# A PILOT RANDOMIZED CONTROLLED TRIAL OF HAND TRACTION FOR NODAL OSTEOARTHRITIS

> **NIH NIH R21** · BAYLOR COLLEGE OF MEDICINE · 2020 · $159,095

## Abstract

Hand osteoarthritis (OA) is a common problem and is associated with substantial functional limitations. To
date, few therapies are effective in reducing pain in hand OA; and most are only based on expert opinion.
Although nodal hand OA has traditionally not been viewed as a biomechanically driven the disease, there is
growing evidence that indeed it is. OA in the knee, a disease long known to be biomechanically driven, can be
treated with distraction, a therapy where external hardware are surgically placed preventing joint motion,
providing intra-articular negative pressure, and increasing the joint space. People awaiting knee total knee
arthroplasty receiving distraction have reduced pain, growth of new articular cartilage, and delay and
sometimes complete avoidance of arthroplasty. Unfortunately, distraction is associated with serious attendant
adverse events including a 10% rate of pulmonary emboli despite anticoagulation and an 85% rate of pin site
infection, limiting widespread use of this treatment. Nevertheless, it is an important proof of concept that
unloading an OA joint may allow structure and symptom improvement. Since distraction has both symptom
and structure benefit in knee OA, then traction therapy, using non-invasive finger traps, may have similar
benefits for hand OA without attendant complications. Thus, we propose a pilot randomized controlled trial of
traction on 100 participants recruited from the Michael E. DeBakey VA Medical Center with at least 3 joints
affected by distal interphalangeal (DIP) nodal hand OA, with at least one symptomatic joint. Participants will be
randomized into two groups (1) standard of care or (2) traction with finger traps plus standard of care.
Specific aim 1: Feasibility of a static hand based orthosis to apply finger traps. We will assess the
logistics of creating and using such a treatment. Specific aim 2. Proof of concept. On a small subsample we
will obtain radiographs to assess whether increased joint space is achieved with finger traction. Specific aim 3.
Symptomatic and functional outcomes. At baseline, and 1, 3, and 6 month follow up visits, we will assess
outcomes of the Australian Canadian Hand OA Index (AUSCAN) pain scale, the visual analog scale pain
scale, the AUSCAN function subscale, the Functional Index for Hand Osteoarthritis (FIHOA), the Disabilities of
the Arm, Shoulder, and Hand (DASH), a hand dexterity test, grip and pinch strength, and tenderness on joint
palpation. Specific aim 4. Imaging outcomes. To assess structural benefits of traction therapy, on all
participants, bilateral hand radiographs at baseline and at 6 months will be used to assess changes in Kellgren
and Lawrence scores, joint space narrowing, and osteophyte scores and the Verbruggen-Veys score. On a
limited sample, high resolution MRI imaging at baseline and at 6 months will evaluate whether there are
greater benefits to the traction splint arm compared to the control arm. If we are able to support feasibilit...

## Key facts

- **NIH application ID:** 9850531
- **Project number:** 5R21AR072358-02
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** Grace Lo
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $159,095
- **Award type:** 5
- **Project period:** 2019-01-15 → 2021-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9850531

## Citation

> US National Institutes of Health, RePORTER application 9850531, A PILOT RANDOMIZED CONTROLLED TRIAL OF HAND TRACTION FOR NODAL OSTEOARTHRITIS (5R21AR072358-02). Retrieved via AI Analytics 2026-06-11 from https://api.ai-analytics.org/grant/nih/9850531. Licensed CC0.

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