Research Projects

PARTE  

Study Overview

Randomized Comparison of PARtial Wrist Fusion With or Without Triquetral Excision 

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Post-traumatic arthritis is the most common form of wrist degeneration. Two conditions associated with this type of arthritis are know as scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC). These conditions can cause debilitating pain and restricted motion and grip strength which can reduce patients’ ability to perform activities of daily living. For individuals that fail to respond to non-operative treatment, a partial wrist fusion surgical intervention is the next step. 
The purpose of this trial is to examine the clinical and radiographic outcomes of partial wrist fusion with or without triquetral removal. The triquetrum is one of several small wrist bones and current studies suggest that removing this bone may be beneficial to those suffering from arthritis and may improve patient function after surgery. 

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Current Status

Recruitment Open. 

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Lead Principal Investigator

Dr. Armin Badre, University of Alberta

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Local Principal Investigator

Dr. Neil White

C3PO Multicenter Study

Study Overview

The Canadian Prospective Pragmatic Perilunate Outcomes Study 

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Hand and wrist injuries are common, however a specific injury type known as acute carpal dislocations or perilunate injuries are not. This type of complex wrist injury is often underestimated or poorly recognized until poor wrist function and pain jeopardizes a person’s ability to accomplish activities of daily living and/or reduces their overall productivity.

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The purpose of this study is:

1) To provide better treatment options for all patients affected by a complex wrist injury

2) To better understand the injury itself, the healing progress of these bones, and if corrective surgery reduces pain and improves function.

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Current Status

Recruitment Open. 

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Lead Principal Investigator

Dr. Neil White

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APE: Alberta Perilunate Epidemiology

Study Overview

A Retrospective Epidemiological Case Series Study of Perilunate Injuries in Alberta

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Perilunate dislocation injuries are an infrequent but devastating wrist injury resulting from high energy trauma. Prompt recognition and treatment of these injuries is crucial for a successful outcome, but they are often associated with a delayed diagnosis and high complication rates. 

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The primary purpose of this study is to better understand the epidemiology and pre-surgical care of perilunate injuries to identify areas that can be optimized to improve outcomes for patients. 

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Current Status: 

Study Ongoing

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Lead Principal Investigator

Dr. Matthew Curran 

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Local Principal Investigator

Dr. Neil White

SBS vs LRTI

Study Overview

A Randomized Prospective Multicenter Study Comparing Suture Button Suspensionplasty (SBS) with Ligament Reconstruction and Tendon Interposition (LRTI) 

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Carpometacarpal (CMC) arthritis is a common condition, which occurs when the tissue covering the bones at the base of the thumb wear away. There is disagreement between surgeons about the best treatment of this condition and many surgical techniques are in common use. 

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In this study, participants with CMC arthritis are randomized to one of two standard surgical techniques:

1. Ligament Reconstruction and Tendon Interposition (LRTI) 

2. Suture Button Suspension (SBS) Arthroplasty using the Arthrex® Tightrope.

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Current Status

Recruitment Open. 

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Local Principal Investigator

Dr. Bertrand Perey (University of British Columbia) 

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Local Principal Investigator

Dr. Neil White

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5MCF: Fifth Metacarpal Neck Fractures

Study Overview

Non-operative Management of Fifth Metacarpal Neck Fractures: The Impact of Angulation on Patient Reported Outcomes

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Fractures of the fifth metacarpal neck, also known as "Boxer's Fractures," happen to the bone just towards the wrist from the pinky finger. These injuries usually heal well and do not affect hand function. However, there is disagreement about how much angulation of the fracture is too much, and opinions between surgeons can differ about whether surgery is needed.

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The purpose of this study is to determine the best way to measure angulation on radiographic imaging, and examine if the degree of angulation correlates with hand function. 

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Current Status

Recruitment Complete. Data Analysis in Progress. 

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Lead Principal Investigator

Dr. Christina Hiscox 

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RESULTS

Study Overview

Repair and Reconstruction of Scapholunate Ligament Injuries

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Traumatic scapholunate dissociation is the most common form of carpal instability. If left untreated, instability often progresses to scapholunate advanced collapse (SLAC) arthritis, a debilitating and progressive condition of the wrist.

This prospective, multicenter longitudinal study aims to evaluate the long-term outcomes of scapholunate interosseous ligament (SLIL) repair (or) reconstruction using standardized metrics. Individuals diagnosed with SLIL injuries are recruited and followed for two years. At baseline, data is collected on demographics, clinical characteristics, treatment types, and outcomes. Data is tracked and changes are monitored throughout the duration of the study. 
By applying consistent data collection methods and follow-up intervals across a large, diverse patient cohort, the study will enable direct comparisons of surgical techniques at various stages of injury and support evidence-based improvements in patient care.
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Current Status

Recruitment open. 

