tREatment of trIaNgular FibrOcaRtilage ComplEx Ruptures (REINFORCER): protocol for randomised, controlled, blinded, efficacy trial of triangular fibrocartilage complex tears

Introduction Triangular fibrocartilage complex (TFCC) tear is often considered to be the cause of ulnar wrist pain. The primary treatment typically involves non-operative methods; however, in cases of persistent symptoms, operative intervention has been proposed as a viable option. Depending on the...

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Main Authors: Teemu Karjalainen, Jarkko Jokihaara, Ville M Mattila, Aleksi Reito, Antti Kaivorinne, Toni Luokkala, Mikko Petteri Räisänen, Robert Gvozdenovic, Maria Wilcke, Turkka Anttila, Annele Pönkkö, Carsten Lauridsen, Tuukka Tanskanen, Matti Juntunen, Olli-Pekka Kangasniemi, Morten Kjaer, Heli Lähdeniemi, Panu Nordback, Shabir Rashidi, Janne Soikkeli, Jerzy Stiasny, Elin Sward, Lars Vadstrup, Johanna Vonkieseritzky
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/12/e086102.full
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author Teemu Karjalainen
Jarkko Jokihaara
Ville M Mattila
Aleksi Reito
Antti Kaivorinne
Toni Luokkala
Mikko Petteri Räisänen
Robert Gvozdenovic
Maria Wilcke
Turkka Anttila
Annele Pönkkö
Carsten Lauridsen
Tuukka Tanskanen
Matti Juntunen
Olli-Pekka Kangasniemi
Morten Kjaer
Heli Lähdeniemi
Panu Nordback
Shabir Rashidi
Janne Soikkeli
Jerzy Stiasny
Elin Sward
Lars Vadstrup
Johanna Vonkieseritzky
author_facet Teemu Karjalainen
Jarkko Jokihaara
Ville M Mattila
Aleksi Reito
Antti Kaivorinne
Toni Luokkala
Mikko Petteri Räisänen
Robert Gvozdenovic
Maria Wilcke
Turkka Anttila
Annele Pönkkö
Carsten Lauridsen
Tuukka Tanskanen
Matti Juntunen
Olli-Pekka Kangasniemi
Morten Kjaer
Heli Lähdeniemi
Panu Nordback
Shabir Rashidi
Janne Soikkeli
Jerzy Stiasny
Elin Sward
Lars Vadstrup
Johanna Vonkieseritzky
author_sort Teemu Karjalainen
collection DOAJ
description Introduction Triangular fibrocartilage complex (TFCC) tear is often considered to be the cause of ulnar wrist pain. The primary treatment typically involves non-operative methods; however, in cases of persistent symptoms, operative intervention has been proposed as a viable option. Depending on the tear’s morphology, treatment may involve debridement (central or radial tear) or repair (peripheral tear). Efficacy of operative treatment has not been studied in a randomised controlled trial.Methods and analysis This is a prospective, randomised, controlled, blinded multicentre trial, with two randomisation stratums. The first stratum includes central or radial TFCC tears, while the second stratum comprises peripheral TFCC tears. Each stratum consists of two parallel 1:1 arms, comparing the efficacy of (1) debridement of central or radial tear with placebo surgery and (2) repair of peripheral tear with physiotherapy. Participants are recruited from secondary and tertiary referral hospitals in Denmark, Finland and Sweden.Primary outcome is the Patient-Rated Wrist Evaluation (PRWE) at 1 year. Secondary outcomes include subjective and objective outcome measures at 6 months, 1, 2, 5 and 10 years follow-ups.Ethics and dissemination The trial was approved by the Pirkanmaa Hospital District Institutional Review Board in March 2020. All participants will be asked to give a written informed consent. The results of the trial will be disseminated as published articles in peer-reviewed journals.Trial registration number NCT04576169.
