Full title
Surgery versus Conservative OsteOarthritis of Thumb Trial (SCOOTT)
Background
Basal thumb osteoarthritis (BTOA) is common and causes significant morbidity. Symptoms include thumb pain, tenderness, and stiffness, negatively impacting activities of daily living and quality of life.
A variety of surgical and non-surgical treatments are available. Our research suggests that only 21 to 45% of patients referred to secondary care receive any non-surgical management at all.
Trapeziectomy is currently the established surgical treatment undertaken, but Carprometacarpal Joint Replacement (CMCJR) is increasingly offered to patients in the NHS, despite lack of high-quality evidence for currently used treatment options.
What we are doing
We will be recruiting over 600 adults with BTOA referred to secondary care who may benefit from surgery. They will be randomised to receive trapeziectomy, CMCJR, or enhanced non-surgical management (ENGAGE).
ENGAGE: We have developed an enhanced package of non-surgical treatment, offering patients a programme of personalised, psychologically informed treatments, supported by evidence-based educational materials, and delivered by trained hand therapists.
We will conduct a pilot phase of eight NHS sites with a further 12 NHS sites set-up for the main trial. Recruitment will be conducted over a 30-month period.
We will be measuring pain, hand function, range of movement, grip and pinch strength, and health-related quality of life. We will also record patient acceptability, complications and record healthcare resource implications and cost-effectiveness.
Co-chief investigators
Ms Emma Reay and Mr Nick Johnson
Sponsor
South Tees Hospitals NHS Foundation Trust
Funder
NIHR Health Technology Assessment (HTA)
Current status
Recruiting