Thumb base osteoarthritis is common. There are no disease modifying treatments and surgery is considered as a last resort. Patients and clinicians have prioritised development of evidence based non-surgical treatments for TBOA (JLA for common hand conditions).
There is both pre-clinical and clinical evidence that ‘off-loading’ the forces through an arthritic synovial joint might prevent progression and even reverse the disease process. This has been achieved surgically in several joints, including the knee and first carpometacarpal joint.
The DISTRACT orthosis takes advantage of the anatomy of the hand to deliver joint distraction without the need for surgery. There is a base orthosis with adjustable distraction arms that attach to the thumb tip. A patent has been filed and the technology is available for licensing via Oxford University Innovation.
Development of the orthosis has been supported by grants from the Royal College of Surgeons / Blonde McIndoe Research Foundation, British Association of Plastic, Reconstructive and Aesthetic Surgeons and Versus Arthritis.
The DISTRACT Study
The DISTRACT Study is a first in human cohort study to assess safety and feasibility of a future randomised controlled trial. Alongside the study, there are surveys for patients and clinicians.
Aim of Distract Surveys
The DISTRACT Survey has been designed to gather the opinions from patients and clinicians to help design the first in human study. It will provide important feasibility information.
- Are patients and clinicians willing to try a distraction orthosis to treat thumb base osteoarthritis?
- When in the treatment pathway should the DISTRACT splint be used?
- How long should the DISTRACT splint be worn for?
It will also help us to understand current treatment pathways for thumb base osteoarthritis in the United Kingdom.
Collaborator status
We welcome one local collaborator per hand unit (plastic surgery or orthopaedic parent specialties).
For PubMed-cited collaborator status, each secure completion of:
- 5 patient surveys
- 8 clinician surveys (including hand surgeons/trainees, hand therapists, rheumatologists, and GPs).
Registration
Registration to join as a collaborator on the survey is open here
Chief Investigator:
Matthew D Gardiner
Consultant Plastic and Hand Surgeon, Frimley Health NHS Foundation NHS Trust
Honorary Departmental Senior Research Fellow, Kennedy Institute of Rheumatology, NDORMS, University of Oxford
Alice Lee
Trainee Lead for DISTRACT Study
Co-applicants
Prof Tonia Vincent, Kennedy Institute of Rheumatology, NDORMS, University of Oxford
Prof David Beard, SITU, NDORMS, University of Oxford
Prof Karen Baker, NDORMS, University of Oxford
Dr Angela Kedgley, Department of Bioengineering, Imperial College London
Donna Kennedy, Imperial College London
Helen McKenna, Pulvertaft Hand Centre, Derby
Vic Jansen, Pulvertaft Hand Centre, Derby
Lizelle Sander-Danby, Nuffield Orthopaedic Centre, Oxford
- National Survey
- Systematic review
- Recruiting Centres
- Data Analysis
- Manuscript Submission
- Publication
FAQs
One. If you are unsure whether someone from your Unit has already registered, please ask locally or get in touch with the steering group (distract.study@gmail.com).
Yes, provided you fulfil one of the respondent categories above.
Once registered, you will be provided with a public survey link, which you can share with patients and clinicians (this requires an internet connection). Alternatively, you can print the survey and manually enter the responses.
To improve survey returns.
Approximately 5 minutes or less.
Yes, there is an option to specify your role in the survey.
Ethical approval is not needed for this survey. You will need to gain permission from your local clinical lead for hand surgery and might need other local permissions.
No, unless the consultant is the sole collaborator from a unit.
Funding sources:
Royal College of Surgeons / Blonde McIndoe Research Foundation, British Association of Plastic, Reconstructive and Aesthetic Surgeons and Versus Arthritis
Email distract.study@gmail.com