Artificial Intelligence in Trapeziometacarpal Joint Osteoarthritis: Improving Assessment and Clinical Decision-Making

This is a retrospective cohort study utilizing radiographic and computed tomography (CT) imaging data collected during routine clinical care at Schulthess Klinik Zürich. The study focuses on developing and validating artificial intelligence (AI)-based tools for the assessment of trapeziometacarpal (TMC) joint osteoarthritis (OA) and implant monitoring.

The project is divided into four subprojects: (1) development of a new radiographic classification system for TMC OA, (2) automation of the classification using deep learning, (3) automated detection of implant migration, and (4) 3-dimensional (3D) reconstruction of the TMC joint from biplanar radiographs.

Data will be sourced from two cohorts: patients from our clinical TMC arthroplasty registry who received the Touch implant, and patients with other wrist-related conditions who underwent radiographic imaging with a visible TMC joint. Together, these cohorts provide a broad coverage across the full spectrum of OA severity.

OA-related features and implant related features will serve as the foundation for model training and validation. Also, they will be validated with CT images regarding reliability and accuracy. The resulting prototypes for automated OA staging, implant migration detection, and 3D modeling of the TMC joint are exclusively used for research purposes. Any future clinical use of these tools, including evaluation under Swissmedic (Swiss Agency for Therapeutic Products) regulations, will be part of a separate project.

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Key information

Conditions

Thumb Osteoarthritis Arthritis Joint Diseases Musculoskeletal Diseases Osteoarthritis Rheumatic Diseases

Sex eligibility

All sexes

Study type

Observational

Primary location

Schulthess Klinik

Zurich, Canton of Zurich, 8008, Switzerland

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Patients will be included in the study if they have provided written general consent for the use of their clinical data and meet the requirements of one of the following two groups:

TMC OA group:

Patients who received a Touch implant for TMC joint arthroplasty and are documented in our clinical registry

Other clinical conditions:

Patients who underwent radiographic imaging for one of the following conditions, with a clearly visible TMC joint, for example: Distal radius fracture, carpal fracture, finger dislocation, or similar.

Exclusion criteria

The exclusion criteria are defined based on the two inclusion groups:

TMC OA group:

Patients with posttraumatic OA.
Patients with rheumatoid arthritis.

Other clinical conditions:

Eaton Littler score higher than one.
Prior surgery affecting the trapezium or the first metacarpal.
Clinical condition resulting in abnormal TMC joint morphology.

Furthermore, patients will also be excluded if they revoke their consent in writing or via verbal withdrawal.

Treatment and study plan

No Intervention: Observational Cohort

Other

No Intervention: Observational Cohort

Primary outcomes

New TMC OA classification

Time frame: Preoperative

Create a novel classification system for TMC OA based on joint and bone features in X-rays. This system should ensure better reliability, accurately reflect joint health, and provide clinically relevant insights for treatment decisions.
Automation of the new TMC OA classification

Time frame: Preoperative

Implement a deep learning-based system to automate TMC joint OA classification in plain radiographs using convolutional neural networks for segmentation and feature extraction. This approach aims to improve consistency and reduce the need for manual annotations.
Automated implant migration detection

Time frame: Postoperative

Develop an AI-based system for detecting implant loosening and migration in postoperative radiographs, for early detection of loosening and long-term monitoring of implant stability.
3D reconstruction of the TMC joint

Time frame: Preoperative

Create a 3D reconstruction of the trapezium and the first metacarpal from biplanar radiographs. This provides advanced insights into individual trapezium geometry to improve surgical planning.

Sponsors and collaborators

Lead sponsor

Schulthess Klinik

Other

Collaborators

ETH Zurich (Switzerland)

Registry information

Acronym: TMCAI

Important dates

Study start: 2025
Primary completion: 2028
Study completion: 2028
First posted: Aug 29, 2025
Registry last updated: Apr 30, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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