Evidence map›Paper›PMID 41168861›Full record

ArticleTrials2025

Partial wrist denervation versus patient education and self-managed exercise therapy in patients with wrist osteoarthritis: study protocol for a randomized controlled trial.

Sara L Larsson, Tobias Tandrup, Elisabeth Brogren, Maria K Wilcke, Elin M Swärd

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06098586 (Partial Wrist Denervation Versus Self-managed Exercise Therapy in Patients with Wrist Osteoarthritis), which is not on this map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06098586 narecruitingnot on this map

Partial Wrist Denervation Versus Self-managed Exercise Therapy in Patients with Wrist Osteoarthritis: a Randomized Controlled Multicenter Trial

TypeinterventionalSponsorKarolinska InstitutetRan2023 to 2027Enrolled140ConditionsOsteoarthritis WristArmsSelf-managed exercise therapy program, Partial wrist denervation
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Sara L LarssonDepartment of Hand Surgery, Skåne University Hospital, Malmö, Sweden.
Tobias TandrupDepartment of Clinical Science and Education, South General Hospital, Karolinska Institutet, Stockholm, Sweden.
Elisabeth BrogrenDepartment of Hand Surgery, Skåne University Hospital, Malmö, Sweden.
Maria K WilckeDepartment of Clinical Science and Education, South General Hospital, Karolinska Institutet, Stockholm, Sweden.
Elin M SwärdDepartment of Clinical Science and Education, South General Hospital, Karolinska Institutet, Stockholm, Sweden. elin.sward@regionstockholm.se.ORCID http://orcid.org/0000-0003-3334-0098

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWrist osteoarthritis (OA) is mainly posttraumatic, affects younger individuals than other types of OA, and can lead to significant disability. The first-line treatment is patient education and exercise, but surgery may be considered if symptoms persist. A mini-invasive surgical approach for wrist OA is partial wrist denervation, which, in theory, alleviates pain by resecting sensory nerve branches while preserving movement. Although denervation has shown mixed results, studies suggest improvements in pain and function. However, the long-term efficacy remains uncertain, with a notable percentage of patients requiring further surgical interventions. This randomized controlled trial (RCT) aims to compare the effectiveness of partial wrist denervation to nonsurgical treatment, consisting of patient education and a self-managed exercise therapy program.

methodsIn this multicenter, two-armed, assessor-blinded, superiority RCT, 140 adult patients with symptomatic scapholunate advanced collapse (SLAC) or scaphoid non-union advanced collapse (SNAC) OA are randomly assigned (1:1) to receive either partial denervation through neurectomy of the anterior (AIN) or posterior (PIN) interosseous nerves or patient education combined with a self-managed exercise therapy program focused on wrist stability and muscle strength. The primary outcome is the change in the Patient-Rated Wrist Evaluation (PRWE) score at 6 months. Secondary outcomes include wrist range of motion, grip strength, pain levels, survival of the interventions, and quality of life over 12 months. DISCUSSION: High-quality evidence regarding the effectiveness of different treatment options in wrist OA is lacking. To our knowledge, this is the first RCT comparing surgical and nonsurgical treatments in wrist OA. Using patient education and exercise therapy as a comparator to partial wrist denervation ensures ethical, clinically relevant care aligning with current OA treatment standards. Ultimately, the findings of this trial will guide and optimize treatment recommendations for wrist OA.

trial registrationClinicalTrials.gov ID NCT06098586. Registered on 23 Oct 24.

Indexed as

DenervationExercise TherapyOsteoarthritisPatient Education as TopicSelf-ManagementWrist JointEquivalence Trials as TopicHumansMulticenter Studies as TopicPain MeasurementQuality of LifeRandomized Controlled Trials as TopicRecovery of FunctionTime FactorsTreatment OutcomeExercise therapyOsteoarthritisPatient educationScaphoid non-union advanced collapseScapho-lunate advanced collapseSLACSNACWristWrist denervation

Identifiers

PMID41168861
PMCPMC12577315

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.