Surgical Denervation: This is an outpatient procedure performed under local anesthesia (depending on the anesthesiologist's decision), which lasts about 30 minutes.
Study summary
Digital osteoarthritis is the second localization of symptomatic osteoarthritis, after the knee. Its cardinal symptoms are particularly intense pain and functional impairment in the case of the erosive form. There is currently no etiological treatment for osteoarthritis. Symptomatic treatments have a modest efficacy, which justifies the search for new treatments. The surgical options are arthrodesis or prosthesis, invasive techniques potentially sources of complications, and finally proposed infrequently given the prevalence of digital osteoarthritis.
DECAD is a prospective phase II trial aimed at evaluating the efficacy of surgical joint denervation in painful digital osteoarthritis.
Eligibility
Sex
ALL
Min age
18 Years
Max age
—
Healthy volunteers
No
Inclusion Criteria:
* Age ≥ 18 years
* Patients with symptomatic digital osteoarthritis according to the criteria of the American College of Rheumatology
* 1 painful PIP joint (Analog digital scale ≥ 4/10) for more than 3 months
* having failed the usual medical treatment for a minimum of 3 months (level 1 analgesics, NSAIDs, infiltrations)
* Signature of informed consent
* patient affiliated to a social security scheme
* knowing how to read French (for the questionnaires)
Exclusion Criteria:
* digital osteoarthritis secondary to other known causes (eg gout, reactive arthritis, RA, psoriatic arthritis, spondyloarthropathies, septic arthritis)
* anesthetic contraindications to surgery or to performing an MRI
* Existence of a pain syndrome in the upper limbs, which would interfere with the assessment of AD.
* Fibromyalgia
* Use of oral, intramuscular or intra-articular or intravenous corticosteroids, immunosuppressants (methotrexate, sulfasalazine, leflunomide, biomedicines), hyaluronic acid infiltration in the finger joints in the previous month
* Introduction of a new treatment for osteoarthritis of the hand in the previous month, including physiotherapy and fitting of a new finger orthosis.
* History of denervation of the proximal interphalangeal joint (PIP)
* Patient under legal protection (guardianship or curatorship) and patient deprived of liberty
* Patient under AME
* Participation in another interventional research involving the human person or period of exclusion at the end of a previous research involving the human person.
Primary outcome measure(s)
Success of the intervention at 3 months — 3 months Success of the intervention at 3 months, defined by a reduction in pain of at least 2 points compared to the measurement at inclusion, with the numerical painscale (from 0 to 10) for the operate finger
Trial sites (1)
Facility
City
Region
Status
Rheumatology department Saint-Antoine Hospital
Paris
France
Recruiting
More Assistance Publique - Hôpitaux de Paris trials in France
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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