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Lead Principal Investigator

Dr. Neil White 

RetroRASL

Study Overview

The Impact of Screw Trajectory on Patient Outcomes Following Reduction and Association of the Scaphoid and Lunate: A Retrospective Analysis

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The ligaments in our wrist allow us to perform activities of daily living. Injuries to these ligaments affect people’s ability to perform such activities, cause pain, and jeopardize a person’s overall wrist function and productivity. The scapholunate interosseous ligament (SLIL) is one the ligaments in the wrist commonly damaged and is treated operatively using a surgical intervention called the reduction and association of the scaphoid and lunate (RASL) technique. However, the long-term effects of the RASL technique and position of the screw on patient outcomes are largely unknown. 

The purpose of this study is to develop a standardized method for assessing the quality of screw placement during the RASL procedure and determine if there is a relationship between screw placement and patient outcomes such as pain and functionality. We have identified approximately 30 patients that have previously received this surgical treatment and ask them to come for a long term follow-up visit  to assess clinical and radiographic outcomes. 

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Current Status

Study complete. In the process of being published.  

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Lead Principal Investigator

Dr. Neil White

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KineRASL

Study Overview

The Assessment of Bone Kinematics Under Weight-bearing CT Between Healthy Hands and RASL Fixations​

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We are also conducting a pilot study with a subgroup of the RetroRASL patients. In this secondary study, we use weight-bearing and dynamic CT imaging to assess differences in wrist bone kinematics (motion) between the healthy hand and the hand that has received the RASL procedure. 

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Current Status

Recruitment complete. Data analysis in progress.  

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Lead Principal Investigator

Dr. Neil White

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Hand OA Pilot Study

Study Overview

Assessing Hand Osteoarthritis with HR-pQCT: A Pilot Study

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Osteoarthritis (OA) is a progressive disease where the cartilage covering individual joints wear away over time and leave the underlying bone exposed. It can affect several joints in the body, including your hands. Hand OA often causes pain, stiffness, and swelling, and restricts a person’s abilities to do common daily activities. With the use of current imaging techniques for hand OA, no relationship is seen between symptomatic and radiographic progression of the disease. It is unclear whether this is due to a lack of sensitivity of conventional radiography or if structure is actually unrelated to symptoms.

The purpose of this pilot study is to assess the extent of osteoarthritis related bone damage using high resolution peripheral quantitative computed tomography (HR-pQCT), a 3-dimensional imaging technique. HR-pQCT may provide novel information regarding the pathogenesis of hand osteoarthritis. 

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Current Status

Recruitment Closed. Analysis in Process.  ​

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Lead Principal Investigators

Dr. Gurpreet Dhaliwal & Dr. Sarah Manske (McCaig Institute for Bone and Joint Health) 

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Kienbock's Long-term Outcomes

Study Overview

Kienbock's Disease - Long Term Follow-up of Outcomes and Disease Progression

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Kienbock's disease is a uncommon disease in which blood supply to a small bone in the wrist, the lunate, is interrupted. Although rare, it can cause significant wrist dysfunction when present. 

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This study is an analysis of patients diagnosed with Kienbock’s Disease. This review will assess outcomes following all forms of surgical management to better understand the outcomes of operative management and determine the best procedure and treatment plan depending on disease stage. It will also characterize the natural history of the illness in cases of non-operative management.

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Current Status 

Recruitment Open.  

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Lead Principal Investigator

Dr. Ruby Grewal (University of Western Ontario) 

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Local Principal Investigator

Dr. Neil White

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SNAPU Trial: Use of Ultrasound for Healing Scaphoid Non-Unions

Study Overview

A Randomized Trial Comparing the Use of Low-Intensity Pulsed Ultrasound (LIPUS) to Placebo in the Treatment of Scaphoid Non-Unions.

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Scaphoid non-union (a broken bone in the wrist that doesn’t heal) is a condition that leads to wrist arthritis if it is not treated. However, the surgeries performed for this problem often mean that patients must spend many weeks off work and in a cast. Ultrasound waves have been used for many years on fractures and have shown some benefit. The purpose of this study is to find out if ultrasound waves produced by the LIPUS machine will speed up the rate of bone healing in the scaphoid bone. Other goals this study looks at are whether using ultrasound will help more patients heal their broken scaphoid and if the ultrasound will help patients return to work earlier.

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Current Status 

Recruitment Closed. Analysis in process.  

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Lead Principal Investigator

Dr. Neil White

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