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

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

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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. 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.

Original languageEnglish
Pages (from-to)e086102
JournalBMJ Open
Volume14
Issue number12
DOIs
Publication statusPublished - 11 Dec 2024
Publication typeA1 Journal article-refereed

Keywords

  • Adult orthopaedics
  • Hand & wrist
  • Randomized Controlled Trial
  • SURGERY
  • Trauma management

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • General Medicine

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