A1 Refereed original research article in a scientific journal

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




AuthorsKaivorinne, Antti; Räisänen Mikko, Petteri; Karjalainen, Teemu; Jokihaara, Jarkko; Gvozdenovic, Robert; Wilcke, Maria; Reito, Aleksi; Anttila, Turkka; Pönkkö, Annele; Lauridsen, Carsten; Tanskanen, Tuukka; Mattila, Ville M; REINFORCER investigators

PublisherBMJ

Publication year2024

JournalBMJ Open

Journal name in sourceBMJ Open

Article numbere086102

Volume14

Issue12

ISSN2044-6055

eISSN2044-6055

DOIhttps://doi.org/10.1136/bmjopen-2024-086102

Web address https://doi.org/10.1136/bmjopen-2024-086102

Self-archived copy’s web addresshttps://research.utu.fi/converis/portal/detail/Publication/477825482


Abstract

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. 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.


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Funding information in the publication
This trial is funded by Finance Finland, The Finnish Medical Foundation, The Finnish Society for Surgery of the Hand, Foundation of Vappu Uuspaa, State funding for university- level health research and Tampere University Hospital Support Foundation, Tampere University Hospital, Wellbeing services county of Pirkanmaa. All funders are foundations, societies or research funds.


Last updated on 2025-15-08 at 15:39