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spelling doaj-art-462c3adb805848e394aab01ce8f90c742025-08-20T02:36:46ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-086102tREatment of trIaNgular FibrOcaRtilage ComplEx Ruptures (REINFORCER): protocol for randomised, controlled, blinded, efficacy trial of triangular fibrocartilage complex tearsTeemu Karjalainen0Jarkko Jokihaara1Ville M Mattila2Aleksi Reito3Antti Kaivorinne4Toni LuokkalaMikko Petteri Räisänen5Robert Gvozdenovic6Maria Wilcke7Turkka Anttila8Annele Pönkkö9Carsten Lauridsen10Tuukka Tanskanen11Matti JuntunenOlli-Pekka KangasniemiMorten KjaerHeli LähdeniemiPanu NordbackShabir RashidiJanne SoikkeliJerzy StiasnyElin SwardLars VadstrupJohanna VonkieseritzkyDepartment of Surgery, Hospital Nova of Central Finland, Jyvaskyla, FinlandDepartment of Musculoskeletal Diseases, Tampere University Hospital, Tampere, FinlandDepartment of Musculoskeletal Diseases, Tampere University Hospital, Tampere, FinlandDepartment of Musculoskeletal Diseases, Tampere University Hospital, Tampere, FinlandDepartment of Musculoskeletal Diseases, Tampere University Hospital, Tampere, FinlandFaculty of Medicine and Health Technology, Tampere University, Tampere, FinlandDepartment of Hand Surgery, Gentofte Hospital, Hellerup, DenmarkDepartment of Clinical Science and Education, Karolinska Institute, Stockholm, SwedenDepartment of Musculoskeletal and Plastic Surgery, Helsinki University Central Hospital, Helsinki, FinlandDepartment of Hand surgery and Orthopaedics, Oulu University Hospital, Oulu, FinlandDepartment of Orthopaedic Surgery, Sonderjylland Hospital Tønder, Sønderborg, DenmarkDepartment of Orthopedic and Traumatology, TYKS Turku University Hospital, Turku, FinlandIntroduction Triangular fibrocartilage complex (TFCC) tear is often considered to be the cause of ulnar wrist pain. The primary treatment typically involves non-operative methods; however, in cases of persistent symptoms, operative intervention has been proposed as a viable option. Depending on the tear’s morphology, treatment may involve debridement (central or radial tear) or repair (peripheral tear). Efficacy of operative treatment has not been studied in a randomised controlled trial.Methods and analysis This is a prospective, randomised, controlled, blinded multicentre trial, with two randomisation stratums. The first stratum includes central or radial TFCC tears, while the second stratum comprises peripheral TFCC tears. Each stratum consists of two parallel 1:1 arms, comparing the efficacy of (1) debridement of central or radial tear with placebo surgery and (2) repair of peripheral tear with physiotherapy. Participants are recruited from secondary and tertiary referral hospitals in Denmark, Finland and Sweden.Primary outcome is the Patient-Rated Wrist Evaluation (PRWE) at 1 year. Secondary outcomes include subjective and objective outcome measures at 6 months, 1, 2, 5 and 10 years follow-ups.Ethics and dissemination The trial was approved by the Pirkanmaa Hospital District Institutional Review Board in March 2020. All participants will be asked to give a written informed consent. The results of the trial will be disseminated as published articles in peer-reviewed journals.Trial registration number NCT04576169.https://bmjopen.bmj.com/content/14/12/e086102.full
spellingShingle Teemu Karjalainen
Jarkko Jokihaara
Ville M Mattila
Aleksi Reito
Antti Kaivorinne
Toni Luokkala
Mikko Petteri Räisänen
Robert Gvozdenovic
Maria Wilcke
Turkka Anttila
Annele Pönkkö
Carsten Lauridsen
Tuukka Tanskanen
Matti Juntunen
Olli-Pekka Kangasniemi
Morten Kjaer
Heli Lähdeniemi
Panu Nordback
Shabir Rashidi
Janne Soikkeli
Jerzy Stiasny
Elin Sward
Lars Vadstrup
Johanna Vonkieseritzky
tREatment of trIaNgular FibrOcaRtilage ComplEx Ruptures (REINFORCER): protocol for randomised, controlled, blinded, efficacy trial of triangular fibrocartilage complex tears
BMJ Open
title tREatment of trIaNgular FibrOcaRtilage ComplEx Ruptures (REINFORCER): protocol for randomised, controlled, blinded, efficacy trial of triangular fibrocartilage complex tears
title_full tREatment of trIaNgular FibrOcaRtilage ComplEx Ruptures (REINFORCER): protocol for randomised, controlled, blinded, efficacy trial of triangular fibrocartilage complex tears
title_fullStr tREatment of trIaNgular FibrOcaRtilage ComplEx Ruptures (REINFORCER): protocol for randomised, controlled, blinded, efficacy trial of triangular fibrocartilage complex tears
title_full_unstemmed tREatment of trIaNgular FibrOcaRtilage ComplEx Ruptures (REINFORCER): protocol for randomised, controlled, blinded, efficacy trial of triangular fibrocartilage complex tears
title_short tREatment of trIaNgular FibrOcaRtilage ComplEx Ruptures (REINFORCER): protocol for randomised, controlled, blinded, efficacy trial of triangular fibrocartilage complex tears
title_sort treatment of triangular fibrocartilage complex ruptures reinforcer protocol for randomised controlled blinded efficacy trial of triangular fibrocartilage complex tears
url https://bmjopen.bmj.com/content/14/12/e086102.full
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