Web-based rehabilitation after surgical salvage procedures for wrist osteoarthritis: protocol for a randomised controlled trial

Introduction Wrist osteoarthritis (OA) is a disabling condition often affecting individuals of working age and frequently resulting from previous trauma. When non-operative management fails, surgical salvage procedures may reduce pain but require structured postoperative rehabilitation. Telerehabilitation has demonstrated comparable outcomes to standard face-to-face rehabilitation in several musculoskeletal conditions; however, evidence following its effectiveness after wrist OA surgery is lacking. This trial aims to evaluate whether a web-based rehabilitation programme is non-inferior to standard, face-to-face rehabilitation following surgical salvage procedures for wrist OA. Methods and analysis This is a prospective, parallel-group, assessor-blinded, randomised controlled non-inferiority trial conducted at a tertiary hand surgery centre. 90 adults undergoing surgical salvage procedures for wrist OA (four-corner fusion, lunocapitate fusion, scaphotrapeziotrapezoid fusion, radioscapholunate fusion or proximal row carpectomy) will be randomised 1:1 to receive either postoperative web-based rehabilitation or standard face-to-face rehabilitation. The primary outcome is the patient-rated wrist evaluation score measured 12 weeks after immobilisation has ended. Secondary outcomes include pain, health-related quality of life, fear of movement, range of motion, grip strength, patient-reported experience, adherence and cost of rehabilitation. Ethics and dissemination Ethical approval has been granted by the Swedish Ethical Review Authority in November 2024. Results will be disseminated through peer-reviewed publications. Trial registration number NCT06814821