritis: a Randomized Controlled Multicenter Trial
Overview
A randomized controlled trial comparing partial wrist denervation to a self-managed exercise therapy program in 140 patients with wrist osteoarthritis.
Detailed description
Backgroud:
High quality evidence regarding the effectiveness of non-operative and operative treatments in wrist osteoarthritis are lacking.
Aim:
To analyze:
1. Does partial wrist denervation and self-managed exercise therapy improve patient-reported outcomes, pain, grip strength and range of motion (ROM) in wrist OA? 2. Is any of the two treatment concepts partial wrist denervation and self-managed exercise therapy more efficient than the other in terms of patient-reported outcomes, pain relief, grip strength and range of motion?
Method:
A multicenter parallel group, two-arm, randomized, controlled, assessor blinded, trial of 140 patients. The study is conducted at the departments of hand surgery at Södersjukhuset Stockholm and Malmö University hospital.
Group1:
Self-managed exercise therapy program containing:
* Patient education: * Exercise therapy program:
The exercise therapy program is designed by Sara Larsson (physiotherapist at the Department of hand surgery in Malmö, Sweden), influenced by previous studies on wrist stability and proprioception. Focus is on functional re-learning and strengthening of the musculoskeletal system with the aim to create a stable wrist that can be used in a pain-free manner in activities of daily living. The program consists of neuromuscular exercises that focus on coordination, wrist stability and strength.
Group 2:
Surgery will be performed under local anesthesia (+ blood-less field or wide-awake local anesthesia no torniquet (WALANT) according to the surgeon's preference) through a single dorsal incision. AIN and PIN neurectomy will be performed as described by Berger (Berger, 1998).
Primary outcome:
Patient Rated Wrist Evaluation (PRWE) score (0-100) (MacDermid et al., 1998) 12 months after intervention.
Interventions
- Behavioral Self-managed exercise therapy program
Exercise program focusing on functional re-learning and strengthening of the musculoskeletal system with the aim to create a stable wrist that can be used in a pain-free manner in activities of daily living. - Procedure Partial wrist denervation
AIN and PIN neurectomy through a dorsal approach as described by Berger (Berger, 1998).
Primary outcome measures
- PRWE [Time frame: 6 months]
Secondary outcome measures (12)
- PRWE [Time frame: 3 months]
- PRWE [Time frame: 12 months]
- PRWE [Time frame: 5 years]
- Pain NRS [Time frame: 3 months]
- Pain NRS [Time frame: 6 months]
- Pain NRS [Time frame: 12 months]
- Pain NRS [Time frame: 5 years]
- EQ5D [Time frame: 3 months]
- EQ5D [Time frame: 6 months]
- EQ5D [Time frame: 12 months]
- EQ5D [Time frame: 5 years]
- GROC [Time frame: 3 months]
Eligibility criteria
Inclusion criteria
- Age ≥ 18 years.
- Chronic wrist pain (≥6 months) due to Scapholunate advanced collapse (SLAC) / Scaphoid non-union advanced collapse (SNAC) grade 1-3 osteoarthritis.
- Radiological signs of osteoarthritis on posteroanterior and lateral radiograph.
Exclusion criteria
- Previous PIN or AIN neurectomy.
- Rheumatoid arthritis or other chronic inflammatory arthritis.
- Symptomatic osteoarthritis in the distal radio-ulnar (DRU), Scapho-trapezio-trapezoid (STT) or thumb carpometacarpal (CMC) joints.
- Ongoing infection.
- Inability to co-operate with the follow-up protocol.
- Systemic or intra-articular glucocorticoids or intraarticular PRP or Hyaluronic acid injections in the affected joint within 3 months prior to enrollment.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Single blind
- Primary purpose
- Treatment
Study locations
Sweden · 2 centers
- Department of hand surgery, Malmo university hospital — Malmö
- Department of hand handsurgery, Södersjukhuset — Stockholm
Publications
- Larsson SL, Tandrup T, Brogren E, Wilcke MK, Sward EM. Partial wrist denervation versus patient education and self-managed exercise therapy in patients with wrist osteoarthritis: study protocol for a randomized controlled trial. Trials. 2025 Oct 30;26(1):453. doi: 10.1186/s13063-025-09241-7. PMID 41168861
Identifiers
NCT: NCT06098586 · 2023-04885-01